E-cigarettes Research Articles

Acute analgesic effect of nicotine vaping using three experimental pain induction tasks: a randomized, placebo-controlled laboratory study.

Pain and nicotine use are co-occurring conditions with a significant impact on health. Experimental evidence supports an acute analgesic effect of nicotine which may reinforce nicotine use among those with chronic pain. Evidence for nicotine analgesia have primarily been gathered in combustible cigarette users and have not been extended to electronic nicotine delivery systems (ENDS or vaping). Furthermore, the mechanisms of nicotine analgesia in humans are not well understood. Assess the effect of acute vaped nicotine on subjective and behavioral indices of pain sensitivity using three tasks designed to probe distinct mechanisms of analgesia. This study recruited ENDS users (N = 86) to undergo a paced vaping protocol followed by pain tasks in counterbalanced order. Across four sessions, participants vaped e-liquid containing nicotine or placebo, and flavor or no-flavor in a 2 × 2 within-subject design. Assessments included cold pressor, submaximal effort tourniquet to induce ischemic pain, and temporal summation of heat pain, an index of central sensitization. Compared to placebo, nicotine increased cold pressor pain tolerance (ηp2 = 0.031), ischemic pain threshold (ηp2 = 0.073) and tolerance (ηp2 = 0.056) but had no effect on temporal summation of pain. Flavor did not affect pain sensitivity. Females reported greater ischemic pain sensitivity (ηp2 = 0.027) and greater reductions in craving (ηp2 = 0.086). Consistent with research from tobacco smoking, analgesia may be reinforcing and contribute to nicotine dependence among ENDS users. More research on sex differences is warranted.

A Vaping Cessation Text Message Program for Adolescent E-Cigarette Users

E-cigarettes are the most commonly used tobacco product among adolescents. Despite known harms of nicotine exposure among teens, there are no empirically tested vaping cessation interventions. To compare the effectiveness of a text message program for nicotine vaping cessation among adolescents with assessment-only control. A parallel, 2-group, double-blind, individually randomized clinical trial with follow-ups at 1 and 7 months after randomization was conducted from October 1, 2021, to October 18, 2023. Participants were recruited via social media ads; the intervention was delivered via text message; and assessments were completed online or by telephone. Eligible individuals were US residents aged 13 to 17 years who reported past 30-day e-cigarette use, were interested in quitting within 30 days, and owned a mobile phone with an active text message plan. To optimize study retention, all participants received monthly assessments via text message about e-cigarette use. Assessment-only controls (n = 744) received only study retention text messages. Intervention participants (n = 759) also received an automated, interactive text message program for vaping cessation that delivers cognitive and behavioral coping skills training and social support. The primary outcome was self-reported 30-day point-prevalence abstinence from vaping at 7 months analyzed as intention-to-treat, with missingness coded as vaping. Among n = 1503 adolescents randomized, average age was 16.4 (SD, 0.8) years. The sample was 50.6% female, 42.1% male, and 7.4% nonbinary/other; 10.2% Black/African American, 62.6% White, 18.5% multiracial, and 8.7% another race; 16.2% Hispanic; 42.5% sexual minority; and 76.2% vaped within 30 minutes of waking. The 7-month follow-up rate was 70.8%. Point-prevalence abstinence rates were 37.8% (95% CI, 34.4%-41.3%) among intervention participants and 28.0% (95% CI, 24.9%-31.3%) among control participants (relative risk, 1.35 [95% CI, 1.17-1.57]; P < .001). No baseline variables moderated the treatment-outcome relationship. There was no evidence that adolescents who quit vaping transitioned to combustible tobacco products. A tailored, interactive text message intervention increased self-reported vaping cessation rates among adolescents recruited via social media channels. ClinicalTrials.gov Identifier: NCT04919590.

Electronic Cigarette and Heated Tobacco Product Use and Their Association With Tobacco Control Factors Among Adults in Indonesia, Kazakhstan, and the Philippines.

Data on e-cigarette (EC) and heated tobacco product (HTP) use and the reasons for their use are useful for policy making. We report comparable nationally representative estimates of EC and HTP use and their associated factors. Global Adult Tobacco Survey data from Indonesia (2021), Kazakhstan (2019), and the Philippines (2021) were analyzed. The weighted prevalence rates and 95% CI of EC and HTP awareness, current use, and ever use, and their distribution by cigarette smoking status were calculated. Binary logistic regression analyses assessed socioeconomic, and tobacco control factors associated with EC and HTP use. The prevalence (%) of EC awareness, ever use and current use were 48.7-69.4, 3.6-8.8, and 1.9-3.0, respectively. The prevalence(%) of HTP awareness, ever use and current use were 2.7-21.7, 0.2-2.1, and 0.1-1.2, respectively. The main reasons for EC and HTP use were attractive flavors(45.8%-73.9%), less harmful than smoking(23.0%-70.1%), and enjoyment(40.8%-76.7%). Avoiding going back to smoking(0.9%-54.4%) and quitting smoking(19.4%-49.8%) were less frequently cited reasons (except in the Philippines). EC/HTP use was associated with younger age, higher education and wealth, current/past smoking, exposure to information about the dangers of tobacco use, and advertisements about tobacco products and smoke-free rules at home. The prevalence of EC and HTP use was higher among younger men with higher education and wealth, and current/past smoking. EC and HTP use should be closely monitored. Regulations to restrict the widespread marketing and sales of EC and HTP are needed to prevent the escalation of their use. The population-level data provide the benchmark for future monitoring use of e-cigarettes and HTPs and identify population subgroups for future surveillance in low- and middle-income countries. The association of EC/HTP use with tobacco control-related factors provides leads for policies that should be formulated and implemented to regulate the product contents, marketing, and sales of EC and HTP.

The association of vaping and electronic cigarette use with postoperative hypoxemia and respiratory complications: a retrospective cohort analysis.

Initially introduced as a safer alternative to smoking, electronic cigarettes (e-cigarettes) and vaping have since been associated with lung injury. Nevertheless, there is limited perioperative data on their potential contribution to the harmful effects of mechanical ventilation on the lungs. We hypothesized that, in adults undergoing noncardiothoracic surgeries, preoperative vaping/e-cigarette use is associated with hypoxemia during the first postoperative hour, and with an increased incidence of intraoperative and postoperative pulmonary complications. We conducted a retrospective cohort study in which we included patients reporting as vapers/e-cigarette users within one year before surgery as the exposure group, and nonvapers as the control group. The primary outcome was the time-weighted average (TWA) SpO2/FIO2 ratio in the postanesthesia care unit during the first postoperative hour. The secondary outcome was a composite of intraoperative and postoperative pulmonary complications until discharge. We used entropy balancing to adjust for confounding, and fit weighted linear regression and logistic regression models to estimate treatment effects. A total of 110,940 patients met the inclusion criteria, and 1,941 of these were vapers/e-cigarette users. The average treatment effect on the treated for TWA SpO2/FIO2 ratio (N = 109,217) was estimated to be a mean difference of 4 (95% confidence interval [CI], 1 to 8; P = 0.007). This is equivalent to a 4% change in SpO2 at a 30% FIO2 (or at a fixed FIO2). The difference was statistically significant. The average treatment effect on the treated for experiencing intraoperative and postoperative pulmonary complications (N = 110,940) was an odds ratio of 1.04 (95% CI, 0.71 to 1.54; P = 0.84). Vaping/e-cigarette use was neither associated with clinically significant hypoxemia during the first hour in the postanesthesia care unit nor with an increase in pulmonary complications. Nevertheless, our findings cannot definitively exclude the deleterious effects of vaping and e-cigarette use on the lungs, and anesthesiologists should consider potential perioperative complications.

Are educational aspirations associated with susceptibility to smoking, e-cigarette use, and smokeless tobacco use in adolescence?

The early socio-economic differences in smoking build on the interplay between individual-, family-, peer-, and school-related factors. The present study aimed to add knowledge to this by examining susceptibility to smoking (S-SM), electronic cigarette (e-cigarette) use (S-EC), and smokeless tobacco (snus) use (S-SN) by educational aspirations in a country with advanced tobacco control policies. National cross-sectional School Health Promotion study survey was conducted among 8.-9. grade students (av. 15-year-olds) in 2017 with no prior smoking (n = 47589), e-cigarette use (n = 49382), or snus use (n = 53335). Gender-stratified, age-adjusted multilevel logistic regression analyses with S-SM, S-EC, and S-SN were considered as outcomes and student- and school-level (aggregated) factors were considered as independent variables. The highest prevalence was observed for S-EC (girls 29%, boys 35%), followed by S-SM (16%, 15%) and S-SN (10%, 16%). Compared to those planning for general upper secondary education, S-SM was the highest for those without educational aspirations (OR = 1.20, 95% CI = 1.04-1.40), S-EC for those planning for vocational education [1.15 (1.05-1.25)], and S-SN for those planning for extra year/discontinuation [1.65 (1.04-2.60)] among girls. Among boys, both S-SM [1.37 (1.23-1.52)] and S-EC [1.19 (1.09-1.29)] were the highest among those planning for vocational education, with no clear associations with S-SN. Current other tobacco/e-cigarette use [OR range 1.27-8.87], positive attitude towards product use in one's age group [3.55-6.63], and liking school [0.58-0.68] consistently associated with susceptibility. Students not planning for academically oriented education had higher susceptibility to different nicotine products. High S-EC warrants monitoring to strengthen policy evaluation and prevention.

Influence of gestational window on offspring vascular health in rodents with in utero exposure to electronic cigarettes.

Studies have shown cerebrovascular dysfunction in offspring with full-gestational electronic cigarette (Ecig) exposure, but little is known about how individual trimester exposure impacts offspring health. This study aimed to determine if there is a critical window during gestation that contributes to vascular and anxiety-like behavioural changes seen with full-term exposure. To test this, rats were time-mated, and the pregnant dams were randomly assigned to Ecig exposure during first trimester (gestational day, GD2-7), second trimester (GD8-14), third trimester (GD15-21) or full-term gestation (GD2-21). We also assessed the effect of maternal preconception exposure. Both male and female offspring from all maternal exposure conditions were compared to offspring from dams under ambient air (control) conditions. Ecig exposure consisted of 60-puffs/day (5days/week) using either 5 or 30watts for each respective exposure group. We found that maternal exposure to Ecig in the second and third trimesters resulted in a decrease (23-38%) in vascular reactivity of the middle cerebral artery (MCA) reactivity in 3- and 6-month-old offspring compared to Air offspring. Further, the severity of impairment was comparable to the full-term exposure (31-46%). Offspring also displayed changes in body composition, body mass, anxiety-like behaviour and locomotor activity, indicating that Ecigs influence neurodevelopment and metabolism. Maternal preconception exposure showed no impact on offspring body mass, anxiety-like behaviour, or vascular function. Thus, the critical exposure window where Ecig affects vascular development in offspring occurs during mid- to late-gestation in pregnancy, and both 5W and 30W exposure produce significant vascular dysfunction compared to Air. KEY POINTS: Exposure to electronic cigarettes (Ecigs) is known to increase risk factors for cardiovascular disease in both animals and humans. Maternal Ecig use during pregnancy in rodents is found to impair the vascular health of adolescent and adult offspring, but the critical gestation window for Ecig-induced vascular impairment is not known. This study demonstrates Ecig exposure during mid- and late-gestation (i.e. second or third trimester) results in impaired endothelial cell-mediated dilatation (i.e. middle cerebral artery reactivity) and alters anxiety-like behaviour in offspring. Maternal exposure prior to conception did not impact offspring's vascular or anxiety-like behavioural outcomes. Rodent models have been a reliable and useful predictor of inhalation-induced harm to humans. These data indicate maternal use of Ecigs during pregnancy should not be considered safe, and begin to inform clinicians and women about potential long-term harm to their offspring.

The effects of combustible cigarettes and electronic nicotine delivery systems on immune cell-driven inflammation and mucosal healing in ulcerative colitis.

The effects of combustible cigarettes (CCs) and electronic nicotine delivery systems (ENDS) on immune cell-driven colon inflammation and intestinal healing of patients with ulcerative colitis (UC) are still unknown and, therefore, were examined in this study. Intracellular staining and flow cytometry analysis of immune cells isolated from UC patients who used ENDS (UCENDS), CCs (UCCC) and who were non-smokers (UCAIR) were performed to elucidate cellular mechanisms which were responsible for CCs and ENDS-dependent modulation of immune response during UC progression. Additionally, dextran sulfate sodium (DSS)-colitis was induced in ENDS/CC/air-exposed mice (DSSENDS/ DSSCC/DSSAIR groups) to support clinical findings. Significantly increased number of immunosuppressive, IL-10, TGF-β and IL-35-producing, FoxP3-expressing CD3+CD4+T regulatory cells (Tregs) was observed in the blood of UCENDS patients while reduced presence of inflammatory, TNF-α and IFN-γ-producing, Tbx21-expressing CD3+CD4+ Th1, IL-4-producing Gata3-expresing Th2 and IL-17, IL-22-producing, RORγT, IL-23R-expressing Th17 cells were noticed in the blood of UCCC patients. Exposure to either CCs or ENDS was associated with enhanced mucosal healing, ameliorated spontaneous recovery and improved survival of DSS-treated mice. An expansion of immunosuppressive cells (IL-10-producing tolerogenic CD11c+ dendritic cells, alternatively activated CD206, Arginase 1-expressing, IL-10-producing F4/80+macrophages, IL-10-producing FoxP3-expressing Tregs) was noticed in the colons of DSSENDS-treated mice, while reduced number of inflammatory, IL-17- and IL-4-producing T lymphocytes was observed in the colons of DSSCC-compared to DSSAIR-treated mice. Despite different mechanisms of action, both ENDS and CCs attenuated on-going colon inflammation, enhanced healing and ameliorated recovery of injured intestines of DSS-treated mice and UC patients. This is the first study that compared the effects of CCs and ENDS on immune cells of patients suffering from ulcerative colitis, providing new information about molecular and cellular mechanisms which were responsible for ENDS and CCs-dependent modulation of immune cell-driven colon injury and inflammation. Obtained results showed that both ENDS and CCs had capacity to attenuate detrimental immune response, enhanced healing and ameliorated recovery of injured intestines.

Exploring the Utility of Long Non-Coding RNAs for Assessing the Health Consequences of Vaping.

Electronic cigarette (e-cig) use, otherwise known as "vaping", is widespread among adolescent never-smokers and adult smokers seeking a less-harmful alternative to combustible tobacco products. To date, however, the long-term health consequences of vaping are largely unknown. Many toxicants and carcinogens present in e-cig vapor and tobacco smoke exert their biological effects through epigenetic changes that can cause dysregulation of disease-related genes. Long non-coding RNAs (lncRNAs) have emerged as prime regulators of gene expression in health and disease states. A large body of research has shown that lncRNAs regulate genes involved in the pathogenesis of smoking-associated diseases; however, the utility of lncRNAs for assessing the disease-causing potential of vaping remains to be fully determined. A limited but growing number of studies has shown that lncRNAs mediate dysregulation of disease-related genes in cells and tissues of vapers as well as cells treated in vitro with e-cig aerosol extract. This review article provides an overview of the evolution of e-cig technology, trends in use, and controversies on the safety, efficacy, and health risks or potential benefits of vaping relative to smoking. While highlighting the importance of lncRNAs in cell biology and disease, it summarizes the current and ongoing research on the modulatory effects of lncRNAs on gene regulation and disease pathogenesis in e-cig users and in vitro experimental settings. The gaps in knowledge are identified, priorities for future research are highlighted, and the importance of empirical data for tobacco products regulation and public health is underscored.

Association between the use of electronic cigarettes and myocardial infarction in U.S. adults

BackgroundCompared with conventional cigarettes, electronic cigarettes are less harmful in some studies. However, recent research may indicate the opposite. This study aimed to determine whether e-cigarette use is related to myocardial health in adults in the U.S.MethodsThis study used data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), a cross-sectional survey of adult US residents aged 18 years or older. We examined whether e-cigarette use was related to myocardial infarction byapplying a logistic regression model to calculate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsThe final analytical sample included 198,530 adults in the U.S. Logistic regression indicated that U.S. adults who reported being former and some days of e-cigarette use had 23% and 52% greater odds of ever having an MI, respectively, than did those who reported never using e-cigarettes (OR = 1.23, 95% CI 1.08–1.40, p = 0.001; OR = 1.52, 95% CI 1.10–2.09, p = 0.010).ConclusionsThe results suggest that former and someday users of e-cigarettes probably have increased odds of myocardial infarction in adults in the U.S. Further research is needed, including long-term follow-up studies on e-cigarettes, since it is still unknown whether they should be discouraged.

Tobacco Industry Engagement in the House of Commons Science and Technology Select Committee E-cigarettes Inquiry

Background: A now extensive literature has documented political strategies of healthharming industries (HHIs), but little is known about their engagement with Parliamentary select committees. Recent investments by trans-national tobacco corporations (TTCs) in electronic nicotine delivery systems (ENDS) has raised concerns that industry actors may be using these to re-engage policymakers in ways precluded by the Framework Convention on Tobacco Control (FCTC) Article 5.3. Methods: This article examines tobacco industry engagement with the House of Commons Science and Technology Committee (STC) inquiry into electronic cigarettes. It draws on a qualitative analysis of semi-structured interviews with committee members and support staff (n=4) triangulated against written and oral evidence submissions. Results: TTCs featured prominently in the STC inquiry via written and oral submissions. Opportunities existed for industry engagement, and potential influence, at each stage of the process. There was an absence of oral testimony from those sceptical about the potential health benefits of ENDS. The governance mechanisms in place for select committees appear inadequate for protecting committee work from industry influence. As it relates to TTCs, this has implications for the UK’s commitments under FCTC Article 5.3, yet understanding of the FCTC and the requirements of Article 5.3 compliance within the committee were limited. Conclusion: The governance of select committees requires urgent reform in order to balance norms of openness and participation with the need to protect their work from power of economic actors with conflicts of interest. This is particularly the case in relation to TTCs and adherence to FCTC Article 5.3. These findings are of relevance to other select committees whose work affects the interests of HHIs. Further research is needed on other committees and sectors.

Urinary anatalline and nicotelline cut-points to distinguish between exclusive and dual use of tobacco products

Objective This study measured anatalline and nicotelline, two minor tobacco alkaloids, to discriminate between exclusive smokeless tobacco (SLT) use, exclusive electronic nicotine delivery systems (ENDS) use, exclusive cigarette use, dual SLT and cigarette use, and dual ENDS and cigarette use. Methods N = 664 urine samples from participants in the Population Assessment of Tobacco and Health Study were analyzed for anatalline and nicotelline. Geometric means and 95% confidence intervals were calculated for biomarker levels and their ratios. Non-parametric Receiver Operating Characteristic analyses were used to determine optimal cut-points of natural log-transformed biomarker ratios for distinguishing between tobacco use groups. Results The anatalline/nicotelline ratio distinguished exclusive cigarette from exclusive SLT use (threshold = 18.1, sensitivity = 89.3%, specificity = 86.4%, AUC = 0.90), and exclusive SLT from exclusive ENDS use (threshold = 12.8, sensitivity = 96.4%, specificity = 76.3%, AUC = 0.90) very well, but had reduced sensitivity and specificity when distinguishing exclusive cigarette from exclusive ENDS or any dual use with cigarettes. Conclusions This research fills a gap in understanding the public health consequences of SLT and ENDS use by providing objective measures that can signal use of these products alone or in combination with cigarettes.

Youth use of electronic nicotine delivery systems (ENDS) in the Population Assessment of Tobacco and Health (PATH) Wave 6: Impact of survey mode

BackgroundThe Population Assessment of Tobacco and Health (PATH) provides annual prevalence data on youth use of electronic nicotine delivery systems (ENDS). However, trends may be complicated by COVID-related changes in survey mode (self-completed vs. telephone interview) across 2019–2021. MethodsTrends in past 30-day (P30D) ENDS use over PATH waves 5 (2019; 100 % self-completed), 5.5 (2020; 100 % telephone interview), and 6 (2021; 33.5 % self-completed, 66.5 % telephone interview) were examined among continuing youth, overall and within survey mode. Further analyses examined the nature of these changes by examining 1) potential response biases in social contexts of nicotine use, and 2) sources of ENDS over time. ResultsTelephone interviewees were less likely to report ENDS use (4.6 % vs. 8.6 % for self-completers), and more likely to report social disapproval of nicotine use, suggesting a reporting bias in telephone interviews. Survey-mode-naïve analyses suggested a large decline in P30D ENDS use prevalence between 2019–20 (10.2–4.6 %) followed by an apparent uptick in 2021 (5.9 %); however, comparing like-to-like survey modes showed a more modest decline (10.2 % in 2019; 8.6 % in 2021; self-completed) with no change between 2020 and 2021 (4.6 % in both; telephone interviews). Analyses suggested that the mode effects were partly, but not wholly, related to social desirability effects. DiscussionChanges in PATH survey mode introduced artifacts into ENDS use prevalence, possibly due in part to social desirability bias suppressing reporting in telephone interviews, rather than a true uptick. It is essential to account for survey mode in PATH surveys.

Abstract We072: Effects of electronic cigarettes on mouse cardiac lymphatic vessels after TAC surgery

Introduction: Heart failure is a public health concern worldwide. It is known that tobacco smoking is a risk factor of heart failure. Tobacco smoking also causes inflammation reaction and lymphatic dysfunction in the lung. However, the effects of electronic cigarettes (ECIG), as a new method of smoking, on the heart and cardiac lymphatic vessels (lymphatics) are not clear yet. The lymphatic vessels play an important role in maintaining cardiac function by modulating fluid homeostasis and transporting macromolecules. It has been reported that cardiac lymphatic vessel formation limits pressure overload-induced heart failure in C57Bl/6 but not in Balb/c mice. How cardiac lymphatics might contribute to the pathogenesis induced by ECIG is not known. Research Questions: The roles of cardiac lymphatic vessels in responses to ECIG exposure are not investigated. I hypothesize that the toxic effects of ECIG on the heart are partially caused by damaging the cardiac lymphatic vessels. Aim: To determine the effects of ECIG exposure on cardiac lymphatics after Transverse aortic constriction (TAC). Methods: I perform TAC surgery on mice as a heart hypertrophy and chronic heart failure model. Mice after TAC or Sham surgery are treated with different vaping components from ECIG: ECIG, propylene glycol and glycerin (PGVG) as vehicle, and air. After 4 weeks of treatment, hearts were harvested for histological analyses. The lymphatic vessel coverage percentage and morphology were examined by immunostaining. Results: Prior research suggested that genetic background in mice might affect the responses of cardiac lymphatic vessels to TAC-induced heart failure. I have established the TAC model using CD-1 mice. My results showed that CD-1 mice treated with PGVG after TAC do not show a significant difference in cardiac lymphatic vessel density compared to Sham group (p value=0.5951). ECIG treatment also did not affect the lymphatic density significantly compared to PGVG treated mice after sham operation (p value=0.8937). ECIG treated mice after TAC surgery showed a trend of increased lymphatic coverage and more mice are still being processed and will be presented at the conference. Conclusion: PGVG treated CD-1 mice do not show changes in lymphatic vessel density 4 weeks post TAC. Longer time points and more mouse numbers are needed to compare the effects of PGVG and ECIG after TAC induced hypertrophy and heart failure. This research is supported by California TRDRP grant.

In utero nicotine exposure affects murine palate development.

Despite data linking smoking to increased risk of fetal morbidity and mortality, 11% of pregnant women continue to smoke or use alternative nicotine products. Studies confirm that nicotine exposure during pregnancy increases the incidence of birth defects; however, little research has focused on specific anatomic areas based on timing of exposure. We aim to determine critical in utero and postnatal periods of nicotine exposure that affect craniofacial development, specifically palate growth. Malformation of the palatal structures can result in numerous complications including facial growth disturbance, or impeding airway function. We hypothesized that both in utero and postnatal nicotine exposure will alter palate development. We administered pregnant C57BL6 mice water supplemented with 100 μg/mL nicotine during early pregnancy, throughout pregnancy, during pregnancy and lactation, or lactation only. Postnatal day 15 pups underwent micro-computed tomography (μCT) analyses specific to the palate. Resultant pups revealed significant differences in body weight from lactation-only nicotine exposure, and μCT investigation revealed several dimensions affected by lactation-only nicotine exposure, including palate width, palate and cranial base lengths, and mid-palatal suture width. These results demonstrate the direct effects of nicotine on the developing palate beyond simple tobacco use. Nicotine exposure through tobacco alternatives, cessation methods, and electronic nicotine delivery systems (ENDS) may disrupt normal growth and development of the palate during development and the postnatal periods of breastfeeding. Due to the recent dramatic increase in the use of ENDS, future research will focus specifically on this nicotine delivery method.

Extensive social media use and frequency of current e-cigarette use among US youth

IntroductionBoth electronic cigarette (e-cigarette) and social media use among youth are public health concerns. While the health impacts of extensive social media use and frequent use of e-cigarettes have been discussed independently in the literature, little is known about the relationship between the two. This study aims to examine the potential association between extensive social media use and the frequency of current, e-cigarette use among United States (US) youth. MethodsData from the 2022 National Youth Tobacco Survey (NYTS) were analyzed. The sample included 23,655 middle and high school students aged 9–18 years. Frequency of current e-cigarette use was categorized based on past-30 day use (i.e., never/former, 1–9 days, 10–29 days, or 30 days). Social media use was dichotomized into less than 4 hours daily and 4+ hours daily (i.e., extensive use). Multivariable multinomial logistic regression estimated the relationship between social media use and e-cigarette use frequency. ResultsOver one-third (35.8 %) of youth used social media extensively and 8.6 % reported current use of e-cigarettes. Extensive social media use was associated with daily e-cigarette use (OR: 1.94, 95 % CI: 1.48–2.56) but not with other use categories. Older age, female sex, lower grades, current other tobacco use, and family tobacco use were also associated with daily e-cigarette use. ConclusionsExtensive social media use is associated with daily e-cigarette use among US youth. Public health interventions should consider the influence of social media on tobacco use behaviors and tailor prevention strategies to address this potential modifiable risk factor.

Current Pharmacotherapies for Smoking Cessation and Promising Emerging Drugs.

Pharmacotherapy is commonly used during quit attempts and has shown an increase in the likelihood of achieving abstinence. However, with established pharmacotherapies, abstinence rates following a quit attempt remain low, and relapse is common. This review aims to investigate the efficacy and harm profiles of current and emerging pharmacotherapies. Literature review of current and emerging pharmacotherapies for smoking cessation and tobacco use disorder. Emerging pharmacotherapies include new formulations of existing therapies, drug repurposing and some new treatments. New treatments are welcome and may incorporate different mechanisms of action or different safety and tolerability profiles compared to existing treatments. However, emerging pharmacotherapies have yet to demonstrate greater efficacy compared to existing treatments. The emergence of Electronic Nicotine Delivery Systems (ENDS) or 'vaping' is a feature of the current debate around tobacco use disorder. ENDS appear to facilitate switching but not quitting and are controversial as a harm minimisation strategy. Studies included a broad range of therapies and trial designs that should be compared with their differences taken into consideration. Strategies to successfully quit smoking vary between individuals and may extend beyond pharmacotherapy and involve complex psychosocial factors and pathways.

Oral Mucosa and Saliva Alterations Related to Vape.

Electronic nicotine delivery systems (e-cigarette, pod, and vape) are currently among the tobacco consumption of adolescents and young adults. The aim is to show oral mucosa and saliva alterations related to vape. A vape-user patient, presenting a white plaque in the posterior region of the hard palate, underwent clinical examination, sialometry, pH evaluation, and excisional biopsy of the white lesion. Molecular changes in saliva and vape liquid were analyzed by vibrational spectroscopy. The histopathological analyses showed hyperparakeratosis without dysplasia. Formaldehyde, ketones, and aromatic hydrocarbon species were identified in e-cig liquid by the FTIR. The use of vape may be related to the development of hyperkeratotic lesions in the oral mucosa as well as significantly modify the patient's salivary patterns as the vape liquid presents carcinogenic and cytotoxic components in its composition.

Prevalence, perception, and attitude regarding electronic cigarettes usage among young adults in Riyadh, Saudi Arabia. A cross-sectional study.

To determine the prevalence of electronic cigarette (e-cigarette) usage among young adults in Riyadh, Saudi Arabia; their perceptions of its harm and legal age, and the reasons and factors influencing their use. This cross-sectional study was carried out within the general community of Riyadh, Saudi Arabia, between December 2023 and April 2024. Participants aged 18-25 years were included. A self-administered online questionnaire was used to gather demographic data, perceptions, and attitudes toward e-cigarettes and reasons for their use. The majority of the 476 participants were female (n=378, 79.4%) and Saudi nationals (n=451, 94.7%). Current e-cigarette usage was 10.5% (n=50), being more prevalent among males (n=46, 46.9%) and non-Saudis (n=12, 48%). Respondents living alone (n=11, 34.4%) or with friends (n=4, 80%), those who perceived e-cigarettes as safer than cigarettes (n=38, 42.2%), or were unsure of age restrictions demonstrated high usage. Key motivators included flavors available, stress relief, and curiosity. Eelectronic cigarette use among Riyadh's youth was remarkable, especially among males. Reducing the e-cigarette usage prevalence in Saudi Arabia should be prioritized.

Prevalence of Electronic Cigarette Use Among Female Residents of Al-Ahsa, Kingdom of Saudi Arabia: A Cross-Sectional Study.

Background Electronic cigarettes (e-cigarettes) have gained considerable popularity on a global scale, with an increasing prevalence among younger adults. The objective of this study was to investigate the prevalence, patterns, and determinants of e-cigarette use among women in Al-Ahsa, Saudi Arabia. Methodology A cross-sectional study was conducted between October 2023 and July 2024 involving 491 adult female participants. The data were collected using a structured questionnaire and subsequently analyzed using SPSS Version 26.0 (IBM Corp., Armonk, NY, USA). Descriptive and inferential statistics, including chi-square tests, were employed to assess relationships between e-cigarette use and various independent variables. Results The prevalence of e-cigarette use among participants was 17.5%. Significant factors associated with e-cigarette use included age (highest among women aged 21 to 30 years, p = 0.038), unemployment (p = 0.011), perceived poor health (p = 0.002), and having friends or family members who use e-cigarettes (p = 0.001). The primary reasons for using e-cigarettes were influence from friends (70.9%) and family members (54.7%), curiosity (33.7%), and appealing flavors (30.2%). A considerable proportion of users reported experiencing dependence and difficulty quitting. Conclusions The prevalence of e-cigarette use among female residents of Al-Ahsa is influenced by a complex interplay of social, demographic, and perceptual factors. The findings underscore the necessity for comprehensive interventions targeting social environments and educational initiatives and addressing misconceptions about the potential risks of e-cigarettes.

Identification of Δ8-Tetrahydrocannabinol (THC) and Δ9-THC Analogs, with Different Lengths of Alkyl Chain at C-3 Position, in Oil Products Distributed on the Internet

Since around 2021, products claiming to contain a Δ9-tetrahydrocannabinol (THC) analog with different lengths of alkyl chain at C-3 position have been sold on the internet in Japan. Δ9-THC has a pentyl group derived from the precursor olivetol at the C-3 position. These products include liquid cartridges for electronic cigarettes, herbal products, and gummy products. This study analyzed and determined the ingredients in five oil products distributed on the internet from 2022 to 2023 that claim to contain THC analogs. Samples of each product were used for GC-MS and LC-MS measurements. After isolating and purifying the unknown components from the products, structural analysis was performed by measuring 1H, 13C-NMR and various two-dimensional NMR [HH correlation spectroscopy (H-H COSY), heteronuclear multiple quantum coherence (HMQC), heteronuclear multiple-bond correlation (HMBC), and nuclear Overhauser effect spectroscopy (NOESY)]. The analysis identified Δ8-tetrahydrocannabivarin (THCV), Δ9-THCV, Δ8-tetrahydrocannabutol (THCB), Δ9-THCB, Δ8-tetrahydrocannabihexol (THCH), Δ9-THCH, Δ8-3-octyl-THC (THCjd) and Δ9-THCjd. These compounds were Δ8-THC or Δ9-THC analogs with different lengths of alkyl chain at C-3 position. Meanwhile, Δ4(8)-iso-THCV and Δ11-THCB were identified as minor components of the product, and were considered to be the reaction byproducts of the synthesis of the Δ8-THC or Δ9-THC analogs. In the future, there are concerns about the distribution of products containing new THC analogs. Therefore, continuous provision monitoring of newly detected in the products is important.