Electronic Cigarette Smokers Research Articles

Conjunctival and Corneal Endothelium Profile in a Sample of Healthy Electronic Cigarette Smokers

Objective: Though e-cigarette is thought of as a healthy alternative way of smoking, the unknown nicotine concentration level and chemical compounds from the aerosol mist and flavourings are potentially harmful and may exert irritation or damage to the ocular surface. Thus, a cross-sectional study was conducted to identify the conjunctival and corneal endothelium profile among healthy e-cigarette smokers, and the relationship between smoking behaviour with the conjunctival and corneal endothelium profile. Material and Methods: Seventeen healthy e-cigarette smokers and 17 non-smokers were recruited for this study where their palpebral redness, bulbar redness, limbal redness, conjunctival roughness, central corneal thickness, endothelial cell density, and coefficient of variation of endothelium cell area were assessed using slit lamp biomicroscope and specular microscope. Results: There was a non-significant, higher mean rank observed in the total palpebral redness, total bulbar redness, total limbal redness, total conjunctival roughness, central corneal thickness, endothelial cell density, and coefficient of variation of the endothelium cell area in e-cigarette smokers compared to non-smokers (p-value>0.05). Only smoking frequency and total palpebral redness showed a statistically significant, positive, and fair correlation (r=0.349, p-value=0.043), while no other smoking behaviour showed a significant correlation (p-value<0.05). Conclusion: The use of e-cigarettes showed no significant impact on the conjunctival and corneal profile among the users, but further research with comprehensive evaluation is required in a larger sample size of more established e-cigarette smoking profiles.

More precise method of low-density lipoprotein cholesterol estimation for tobacco and electronic cigarette smokers: A cross-sectional study

More precise method of low-density lipoprotein cholesterol estimation for tobacco and electronic cigarette smokers: A cross-sectional study

Effect of Smoking Dry Cigarettes, Electronic Cigarettes, and Hookah on Vitamin D3 Levels and Blood Parameter in Samples of Youth from AL-Hawija City, Kirkuk governorate

The study aimed to demonstrate the role of smoking on vitamin D3 levels and blood parameters represented by a group of young men who smoke cigarettes, electronic cigarettes and hookah in the city of Hawija, Kirkuk Governorate. The experiment was distributed into four groups, aged between 25 and 30 years, with 25 samples for each group. The first group was non-smokers, the second group was cigarette smokers, the third group was electronic cigarette smokers and the fourth group was hookah smokers. Blood samples were taken in the Hawija laboratories, where the results of the study showedThe results of the study showed a significant decrease (P≤0.05) in vitamin D3 levels in the dry cigarettes, electronic cigarettes and hookah groups compared to the control group, while the packed cell volume (PCV), red blood cells (RBC) and hemoglobin (Hb) tests showed a significant increase (P≤0.05) in the dry cigarettes, electronic cigarettes and hookah groups compared to the control group, while the platelets and white blood cells (WBC) tests showed a significant increase (P≤0.05) in the dry cigarettes and electronic cigarettes groups compared to the non- smoking control group, while the values of platelets and white blood cells (WBC) did not show any statistically significant differences in the hookah smokers group.

Evaluation of Dry Eye Parameters Among Electronic Cigarette Smokers.

Introduction The emergence of electronic cigarettes as the "healthier" version of smoking has been popular, especially among young adults. However, knowledge about the potential effects of e-cigarettes on ocular structures is scarce. Objective To compare the mean change in dry eye parameters between e-cigarette smokers and non-smokers and to correlate between dry eye parameters with device power output. Methodology A cross-sectional, single-visit study was conducted involving 85 e-cigarette smokers and 85 non-smokers. All participants were evaluated on dry eye parameters, including the Ocular Surface Disease Index (OSDI) score, tear meniscus height (TMH), tear break-up time (TBUT), cornea fluorescein staining, and Schirmer's I test. The mean change in dry eye parameters was compared between e-cigarette smokers and non-smokers. The correlation between dry eye parameters with device power output was analyzed. Results Specifically, 32.94% of e-cigarette smokers were found to have a TMH <0.2 mm, compared to only 5.88% of non-smokers (p<0.001). A significant change in mean TBUT was found between the e-cigarette smokers (10.41+2.65 seconds) and non-smokers (12.66+3.14 seconds, p<0.001). The lower mean Schirmer's I test was found among e-cigarette smokers (12.75+7.24 mm, p<0.001). No significant change in the median OSDI score and corneal fluorescein staining. The OSDI score and device power output were found to have a significant positive correlation (p=0.003). There was a significant association between dry eye signs and device power output, including TMH (p=0.047), TBUT (p=0.002), Schirmer's I test (p<0.001), and corneal fluorescein staining (p<0.001). Conclusion Electronic cigarette smokers are prone to develop dry eyes. Concern should be raised on the risk of electronic cigarette use on ocular health, and regulation on e-cigarette ban should be revisited.

Does electronic cigarette use adversely affect cardiac autonomic function?

Introduction: tobacco cigarette (TC) smoking is a predominant risk factor for cardiovascular disease and a leading preventable cause of death (Kondo et al., 2019, Circ J, 83, 1980-1985). Electronic Cigarette (EC) use has increased significantly in recent years (King et al., 2015, Nic Tob Res, 17, 219-227), mainly as it is considered a safer alternative to TC. A low heartrate variability (HRV) is an independent marker of adverse cardiovascular morbidity and all-cause mortality (Fang et al., 2020, Bio Res Nur, 22, 45-56). TC smokers have a lower HRV, and similar responses have now also been observed in EC smokers (Arastoo et al., 2020, Am J Physiol Heart Circ Physiol, 319, 262-270). However, the influence of cognitive / psychological stress on HRV in TC and EC users remains unexplored. As such, this study aims to assess the impact of cognitive stress on Time and Frequency domain measures of HRV. Methods: upon receiving ethical approval, HRV data was collected through electrocardiogram (ECG) recordings of healthy controls (HC), TC and EC smokers which were recorded using lead II ECG at 1000 Hz on LabChart during periods of rest (5 min) and cognitive stress (serial subtraction; 5 min). Time and frequency domain measures of HRV were assessed with LabChart. Data will be compared between groups using one-way analysis of variance (ANOVA) and two-way mixed methods ANOVA as appropriate. Conclusions: we hypothesise that EC smokers will present similar impaired autonomic function and reduced HRV as TC smokers during rest and cognitive stress in comparison to HC.

Nicotine Dependency Levels Among Adult Electronic Cigarette Smokers in Jeddah, Saudi Arabia: An Analytical Cross-Sectional Study.

Electronic cigarettes (ECs) are a recent method to deliver nicotine with less harmful effects than traditional cigarettes. Studying nicotine dependence in adult EC users is a crucial area, but few measures are available to evaluate nicotine dependence induced by EC. Our study aims to estimate the levels of nicotine dependency among adult EC smokers using a modified Fagerström Test of Nicotine Dependence (e-FTND) in Jeddah, Saudi Arabia, and to identify EC-associated sociodemographic and smoking-related factors affecting nicotine dependency. An analytical cross-sectional study was conducted on adults 18 years of age and older in Jeddah, Saudi Arabia, from December 2023 to March 2024. Data were collected from the participants using a pre-tested structured self-administered questionnaire, and nicotine dependence was assessed using the modified e-FTND. Descriptive statistics such as frequency, mean, and standard deviation were applied. Chi-square was used to assess the association between categorical variables. Ordinal regression was used to predict the nicotine dependency levels with different variables. A total of 344 participants were included in the study. The mean e-FTND score for EC users was 4.14 ± 2.45. Females had a lower likelihood of experiencing higher dependence compared to males (OR = 0.52, 95% CI: 0.32, 0.85). Using ECs for more than three years was associated with higher odds of increased dependence (OR = 3.18, 95% CI: 1.28, 7.98; p < 0.001). The use of Pod system devices lowered the odds of developing high nicotine dependence (OR = 0.32, 95% CI: 0.13, 0.75; p = 0.01) compared to Iqos device users, while mechanical Mod device users exhibited a trend towards higher dependence, although it was not statistically significant. Nicotine concentration in ECs had a significant impact on the degree of nicotine dependence. Higher concentrations were associated with increased odds of higher dependence (12-18 mg: OR = 3.26, 95% CI: 1.55, 6.91; >18 mg: OR = 4.53, 95% CI: 2.37, 8.75; p < 0.001). Most exclusive EC users in the study developed a moderate nicotine dependence level. The EC device type and nicotine concentration were significant drivers of nicotine dependence. Additionally, the personal characteristics of the users, such as male gender and duration of use, were associated with a higher risk of dependence. An in-depth understanding of the magnitude of nicotine dependence among EC users will enhance the opportunity for tailored health-enhancing interventions and policies.

Effect of different types of smoking on oral health and on cellular changes in oral mucosa

ObjectivesSmoking is known to be a major risk factor for several diseases. Recently, electronic cigarettes have been introduced to the market; however, their effect on oral health has not been well studied yet. We aim to compare the effect of different types of smoking on oral health and to evaluate cytomorphological changes in oral mucosa among different types of smokers. Study designA total of 112 participants were recruited, conventional cigarette smokers (n = 28), electronic cigarettes smokers (n = 26), hookah smokers (n = 29) and non-smokers (n = 29). Oral examination, brush cytology and salivary flow test were performed. Cytological smears were stained and examined for cytomorphological changes. Oral symptoms, type, and frequency of smoking were obtained through questionnaires. SPSS program was used for statistical analysis. ResultsMost of the oral symptoms reported in this study were among conventional and electronic cigarettes smokers. While hookah smokers reported the least oral symptoms. Increase in DMFT and gingival index were observed among all smokers, mainly among conventional cigarettes smokers. Conventional cigarette and hookah smokers were found to have the most significant cellular changes. Electronic cigarette smokers had certain cellular changes as well. ConclusionAll types of smoking adversely affect oral health and can induce cellular changes in the oral mucosa.

Impact of electronic cigarette use on the increased risk of diabetes: the Korean Community Health Survey.

Only a few studies have solely investigated the health impacts of electronic cigarettes on diabetes while considering the impact of conventional cigarettes. Therefore, this study aimed to examine the effect of electronic cigarette smoking on diabetes in Korean dual smokers, electronic cigarette smokers, conventional cigarette smokers, and non-smokers. Data were obtained from the 2021 and 2022 Korean Community Health Surveys of 460,603 Korean adults. The main independent variable was smoking behavior. Participants were categorized according to their smoking behavior, as dual smokers, electronic cigarette smokers, conventional cigarette smokers, and non-smokers. The dependent variable, the presence of diabetes, was defined by a doctor's diagnosis. Multiple logistic regression analysis was performed to examine the association between smoking behavior and diabetes. Subgroup analyses were also performed to investigate the associations among different socioeconomic groups. Conventional cigarette smokers had a higher risk of diabetes than did non-smokers (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.19 to 1.26). More importantly, those who only vaped electronic cigarettes were at high risk of diabetes (aOR, 1.15; 95% CI, 1.01 to 1.31). Lastly, dual smokers had the highest aOR for diabetes among other smoking behavior groups (aOR, 1.39; 95% CI, 1.22 to 1.58). Dual smoking was associated with the highest risk of diabetes in most subgroups. This study suggests that conventional cigarette use and smoking electronic cigarettes negatively impact diabetes, and using both types leads to worse health outcomes. Therefore, cessation of all types of smoking is necessary for a healthy life.

Electronic cigarettes and their association with stress, depression, and anxiety among dental students in the UAE-a pilot cross sectional study.

During dental school, students may encounter stressful events that contribute to stress, anxiety, and depression; in response to these factors, some students use vaping or electronic cigarettes. To evaluate the relationship between electronic cigarettes use and stress, anxiety, and depression among dental students. A cross-sectional study included 142 dental students in their preclinical, clinical, or internship year was conducted. The 142 participants were split evenly between two groups: smokers and nonsmokers. The average age of the study's male and female participants was 21.6 years. Using the DASS 21 scale, participants were instructed to complete an electronic questionnaire assessing the association between electronic cigarettes use and stress, anxiety, and depression in smokers and nonsmokers. According to the findings of this study, stress, anxiety, and depression were significantly associated with electronic cigarette use. Compared to non-smokers, electronic cigarette smokers reported higher levels of severe/extremely severe depression (OR: 10.34, 95% CI: [4.23-24.1]), anxiety (OR: 13.8, 95% CI: [5.4-30.1]) and stress (OR: 27.6, 95% CI: [8.9-85.8]). Compared to males, females were 2.5 times (95% CI: [1.02-6.1]) more likely to report severe/extremely severe anxiety (P < 0.05). This study demonstrates a significant correlation between the use of electronic cigarettes and elevated levels of stress, anxiety, and depression among dental students in the UAE.

Comparison of exhaled carbon monoxide levels and its association with nicotine dependence between electronic and tobacco cigarettes: A cross-sectional study among teenage smokers.

Carbon monoxide (CO), resulting from incomplete combustion such as tobacco smoking, serves as an indicator of nicotine addiction. The aim of this study was to compare the levels of exhaled CO levels between electronic cigarette (e-cigarette) and tobacco smokers and to determine the association between nicotine dependence and exhaled CO levels in e-cigarette and tobacco smokers. A cross-sectional study was conducted using purposive sampling on active smokers, with 70 smokers in each group. The nicotine dependence was measured using the Penn State Nicotine Dependence Index (PSNDI) questionnaire for the e-cigarette group and the Fagerstrom questionnaire for the tobacco smoking group. The CO level was measured using the smokerlyzer piCO. To compare the mean exhaled CO levels between e-cigarettes and tobacco smoker groups, the Mann-Whitney test was used. The Mann-Whitney test and Kruskal-Wallis test were used to assess the associations between nicotine dependence and mean exhaled CO levels in the e-cigarette smoker group and in the tobacco smoker group, respectively. The majority of e-cigarette smokers were 17 years old (65.7%) and male (75.7%). Among tobacco smokers, the majority were also 17 years old (44.3%), and mostly male (91.4%). The mean exhaled CO levels in the tobacco smoker group were significantly higher than the e-cigarette smoker group, 6.86 ppm vs 1.61 ppm with p<0.001. There was a significant association between nicotine dependence and exhaled CO levels among tobacco smokers (p<0.001). Nicotine dependence was not associated with exhaled CO levels among e-cigarette smokers. This study highlights that the smokerlyzer piCO devise could be used to screen nicotine addiction in tobacco smokers.

Effect of smoking on coronavirus disease susceptibility: A case-control study.

Tobacco use has changed since the onset of the coronavirus disease (COVID-19) pandemic. The effect of smoking on COVID-19 susceptibility has not yet been determined. In this study, we aimed to assess the association between smoking and COVID-19 susceptibility. This retrospective case-control study was conducted at the quarantine center of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, between April and June 2020. A total of 142 adults participated in the study, 73 of whom tested positive for COVID-19 and were matched for both sex and age with participants in the control group. Telephone interviews were conducted to assess the risk factors associated with that exposure. Different variables are investigated for their impact on COVID-19 infection susceptibility. The current study's findings indicated that smokers comprised only 27.5% (n=39) of the participants. There was no association between the COVID-19 swab results and smoking status (χ2=1.857; p=0.395). Furthermore, there was no significant association between any of the smoking parameters and susceptibility to COVID-19, except for the smoking period (t= -2.105, p=0.041). The odds of having a positive swab result among cigarette smokers were lower than those among pipe, waterpipe, and electronic cigarette smokers (OR=0.600; p=0.394). An association was also observed between COVID-19-positive swab results and contact with an individual with COVID-19 or respiratory disease (χ2=79.270 and χ2=18.929, respectively, p≤0.001). This study revealed no association between smoking status and COVID-19 swab test results. Further research with a bigger sample size is suggested to confirm the relationship between smoking and COVID-19 susceptibility.

Ocular surface assessment and morphological alterations in meibomian glands with non-contact meibography in electronic cigarette smokers.

The study aimed to evaluate the ocular surface and meibomian gland morphology in electronic cigarette (e-cigarette) smokers. The upper and lower eyelids of 25 male e-cigarette smokers and 25 healthy male non-smoker patients were evaluated using Sirius meibography. Meibomian glands loss was automatically calculated using Phoenix meibography imaging software module, with the result obtained as percentage loss. Ocular Surface Disease Index (OSDI) questionnaire, tear breakup time test, and Schirmer II test were administered and performed in all cases. The mean e-cigarette smoking duration was 4.9 ± 0.9 (range, 3.4-7) years. While the mean Schirmer II test value was 9.16 ± 2.09 mm in e-cigarette group, it was 11.20 ± 2.14 mm in control group (p=0.003). Mean tear breakup time was 6.96 ± 2.31 seconds in e-cigarette group and 9.84 ± 2.13 seconds in control group (p=0.002). The mean OSDI value was 28.60 ± 6.54 and 15.16 ± 7.23 in e-cigarette and control groups, respectively (p<0.001). In Sirius meibography, the average loss for the upper eyelid was 23.08% ± 6.55% in e-cigarette group and 17.60% ± 4.94% in control group (p=0.002), and the average loss for the lower eyelid was 27.84% ± 5.98% and 18.44% ± 5.91%, respectively (p<0.001). Additionally, a significant positive correlation was identified between the loss rates for both upper and lower eyelid meibography with e-cigarette smoking duration (r=0.348, p<0.013 and r=0.550, p<0.001, respectively). Long-term e-cigarette smoking causes damage to the meibomian glands; therefore, meibomian gland damage should be considered in ocular surface disorders due to e-ci-garette smoking.

Periodontal and Peri-Implant Health Status in Traditional vs. Heat-Not-Burn Tobacco and Electronic Cigarettes Smokers: A Systematic Review.

The aim of the present systematic review was to evaluate and possibly differentiate the effects of traditional cigarettes, heat-not-burn tobacco, and electronic cigarettes on periodontal and peri-implant health status. Electronic cigarettes and heat-not-burn tobacco have become very popular in recent years and have been proposed to consumers as a safer alternative to conventional tobacco smoke, although their effect on periodontal and peri-implant health remains unclear. The study protocol was developed according to PRISMA guidelines, and the focus question was formulated according to the PICO strategy. A literature search was conducted across PubMed/MEDLINE and the COCHRANE library from 2003 to April 2022. From the 1935 titles initially identified, 18 articles were finally included in the study and extracted data were qualitatively synthesized. It may be carefully concluded that e-cigarettes may cause attenuated clinical inflammatory signs of periodontitis and, hypothetically, of peri-implantitis when compared to conventional tobacco smoke. Both alternative smoking products, containing nicotine, may likewise exert negative effects on periodontal and peri-implant health, as demonstrated by in vitro studies. Further investigations are needed to assess the impact of electronic cigarettes and heat-not-burn tobacco products on periodontal and peri-implant health status.

Assessment of Cardiopulmonary Function among Electronic Cigarettes Smokers, Conventional Cigarette Smokers and Nonsmokers using Electrocardiogram and Six-minute Walk Test

Assessment of Cardiopulmonary Function among Electronic Cigarettes Smokers, Conventional Cigarette Smokers and Nonsmokers using Electrocardiogram and Six-minute Walk Test

Comparative assessment of periodontal treatment needs among the electronic cigarette users and traditional smokers.

It is currently presumptuous that electric cigarettes are less harmful than the conventional ones; this is increasing the consumption of electric cigarettes. Therefore, this study intended to evaluate the periodontal treatment needs among conventional smokers, electronic cigarette smokers and non-smokers. This cross-sectional designed study involved 150 patients with a mean age of 29.88±7.81 years. Among all patients, 50 patients were recruited in each group. The periodontal condition and the treatment need for the patients were assessed using the community periodontal index treatment need (CPITN). Fisher exact test was used to find the significant association of all three groups with the periodontal status and the treatment need. Female patients (12.5%) showed better periodontal status than the male patients (87.5%) and required less complicated periodontal treatment independently from smoking type. Furthermore, deeper pocket depth ≥6 mm (75%) has been found among the conventional cigarette smokers whereas the majority of the electric cigarette smokers (50%) have calculus deposition. Thus, 50% of the electric smokers require professional scaling whereas 57.1% of conventional smokers prerequisite complex periodontal treatment. Besides, there was a significant difference (p≤0.05) observed among all groups in periodontal health index and treatment need. Conventional cigarette consumers need more complicated periodontal treatment compared to the patients who consume electric cigarettes.

Intention to quit smoking according to smoking preferences and perceptions of electronic cigarettes among university students in South Korea.

This study aimed to alleviate unhealthy smoking habits among university students and provide the basic data necessary for public health-oriented approaches such as developing regulations and policies on electronic cigarettes by analyzing the relationship between university students’ smoking preferences, perceptions of electronic cigarettes, and intention to quit smoking.This study involved 567 college students and conducted frequency and chi-squared analyses of the general characteristics, smoking preferences, and perceptions of electronic cigarettes. This study also performed logistic regression analysis to analyze the relationship between intention to quit smoking stratified by smoking preferences and the perceptions about electronic cigarettes. SPSS version 25.0 was used for data analysis.This study showed that electronic cigarette smokers were approximately 6.4 to 10.8 times more likely to think that electronic cigarettes positively affect smoking cessation attitude than nonsmokers. This study showed that regular cigarette smokers were approximately 1.7 to 2.2 times and other smoker 3.3 to 3.9 times more likely to think that electronic cigarettes positively affect smoking cessation attitude than nonsmokers. Those who perceived harmless to the human body, capable of reducing the frequency of smoking, and less harmful than tobacco were approximately 2.6 to 2.9, 11.6 to 12.8, and 3.3 to 3.7 times more likely have intention to quit smoking, respectively.Regular health education, advertising awareness of health hazards, and public health science-oriented approaches and policies for smoking cessation support services are needed to create awareness on electronic cigarettes among university students.

The Prevalence and Extent of Physiological and Pathological Gingival Pigmentation in Patients Visiting Riyadh Elm University Clinics

Background: Gingival pigmentation presents as a diffuse deep discoloration or as irregularly shaped brown and light brown or black patches, striate, or strands. It is generally agreed that pigmented areas are solely pre-sent when melanin granules, synthesized by melanocytes, are transferred to keratinocytes. Aim: To study the prevalence, extent, and etiology of gingival pigmentation among Riyadh Elm University clin-ics’ attendees. Design and Settings: Examinations were done in Riyadh Elm University by four calibrated examiners. Methods: Patients underwent a Gingival Index examination, followed by an assessment of the presence or ab-sence of gingival pigmentations. If the latter were present, the patient underwent a Hedin’s Melanin Index, a Gingival Melanosis Record, and a Von Luschan Scale examination to evaluate the extent, distribution, and col-or of the pigmentation. Statistical analysis: Cohen’s Kappa Test and Chi-Square Test Results: A total of 139 (80.3%) patients had gingival pigmentation, of which 79 (56.8%) were males. Gingival pigmentations were found in 42 (93.3%) cigarette smokers, 40 (83.3%) hubbly bubbly smokers, and 20 (86.9%) electronic cigarette smokers. Both arches were affected in 102 patients, the canines’ area had the highest incidence of pigmentation (88.9%) while the molars had the least incidence (18.1%). Scores of 2 and 3 on the Hedin’s Index were the highest at 51 and 52 patients respectively. The mean color of the pigmentations on the Von Luschan scale was 21.49 ± 4.59, but it was higher for smokers and patients with severe inflamma-tion. Conclusions : Gingival pigmentation was more prevalent among all types of smokers—cigarettes, hubbly bubbly, and e-cigarettes compared to non-smokers. More pigmentations were also associated with the higher intake. The major patterns of pigmentation distribution were the short-connected-continuous ribbons and the more-than-two-solitary-papillae. Keywords: Gingival Pigmentation, Hedin’s Index, Color, Distribution, Smokers

The effect of conventional versus electronic cigarette use on treatment outcomes of peri-implant disease

AimTo compare changes in clinical periodontal parameters (gingival consistency, colour, BOP, PI, PD) and changes of salivary inflammatory biomarkers (IL-1 β, IL-6, MMP-8, TNF- α and TIMP-1 between conventional, electronic cigarette smokers and non-smokers after peri-implant treatment.MethodsStudy participants were grouped into three groups (i) Conventional cigarette smokers (ii) Electronic cigarette smokers and (iii) non-smokers respectively. A total of 60 adult patients aged (40–56 years) with 60 implants with active per-impantitis was included.Clinical and Biological parameters were evaluated before surgical treatment at baseline, one, six and twelve month post treatment. Pearson’s chi-square test was used to compare the distribution of the categorical while Two-way repeated analysis of variance was used to compare the mean values of quantitative outcome variables among all study groups across the 4 time points.ResultsA total of 60 subjects (60 implants) were selected and classified into three groups as per their smoking method 20 participants in each group with one single targeted implant diagnosis with active peri-implantitis. The gingival colour, the change was statistically significant at one year of post treatment.The gingival consistency distribution across the three groups is not statistically significant at baseline, but it is statistically significant at one-month (p = 0.001), six months (p = 0.029) and at the completion of one-year (p = 0.018) post treatment. The plaque index of 100% of non-smokers had changed to ‘0’ and 35% change in cigarettes and 30% change in electronic smokers which is statistically significant (p = 0.016).The prevalence of BOP was observed in the three groups as 72%, 76.5% and 88.9% at baseline. The mean values of PD have shown statistically significant change across the three groups over the four-time intervals of observation (p = 0.024). The comparison of mean values of IL-1 β, IL-6 and TIMP-1 has shown statistically significant change across the three groups over the four intervals of observation (p < 0.0001).ConclusionsElectronic cigarette smoking was found to be most prevalent risk indicator for peri-implantitis. Compromised response of peri-implantitis treatment both clinically and biologically was found more among electronic cigarette smokers when compared to conventional cigarette smokers and non-smokers.Trial registration: This case-control study was conducted at King Saud University’s Dental College, Riyadh, Saudi Arabia, in accordance with “Helsinki Declaration of Human Studies” and approved by the Institutional Review Board (Reference no: 87563).

Electronic cigarettes, vaping-related lung injury and lung cancer: where do we stand?

Electronic cigarettes have been considered a promising alternative to nicotine replacement products to help heavy tobacco smokers quit smoking. They work thanks to a heating coil causing evaporation of the liquid rapidly followed by cooling, thus creating an aerosol, a completely different mechanism from the combustion of tobacco in traditional cigarettes. The term 'vaping' indicates the use of electronic cigarettes or other devices to inhale heated, aerosolized nicotine, or other substances like cannabidiol, tetrahydrocannabinol, or butane hash oils together with solvents, mainly propylene glycol and vegetable glycerine or their combination. A very fast increase of vaping among adolescents has been observed since electronic cigarettes and other vaping devices first appeared. Although electronic cigarettes have been advocated as a short-term cessation aid for tobacco smokers or as a long-term alternative, there is the concrete risk that they can be perceived by young nonsmokers as a less dangerous alternative to tobacco smoking, thus stimulating nonsmokers to start smoking rather than helping heavy tobacco smokers to quit smoking. Moreover, several cases of exogenous lipoid pneumonia and diffuse alveolar hemorrhage with proven alveolar injury, as well as vaping-associated bronchiolitis obliterans, have been recently reported among electronic cigarette smokers, with severe clinical impact, thus posing the risk of the life-threatening toxic potential of vaping. At the moment, no definitive assessment can be made about the efficacy of electronic cigarettes as a smoking cessation aid, and further studies are required about vaping-related life-threatening acute lung injury.

The Association Between the Pattern of Electronic Cigarette Smoking and Gastroesophageal Reflux

Background: This study was aimed to investigate the proportion of gastroesophageal reflux (GER) among electronic cigarette (e-cig) smokers and its association with the pattern of e-cig smoking.Method: This cross-sectional study underwent among e-cig smokers community in Cirebon City, Jawa Barat, ranged from March to August 2020. Subjects were enrolled through consecutive sampling method. The data collection used survey containing the pattern of e-cig smoking and GER. The pattern of e-cig smoking included the duration of e-cig smoking and the amount of e-cig smoking. Gastroesophageal reflux consisted of GER-related symptoms (heartburn, regurgitation, and nocturnal symptom) and gastroesophageal reflux disease (GERD). GERD was defined as GERD questionnaire score cut-off 8. Data analysis used chi square test. This study has been approved by The Medical Research Ethics Committee, Faculty of Medicine, Universitas Swadaya Gunung Jati.Results: There were 273 respondents in this study. The proportion of heartburn was 6.6%, 10.3% for regurgitation, 3.7% for nocturnal symptom, and 5.5% for GERD. There was no association between duration of e-cig smoking and heartburn (p 0.681), regurgitation (p 0.568), nocturnal symptom (p 0.764), and GERD (p 0.113). There was no association between amount of e-cig smoking and heartburn (p 0.062), regurgitation (p 0.770), nocturnal symptom (p 0.985), and GERD (p 0.605).Conclusion: There was relatively low proportion of GER among e-cig smokers. There was no association between the pattern of e-cig smoking and GER in this study.