E-cigarette Users Research Articles

Biomarkers of Nicotine and Toxicant Exposure by E-liquid Nicotine Concentration Level among U.S. Adult Exclusive E-cigarette Users.

The current e-cigarette market has been rapidly evolving with an increase in the share of high nicotine concentration vaping products. This study examined urinary biomarkers of exposure (BOEs) by nicotine concentration level among exclusive e-cigarette users. Data were drawn from Wave 5 (December 2018-November 2019) of the Population Assessment of Tobacco and Health (PATH) Study. Between-subject differences in BOEs of nicotine, metal, tobacco-specific nitrosamine (TSNA), and volatile organic compounds (VOC) were examined across e-cigarettes containing nicotine or not (yes [n=300] vs. no [n=31] vs. non-tobacco use [n=3021]) and different nicotine concentration levels (0.1-1.7%, 1.8-4.9%, and 5.0%+). Among 3353 participants, exclusive e-cigarette users exhibited higher mean concentrations of nicotine metabolites than non-tobacco users. Nicotine e-cigarette users had higher concentrations of TNE2 (mean [95% CI]=21.8 [15.2-31.2] vs. 0.2 [0.1-0.6] nmol/mg creatinine, p<.0001) and cotinine (1418.2 [998.0-2015.4] vs. 12.2 [0.1-0.6], p<.0001) ng/mg creatinine, p<.0001) than non-nicotine e-cigarette users. Users of e-cigarette products with nicotine levels of 1.8-4.9% had higher TNE2 and cotinine levels than those using 0.1-1.7%, though differences were insignificant after adjusting for covariates. As compared to non-tobacco users, nicotine vapers had higher concentrations of lead (adjusted p=0.01). Nicotine containing e-cigarette users exhibited elevated levels of nicotine metabolites than non-nicotine containing vapers and non-tobacco users. Future research needs to investigate health effects of e-cigarette use across different nicotine levels Impact: Regulating the nicotine content in e-cigarettes could be crucial in managing nicotine exposure and potentially mitigating associated health risks.

12582 Electronic-cigarette Exposure Induces Hyperglycemia With A Fibrotic Phenotype In Skeletal Muscle In Mice Subjected To A High-fat Diet

Abstract Disclosure: J. Rivera: None. J. Chavez: None. J. Espinoza-Derout: None. K.M. Hasan: None. X.M. Shao: None. A.P. Sinha-Hikim: None. T.C. Friedman: None. Obesity and electronic cigarette (e-cigarette) use are highly prevalent among youth in the USA. Indeed, young e-cigarette users report less physical activity, leading to a decline in quality of life. Recent studies show e-cigarettes reduce skeletal muscle (SkM) performance in mice; however, the underlying metabolic and SkM cellular effects are unclear. E-cigarettes plus a high-fat diet (HFD) increase mice lipolysis and plasma-free fatty acids. These harmful changes in the liver and heart are prevented by the lipolysis inhibitor Acipimox (Acip). As SkM plays a crucial role in metabolic and chronic disease prevention, understanding the impact of e-cigarettes and HFD on SkM is essential.We exposed C57BL6 mice to e-cigarette inhalation in a free-moving system to deliver 2.4% nicotine in a similar way to humans. Mice were fed with an HFD and divided into 3 groups: Saline (control), e-cigarette (bluCig), and e-cigarette plus Acip (rescue group) for 12 weeks. SkM uptakes 70-80% of the postprandial glucose, so we performed a glucose tolerance test. We found higher glycemia in the e-cigarette compared to the Saline group, while the e-cigarette plus Acip group showed improved glycemia. Histological analysis of SkM with Hematoxylin and eosin (HE) staining revealed large extracellular fibrotic structures in the group with e-cigarettes, suggesting fibrosis. Sirius Red (SR) stain identified collagen deposition. The SR quantification showed an increase in the collagen in the e-cigarette to the saline-exposed group without recovery in the e-cigarette plus Acip group. Fibrosis restricts the SkM hypertrophy. So we analyzed the insulin-like growth factor-1 (IGF-1) (a key anabolic factor) by RT-qPCR. The mRNA levels of IGF-1 were reduced in the SkM of e-cigarettes compared to the Saline group, without recovery of the Acip group. In SkM hypertrophy, Satellite cells (SCs) are stimulated by IGF-1 and SkM fibrosis can affect SCs by restricting them. So we analyzed by western blot the SCs through the transcriptional factor PAX7 (SC marker). We found PAX7 levels were lower in the e-cigarette compared with the Saline group without recovery in the Acip group. These findings suggest the detrimental effects of e-cigarettes on glycemia and SkM health in mice, with implications for long-term health outcomes, particularly among obese individuals and e-cigarette users. Further research is necessary for understanding these adverse effects and promoting youth health. GRANT SUPPORT: U54MD007598, SC2GM135127, U54MD007598-14S2, PR190942, DA050723, and R25DA050723 grants. Presentation: 6/3/2024

Online social platform engagement by young treatment seekers in a digital vaping cessation intervention: Effects on confidence in the ability to quit vaping and vaping abstinence

BackgroundThe evidence-based vaping cessation program, This is Quitting (TIQ), has been found to be effective in promoting abstinence among young people who use e-cigarettes. PurposeTo estimate acceptability and engagement with Discord among treatment seeking youth and young adults and assess the benefit of adding an online social platform via Discord to TIQ. MethodsBetween February and March 2023, 527 TIQ participants (aged 13–24 years) were invited to join Discord with other TIQ users (TIQ Discord). Participants completed two online surveys, at baseline and 1-month post study enrollment. Descriptive statistics were used to describe acceptability and engagement with TIQ Discord. Chi-square, Fisher's exact, and t-tests were used to compare changes in confidence in ability to quit and vaping abstinence across those who joined and engaged with TIQ Discord, compared to those receiving TIQ only. ResultsAmong the n = 319 who were invited to TIQ Discord and provided follow-up data, 57.4 % joined. Among those who joined (n = 183), 61.7 % engaged with TIQ Discord by contributing at least one message or reaction. The mean number of contributed messages was 4.0 (median = 1, range = 1 to 51) and reactions was 0.31 (median = 0, range = 0 to 14). Engaging with TIQ Discord was positively associated with increased confidence in quitting at follow-up (p-value = 0.02), but vaping abstinence at follow-up did not differ (p-value = 0.87). DiscussionOver half of participants who were invited to TIQ Discord joined – indicating high acceptability and an uptake rate that is higher than what is typically observed for online cessation communities. Engagement was positively associated with proximal outcomes, but self-selection prevents causal attribution. Pilot study results suggest acceptability of Discord for providing digital cessation support to young people in combination with a text-message cessation intervention.

Exploring the Experiences, Perceptions and Social Dynamics of Electronic Cigarette Users: A Qualitative Study.

Electronic cigarettes, or e-cigarettes, are rapidly gaining popularity throughout the globe as safer alternatives to traditional cigarette smoking. There are significant public health concerns due to the uncertainty of long-term health consequences. This study aims to examine the experiences, attitudes and social dynamics of e-cigarette users to provide guidance for public health policies and interventions. In this qualitative descriptive study, semi-structured interviews were conducted. Fifteen e-cigarette users were recruited using a snowball sampling strategy, where initial participants referred other suitable users. All participants had at least 6 months of regular e-cigarette use. Data were collected through face-to-face interviews with open-ended questions. The interviews were transcribed verbatim and reviewed by the researchers. This review identified four main themes and eight sub-themes. The four main themes identified as a result of the analysis are as follows: (1) initiation and usage experiences; (2) perceptions of health effects; (3) social and environmental factors and (4) addiction and future plans. Participants primarily began using e-cigarettes out of curiosity, due to the appealing fragrance and the belief that they were less harmful than traditional cigarettes. Usage patterns varied among participants, with some reporting minimal cravings in the early morning hours. Opinions on the long-term health effects of e-cigarettes were diverse, with many participants acknowledging uncertainty. Peers and family members perceived e-cigarettes as more socially acceptable than traditional smoking, resulting in fewer negative reactions. Finally, participants' levels of addiction and intentions to quit varied, with some expressing a desire to reduce or cease usage due to health concerns. The findings of this study indicate that the adoption of e-cigarettes is influenced by a confluence of factors, including curiosity, the perception of reduced damage in comparison to conventional cigarettes and social acceptance. Notwithstanding these claimed advantages, users have a diverse array of beliefs and understandings concerning the enduring health consequences of e-cigarettes. The presence of varying levels of addiction and the corresponding aspirations to cease the behaviour highlight the necessity for focused public health interventions. E-cigarette users were actively involved in this study, providing essential insights and feedback throughout. Their first-hand experiences shaped the interview guide and contributed to the identification of key themes. Participants also reviewed and confirmed the accuracy of the interview transcripts, ensuring the reliability of the data.

Heterogeneous Association Between E-Cigarette Use and Diabetes Prevalence Among U.S. Adults

IntroductionE-cigarette use has increased among US adults. While the association between traditional cigarette smoking and the diabetes/prediabetes prevalence is well established, the relationship between e-cigarette use and these conditions remains unclear. This study examines the association between different types of cigarette use (including e-cigarettes alone, combustible cigarettes alone, and dual use) and the prevalence of prediabetes and diabetes among US adults. MethodsWe analyzed 1,285,783 observations from the 2020-2022 Behavioral Risk Factor Surveillance System surveys. Self-reported prediabetes and diabetes diagnoses were outcomes of interest. Propensity score matching with one-to-one nearest-neighbor matching was used to create balanced groups of smokers and non-smokers. Multivariable logistic regressions examined associations between self-reported smoking status and outcomes. We also conducted subgroup analyses to assess potential variations in these associations. Analyses were performed in September-December 2023. ResultsAfter propensity score matching and adjusting for covariates, sole e-cigarette users (adjusted odds ratio [AOR], 1.07; 95% CI, 1.03-1.11) and dual users (AOR, 1.28; 95% CI, 1.23-1.33) had higher odds of prediabetes diagnosis compared with never users. Sole e-cigarette use was not associated with diabetes risk, but dual users showed higher odds for diabetes diagnosis (AOR, 1.09; 95% CI, 1.06-1.11) versus never users. E-cigarette use was associated with varying odds of prediabetes and diabetes across different demographic groups. ConclusionsThis cross-sectional analysis found that e-cigarette use is associated with higher odds of prediabetes, with dual use potentially linked to increased odds of both prediabetes and diabetes. However, due to study limitations, including its cross-sectional design, self-reported data, and unmeasured confounders, these findings should be interpreted cautiously. As causal relationships and temporal sequences cannot be established, large prospective studies are needed to explore the metabolic health implications of emerging tobacco product use.

Electronic cigarette use and consumption patterns in medical university students.

A major public health hazard is youth e-cigarette use. Although new, e-cigarette health hazards are becoming well-known in the literature. E-cigarette sale restrictions and laws differ globally. In this cross-sectional study, we studied medical university students' tobacco and e-cigarette use and characteristics in a country where sales and import of e-cigarettes are banned. The primary objective is to determine the prevalence of electronic cigarette use and understand consumption patterns among medical faculty students in this setting. The questionnaire was sent using a web-based student information system. Sociodemographic features, tobacco and e-cigarette use, consumption patterns, and e-cigarette risk perceptions were covered in 54 questions. The study comprised 1,054 students (48.7% male) aged 21.5 ± 2.6 years who completed the questionnaire. 37.7%, 20.9% and 23.6% have smoked cigarettes, e-cigarettes, or water pipes. Current cigarette smokers were 17.0%, e-cigarette users 4.0%, and water pipe smokers 4.5%. E-cigarette users were 52.3% dual smokers. The most common symptoms reported by e-cigarette users were cough (58.4%) and dyspnea (54.2%). Multivariable models showed that the male sex, greater monthly income, and a current smoker friend were independent risk factors for e-cigarette ever use, while the male sex, paternal current smoking, and close friends' current smoking status were risk factors for dual use among medical trainees. Many medical students who used electronic cigarettes underestimated nicotine's health hazards and harmful chemicals in e-cigarettes. Despite e-cigarette sales being prohibited in our country, 56.4% and 25.4% of e-cigarette users provided e-cigarettes from tobacco shops and through online sales, respectively. Medical university students use tobacco most often by smoking cigarettes. Despite medical university students being aware of the health hazards of e-cigarettes, the current use of electronic cigarettes is 4.0%. Male sex, greater monthly income, and having current smoker friends are independent risk factors for e-cigarette use, while paternal smoking is a risk factor for dual use among medical trainees. Although in the country, sales of e-cigarettes are banned, ever-use rates for e-cigarettes were remarkably high at 20.9%, and the ease of accessing e-cigarettes was striking.

Single-cell transcriptomics reveals e-cigarette vapor-induced airway epithelial remodeling and injury

BackgroundIn recent years, e-cigarettes have been used as alternatives among adult smokers. However, the impact of e-cigarette use on human bronchial epithelial (HBE) cells remains controversial.MethodsWe collected primary HBE cells of healthy nonsmokers and chronic obstructive pulmonary disease (COPD) smokers, and analyzed the impact of e- cigarette vapor extract (ECE) or cigarette smoke extract (CSE) on HBE cell differentiation and injury by single-cell RNA sequencing, immunostaining, HE staining, qPCR and ELISA. We obtained serum and sputum from healthy non- smokers, smokers and e-cigarette users, and analyzed cell injury markers and mucin proteins.ResultsECE treatment led to a distinct differentiation program of ciliated cells and unique patterns of their cell–cell communications compared with CSE. ECE treatment caused increased Notch signaling strength in a ciliated cell subpopulation, and HBE cell remodeling and injury including hypoplasia of ciliated cells and club cells, and shorter cilia. ECE-induced hypoplasia of ciliated cells and shorter cilia were ameliorated by the Notch signaling inhibition.ConclusionsThis study reveals distinct characteristics in e-cigarette vapor-induced airway epithelial remodeling, pointing to Notch signaling pathway as a potential targeted intervention for e-cigarette vapor-caused ciliated cell differentiation defects and cilia injury. In addition, a decrease in SCGB1A1 proteins is associated with e- cigarette users, indicating a potential lung injury marker for e-cigarette users.

Stopping use of E-cigarettes and smoking combustible cigarettes: findings from a large longitudinal digital smoking cessation intervention study in the United States.

Digital interventions have been widely implemented to promote tobacco cessation. However, implementations of these interventions have not yet considered how participants' e-cigarette use may influence their quitting outcomes. We explored the association of e-cigarette use and quitting smoking within the context of a study testing a digital tobacco cessation intervention among individuals in the United States who were 18 years and older, smoked combustible cigarettes, and enrolled in the intervention between August 2017 and March 2019. We identified four e-cigarette user groups (n = 990) based on the participants' baseline and six-month e-cigarette use (non-users, n = 621; recently started users, n = 60; sustained users, n = 187; recently stopped users, n = 122). A multiple logistic regression was used to estimate the adjusted odds ratios (AOR) of six-month quit outcome and the e-cigarette user groups. Compared to e-cigarette non-users, the odds of quitting smoking were significantly higher among recently stopped users (AOR = 1.68, 95% CI [1.06, 2.67], p = 0.03). Participants who were most successful at quitting combustible cigarettes also stopped using e-cigarettes at follow-up, although many sustained using both products. Findings suggest that digital tobacco cessation interventions may carefully consider how to promote e-cigarette use cessation among participants who successfully quit smoking. ClinicalTrials.gov identifier NCT03224520 (July 21, 2017).

Episodic future thinking reduces delay discounting among persons who use e-cigarettes.

There has been an alarming increase in e-cigarette dependence among young adults, many of whom would like to quit vaping nicotine but are finding it difficult to do so. Episodic future thinking (EFT), a cognitive intervention involving imagining future events, has been shown to reduce cigarette craving, demand intensity, and self-administration among cigarette smokers but has not been tested with e-cigarette users. This study tested if a brief EFT intervention decreases delay discounting and smoking choice using a within-subjects experimental design administered via Zoom. Daily young adult e-cigarette users attended a baseline session and two counterbalanced experimental sessions: (a) EFT in which participants preexperienced and described positive future events and (b) standardized episodic thinking, a control intervention in which participants described their experiences watching three short videos. Measures of craving, mood, and delay discounting across three commodities: Money, e-cigarette products, and food were completed pre- and postmanipulation. As predicted, monetary delay discounting showed a greater decrease following EFT relative to standardized episodic thinking (p = .006; ηp² = .229). There were no effects on craving or mood. Participants also completed a 40-min vaping versus money choice task. Approximately 70% of participants chose to abstain for the full 40 min after EFT compared to 60% after the control condition, a nonsignificant difference (p = .184). Additional research is needed to support the efficacy of EFT as an intervention for helping e-cigarette users increase their ability to abstain. The study demonstrates the feasibility of conducting experimental research on e-cigarettes in a virtual setting. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effect of nicotine mouth spray on urges to vape: A randomized, placebo-controlled, pharmacodynamic clinical trial in exclusive e-cigarette users.

To determine whether nicotine mouth spray provides rapid and prolonged relief of urges to vape and measure the steady-state plasma nicotine levels during vaping and ad libitum mouth spray usage in e-cigarette users. Randomized, parallel group, double-blind trial. Single site at Hammersmith Medicines Research Ltd (HMR), London, UK. 216 (25.9% females, average age 27.6±7.63 [standard deviation, SD]) exclusive vapers who used their e-cigarette within 30 minutes of waking up and had vaped about 2years on average. Two sprays of 1mg nicotine mouth spray (Nicorette QuickMist Freshmint, n = 109), or placebo (identical in appearance and presentation, n = 107). Urge to vape was rated on a 100 mm visual analogue scale before and repeatedly for 2hours after administration. The primary outcome measured average change from baseline in urges to vape ratings during the first hour. Nicotine mouth spray achieved statistically significantly greater reductions in urges to vape than placebo from the first assessment point at 30 seconds to 1hour, when the estimated mean treatment difference was 11.90 mm (95% confidence interval [CI] = 6.86-16.95, P < 0.001). The integrated urge to vape over 11 hours ad libitum usage showed a statistically significant benefit compared with placebo (2.00 [0.88 SD] vs 2.51 [0.84 SD], P< 0.001). Mean steady-state plasma nicotine concentrations were lower after nicotine mouth spray usage compared with vaping (6.22 [4.70 SD] ng/ml vs 9.91 [7.59 SD] ng/ml, respectively). Adverse events were more commonly reported in the nicotine mouth spray group and were mostly mild. Among regular e-cigarette users, nicotine mouth spray provided statistically significant and fast relief of urges to vape one hour after dosing. Nicotine mouth spray showed statistically significant reductions in urges to vape as soon as 30 seconds and up to 2hours after dosing compared with placebo, and nicotine mouth spray was well-tolerated and safe.

Comparing E-Cigarettes and Traditional Cigarettes in Relation to Myocardial Infarction, Arrhythmias, and Sudden Cardiac Death: A Systematic Review and Meta-Analysis.

The use of electronic cigarettes (e-cigarettes) as a perceived safer alternative to traditional cigarettes has grown rapidly. However, the cardiovascular risks associated with e-cigarettes compared to regular cigarettes remain unclear. To systematically review and compare the cardiovascular outcomes of e-cigarette use versus traditional cigarette use, focusing on the risks of myocardial infarction, arrhythmias, and sudden death. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Peer-reviewed studies published in English were included if they reported cardiovascular outcomes related to e-cigarette or traditional cigarette use. A total of 20 studies were included, covering observational and interventional studies focusing on heart rate variability, myocardial infarction, arrhythmias, and sudden cardiac events. The quality of the evidence was assessed using the GRADE criteria, and data were extracted and analyzed based on the PICOS (Population, Interventions, Comparisons, Outcomes, and Study designs) framework. The systematic review found that both e-cigarettes and traditional cigarettes pose significant cardiovascular risks, with traditional cigarettes linked to a higher incidence of myocardial infarction, arrhythmias, and sudden cardiac death. E-cigarette users also face increased risks of arrhythmias and myocardial infarction compared to non-smokers, primarily due to the constituents of aerosolized e-liquid, including nicotine and flavorings, which contribute to adverse cardiac effects. Regular e-cigarette use, particularly in combination with traditional cigarette use, was associated with a heightened risk of myocardial infarction. Studies also reported heart function abnormalities, such as systolic and diastolic dysfunction, and reduced ejection fractions. Additionally, changes in heart rate variability, heart rate, and blood pressure were observed, indicating both acute and chronic effects of e-cigarettes on cardiovascular autonomic regulation. While e-cigarettes may present a lower cardiovascular risk compared to traditional cigarettes, they are not without harm. Both products are linked to increased risks of myocardial infarction and arrhythmias, though traditional cigarettes pose a higher overall threat. Given the limitations in the current evidence base, particularly concerning the long-term effects of e-cigarette use, further research is needed to clarify these cardiovascular risks and inform public health guidelines.

The Vaper's Perspective: A Qualitative Study of E-Cigarette Users and Smokers in Slovenia.

The use of e-cigarettes has been rapidly expanding in recent years. The reasons people in Slovenia chose to use electronic cigarettes have not been studied to date. This study examines e-cigarette users' attitudes regarding their health risks. The aim of the study was to examine the users' standpoint towards e-cigarettes and their understanding of the impact on people's health. This qualitative study consists of 15 semi-qualitative interviews. Fifteen active or former tobacco smokers and/or e-cigarette users were interviewed using semi-structured interviews between 1 December 2019 and 30 April 2020. Data were analysed using qualitative content analysis. The employed inductive analysis consisted of coding, creating categories and abstraction; that is, framing a general description of the research topic through generating categories. Data show that the interviewees do not have a unified opinion regarding the use and harmful effects of e-cigarettes. They agree that e-cigarettes are less harmful than regular cigarettes, but do not believe that they completely eliminate harmful effects for people that smoke regularly. The results also show that vaping is typical of young people, who use e-cigarettes as an important element of their subculture. The use of e-cigarettes in Slovenia is still a matter of public debate, because the advantages and harmful effects of using e-cigarettes are not yet well known. National guidelines for reducing the harmful effects of e-cigarettes are needed.

E-cigarette use and associated factors among adults aged 18-44 years in China: Findings from an online survey.

There needs to be more up-to-date evidence on the prevalence of e-cigarette use among Chinese adults. This study aims to investigate the prevalence and associated factors of e-cigarette use among adults aged 18-44 years in China. Cross-sectional design and convenience sampling were used. The data for this study were obtained from an online survey conducted in mainland China from April to May 2023. The target population was adults aged 18-44 years. Descriptive analysis was employed to report the prevalence of e-cigarette use, while adjusted multivariable logistic regression was performed to examine the association between e-cigarette use and related factors. A total of 4256 participants were included in this study; 12.9% were current e-cigarette users, 5.9% were frequent users, and 7.0% were occasional users. The descriptive analysis results indicated that males and cigarette users had a higher prevalence of e-cigarette use. Multivariable analysis showed that e-cigarette use was significantly associated with female gender (AOR=0.76, 95% CI: 0.60-0.96), those aged 25-34 years with monthly income 6000-8999 CNY (AOR=2.01; 95% CI: 1.18-3.41), those aged 25-34 years with monthly income ≥9000 CNY (AOR=2.20; 95% CI: 1.26-3.82), college or undergraduate degree (AOR=1.91; 95% CI: 1.22-3.00), urban residence (AOR=1.72; 95% CI: 1.34-2.20), being a current smoker (AOR=3.32; 95% CI: 2.64-4.16), perception of harm (AOR=0.66; 95% CI: 0.60-0.73), and perception of benefit (AOR=2.31; 95% CI: 2.04-2.61). The prevalence of current e-cigarette use among adults in China was 12.9% within our sample. In addition to sociodemographic factors, individuals with a higher perception of the harm associated with e-cigarettes were less likely to engage in e-cigarette consumption. Conversely, individuals who perceive the 'benefits' of e-cigarettes more favorably use them. Targeted interventions, such as health education, are recommended to help adults develop a correct understanding of e-cigarettes and lower the prevalence of e-cigarette use.

Circulating extracellular microvesicles associated with electronic cigarette use increase endothelial cell inflammation and reduce nitric oxide production.

The purpose of this study was to determine the effect of circulating microvesicles isolated from chronic electronic (e-)cigarette users on cultured human umbilical vein endothelial cell (HUVEC) expression of nuclear factor-κB (NF-κB), cellular cytokine release, phosphorylation of endothelial nitric oxide synthase (eNOS) and NO production. The HUVECs were treated with microvesicles isolated via flow cytometry from nine non-tobacco users (five male and four female; 22±2years of age) and 10 e-cigarette users (six male and four female; 22±2years of age). Microvesicles from e-cigarette users induced significantly greater release of interleukin-6 (183.4±23.6vs. 150.6±15.4 pg/mL; P=0.002) and interleukin-8 (160.0±31.6vs. 129.4±11.2 pg/mL; P=0.01), in addition to expression of p-NF-κB p65 (Ser536) (18.8±3.4 vs. 15.6±1.5 a.u.; P=0.02) from HUVECs compared with microvesicles from non-tobacco users. Nuclear factor-κB p65 was not significantly different between microvesicles from the non-tobacco users and from the e-cigarette users (87.6±8.7vs. 90.4±24.6 a.u.; P=0.701). Neither total eNOS (71.4±21.8vs. 80.4±24.5 a.u.; P=0.413) nor p-eNOS (Thr495) (229.2±26.5vs. 222.1±22.7 a.u.; P=0.542) was significantly different between microvesicle-treated HUVECs from non-tobacco users and e-cigarette users. However, p-eNOS (Ser1177) (28.9±6.2vs. 45.8±9.0 a.u.; P<0.001) expression was significantly lower from e-cigarette users compared with non-tobacco users. Nitric oxide production was significantly lower (8.2±0.6vs. 9.7±0.9μmol/L; P=0.001) in HUVECs treated with microvesicles from e-cigarette users compared with microvesicles from non-tobacco users. This study demonstrated increased NF-κB activation and inflammatory cytokine production, in addition to diminished eNOS activity and NO production resulting from e-cigarette use. HIGHLIGHTS: What is the central question of this study? Circulating microvesicles contribute to cardiovascular health and disease via their effects on the vascular endothelium. The impact of electronic (e-)cigarette use on circulating microvesicle phenotype is not well understood. What is the main finding and its importance? Circulating microvesicles from e-cigarette users increase endothelial cell inflammation and impair endothelial nitric oxide production. Endothelial inflammation and diminished nitric oxide bioavailability are central factors underlying endothelial dysfunction and, in turn, cardiovascular disease risk. Deleterious changes in the functional phenotype of circulating microvesicles might contribute to the reported adverse effects of e-cigarette use on cardiovascular health.

Young users of electronic cigarettes exhibit reduced cardiorespiratory fitness.

Electronic nicotine delivery systems, often referred to as e-cigarettes, are popular tobacco products frequently advertised as safer alternatives to traditional cigarettes despite preliminary data suggesting a potential negative cardiovascular impact. Cardiorespiratory fitness is a critical cardiovascular health marker that is diminished in individuals who consume traditional tobacco products. Whether the use of e-cigarettes impacts cardiorespiratory fitness is currently unknown. Thus, the purpose of this study was to investigate the impact of regular e-cigarette use on cardiorespiratory fitness in young healthy adults. Twenty-six users of e-cigarettes (ECU, 13 males, and 13 females; age: 24 ± 3 yr; e-cigarette usage 4 ± 2 yr) and 16 demographically matched nonusers (NU, 6 males, and 10 females; age: 23 ± 3 yr) participated in this study. Cardiorespiratory fitness was measured by peak oxygen consumption (V̇o2peak) during a cardiopulmonary exercise test. Measurements of chronotropic response, hemodynamic, oxygen extraction, and utilization were also evaluated. Our results suggest that regular users of e-cigarettes exhibited significantly lower peak oxygen consumption when compared with nonusers, even when controlled by fat-free mass and lean body mass. Hemodynamic changes were not different between both groups during exercise, whereas lower chronotropic responses and skeletal muscle oxygen utilization were observed in users of e-cigarettes. Results from the present study demonstrate that young, apparently healthy, regular users of e-cigarettes exhibit significantly reduced cardiorespiratory fitness, lower chronotropic response, and impaired skeletal muscle oxygen utilization during exercise. Overall, our findings contribute to the growing body of evidence that supports adverse effects of regular e-cigarette use on cardiovascular health.NEW & NOTEWORTHY E-cigarettes are tobacco products frequently used by youth and young adults. Little is known about the long-term health effects of their prolonged use. Results from the present study demonstrate that young, apparently healthy, regular users of e-cigarettes exhibit significantly reduced cardiorespiratory fitness, a marker of cardiovascular health and a predictor of all-cause mortality. We also identified that the young users of e-cigarettes present with lower chronotropic response and impaired skeletal muscle oxygen utilization during exercise.

INDICATORS OF LOCAL ORAL IMMUNITY IN USERS OF NEW TYPES OF TOBACCO PRODUCTS

Introduction. The organs and structures of the oral cavity are among the first to come into contact with the aerosol when using electronic cigarettes and heated-tobacco products, and some of the aerosol components enter various biological fluids of the mouth, inevitably provoking a response of the body to external influences. One of the markers of the response are immunoglobulins, and their analysis is intended to help in studying the effect of electronic cigarettes and heated-tobacco products on humans. Objective. The aim of the study was to estimate changes in immunoglobulins A, G and M of gingival fluid, oral fluid and saliva among users of new types of tobacco products. Material and methods. The study included 4 groups of 5 people each: regular cigarette smokers, e-cigarette users, users of tobacco heating sys-tems and non-smokers. For laboratory studies, gingival fluid, saliva and oral fluid were taken from the subjects. Results. Various changes in the concentration of immunoglobulins relative to the control group were observed in all groups of smoking patients. Conclusion. The results may indicate inhibition of the function of local immunity both when exposed to tobacco smoke and when exposed to aerosol of heated-tobacco products or electronic cigarettes, which increases the vulnerability of organs and structures of the oral cavity to pathogenic microor-ganisms.

Perceptions of E-Cigarette Use as Means for Smoking Cessation among Selected E-Cigarette Users in Iligan City

Background and Aim Understanding users’ perspectives, duration of use, and stages of change related to smoking cessation is crucial for informing effective interventions.  Design We employed a correlational design and used questionnaires to collect data from 120 e-cigarette users in Iligan City. Respondents were divided into two groups based on smoking cessation stage categories: action and maintenance.  Results Respondents generally held positive views of e- cigarettes as a smoking cessation tool. Nearly 30% of the users transitioned from traditional cigarettes to e- cigarettes within six months. More than half of the respondents were actively taking steps to quit (action stage), while almost 46% had successfully quit and were in the maintenance stage. The study found no significant association between the perceptions of e-cigarette use as a tool for smoking cessation and the stage of change in smoking cessation, as well as between the duration of e- cigarette use and the stage of change in smoking cessation.  Conclusion Even if our findings suggest that perceptions on e- cigarette smoking and duration of e-cigarette use showed no significant association with smoking cessation stages of change, respondents revealed a leap by taking actions to quit traditional smoking.

Quitting on TikTok: Effects of Message Themes, Frames, and Sources on Engagement with Vaping Cessation Videos

This study examined how message themes, frames, and sources in vaping cessation videos on TikTok influenced positive (i.e. likes, shares, positive comments regarding quitting vaping) and negative video engagement (i.e. negative comments regarding quitting vaping). TikTok videos (N = 412) with the hashtags #quitvaping and #quittingvaping were analyzed. Aspect-based sentiment analysis was conducted to evaluate the sentiment of quitting vaping in comments. Negative binomial regression models predicted video engagement from six message themes, ratios of gain and loss frames, and message sources. Themes related to nicotine addiction and physical health effectively drove positive engagement, such as likes and shares. The theme of harmful chemicals elicited mixed responses, generating both positive and negative comments regarding quitting vaping. Videos with a higher ratio of gain frames led to more positive engagement, including likes, shares, and positive comments regarding quitting vaping. Sources with informal expertise (e.g. those who have successfully quit vaping) and current e-cigarette users were more effective in engaging the TikTok audience than non-expert and non-user sources. These findings provide insights into messaging strategies that can effectively engage TikTok audiences and encourage vaping cessation.

Sex differences in tobacco use, attempts to quit smoking, and cessation among dual users of cigarettes and e-cigarettes: Longitudinal findings from the US Population Assessment of Tobacco and Health Study

SignificanceA growing number of adults use more than one tobacco product, with dual use of cigarettes and e-cigarettes being the most common combination. Monitoring sex disparities in tobacco use is a public health priority. However, little is known regarding whether dual users differ by sex. MethodsData came from Waves 4–6 (12/2016–11/2021) of the Population Assessment of Tobacco and Health Study, a US nationally-representative longitudinal survey. This analysis included current adult dual users of cigarettes and e-cigarettes. We used weighted generalized estimating equations to assess the association between sex and (1) making a cigarette quit attempt (n = 1882 observations from n = 1526 individuals) and (2) smoking cessation (n = 2081 observations from n = 1688 individuals) across two wave pairs, adjusting for age, education, ethnicity, time-to-first cigarette after waking, and e-cigarette use frequency. ResultsAmong US dual users, 14.1% (95% Confidence Intervals [Cl] = 11.9–16.4) of females and 23.4% (20.0–26.9) of males were young adults (aged 18–24), 11.7% (9.2–14.2) of females and 14.4% (11.6–17.2) of males had <high school education, and 82.2% (79.4–84.5) of females and 78.7% (75.1–82.4) of males were white. Overall, 44.9% (41.6–48.1) of females compared with 37.4% (33.5–41.3) of males made an attempt to quit smoking between a baseline and follow-up wave (Adjusted Risk Ratio [ARR] = 1.23, 1.05–1.45). In contrast, there were no apparent differences between females (22.1%, 19.0–25.2) and males (24.3%, 21.5–27.1) in smoking cessation (ARR = 1.06, 0.84–1.35). ConclusionUS females who dually use e-cigarettes and cigarettes were more likely to attempt to quit smoking, but not more likely to succeed at quitting, than males.

Perception of Health Risks of Electronic Cigarette Use Among College Students: Examining the Roles of Sex, Field of Study, Vaping Device Type, and Their Associations.

Electronic cigarettes are marketed as a safer alternative to regular (combustible) cigarettes, based on the claim that there is no tobacco burning and fewer toxic chemicals in their vapor. However, recent evidence challenges the notion that e-cigarette aerosols are benign. Heating of compounds in e-liquids to high temperatures can lead to the release of toxic compounds in e-cigarette aerosols. However, users and the public may not be aware of these unique harms, impacting their perception of harm from using e-cigarettes. This research explored the perceptions of harm of e-cigarettes compared to regular cigarettes among 418 college students, aged 18-34, by employing a Qualtrics based smartphone survey. The findings revealed a vaping prevalence of 16.7% among our study population, indicating e-cigarette use among college aged young adults is at concerning levels. Perceptions of harm varied significantly by vaping status, sex, and field of study. Non-e-cigarette users and female students were less likely to perceive e-cigarettes as less harmful than regular cigarettes. Among e-cigarette users (vapers), male vapers and users of pod-type devices, such as JUUL and disposables, were more inclined to view e-cigarettes as less harmful. Among vapers, students in non-health-related fields were significantly more likely to perceive e-cigarettes as less harmful than regular cigarettes, underscoring the impact of educational background on health risk awareness. In conclusion, this study provides crucial insights into the varied perceptions of e-cigarettes among young adults. The results emphasize the need for targeted public health interventions and educational efforts to address this growing public health concern.