Electronic Cigarette Use Research Articles

A cross-sectional study of the prevalence of electronic cigarette use, knowledge and attitudes among Saudi youth

A cross-sectional study of the prevalence of electronic cigarette use, knowledge and attitudes among Saudi youth

Molecular imaging of pulmonary inflammation in electronic and combustible cigarette users: a pilot study.

Electronic cigarette (EC) use has increased dramatically, particularly among adolescents and young adults, which, like cigarette use, can cause pulmonary inflammation and increase the risk of lung disease. Methods: This preliminary study used positron emission tomography with 18F-6-(1/2)(2-fluoro-propyl)-4-methylpyridin-2-amine (18F-NOS) to quantify inducible nitric oxide synthase (iNOS) expression to characterize oxidative stress and inflammation in the lungs in vivo in three age- and sex-matched groups: (1) 5 EC users, (2) 5 cigarette smokers, and (3) 5 never smoke/vape controls. Results: EC users showed greater 18F-NOS non-displaceable binding potential (BPND) than cigarette smokers (P = 0.03) and never smoke/vape controls (P = 0.01); whereas BPND in cigarette smokers did not differ from controls (p> 0.1). 18F-NOS lung tissue delivery and iNOS distribution volume did not significantly differ between groups. Although there were no group differences in peripheral inflammatory biomarker concentrations, 18F-NOS BPND correlated with the pro-inflammatory cytokine tumor necrosis factor-α concentrations (rs= 0.87, P = 0.05) in EC users. Additionally, when EC users and cigarette smokers were pooled together, vaping episodes/cigarettes per day correlated with interleukin-6 levels (rs= 0.86, P = 0.006). Conclusion: This is the first PET imaging study to compare lung inflammation between EC and cigarette users in vivo. We found preliminary evidence EC users had greater pulmonary inflammation than cigarette smokers and never smoke/vape controls, with a positive association between pulmonary and peripheral measures of inflammation.

Nicotine Dependence from Electronic Cigarettes Use and Depressive Symptoms Among Adolescents.

The use of electronic cigarettes (e-cigarettes) has been increasing among adolescents in the United States since they were first introduced to the U.S. market in 2007. With depression as a major risk factor for suicide in adolescents, this study examined nicotine dependence from the use of e-cigarettes and depressive symptoms among adolescents. The authors conducted a retrospective patient chart review at a pediatric clinic in the Midwestern United States, from May 2021 to September 2021. As a standard practice, the clinic uses the adapted Penn State Nicotine Dependency Index to evaluate its patients' nicotine dependence from the use of e-cigarettes, and the PHQ-9 modified for teens to screen for depressive symptoms of its patients. Data on 69 patients were included in the study. The authors used standard descriptive statistics and an adjusted odds ratio (aOR) to analyze the data on the 69 adolescents. The mean age of the adolescents was 17.6 (SD = 2.3), 46.4% (n = 32) were female, and 53.6% (n = 37) were male. More than 88% (n = 61) of the adolescents met criteria for high nicotine dependence from e-cigarette use and 30.4% (21 of 69) of them screened positive for depression. Findings of the analyses indicated that there was not a statistically significant association between nicotine dependence from e-cigarette use and depressive symptoms (aOR = 1.07; 95% confidence interval, 0.93-1.23; p = 0.297). The results showed that while a third of the adolescents screened positive for depression and the majority (88%) depended on nicotine from e-cigarettes, there was no association between the outcomes. Future larger multicenter studies are needed to better understand the association between nicotine dependence from e-cigarettes and depressive symptoms as reported in the literature.

Electronic cigarettes use in COVID-19 era among students of a tertiary institution in Nigeria.

Electronic cigarette (e-cigarette) use is becoming popular among undergraduate students in Nigeria with a tendency for escalation because of the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to assess electronic cigarette use in COVID-19 era among undergraduate students of a tertiary institution in Lagos state, Southwestern Nigeria. A tertiary institution in Southwestern Nigeria. The study design was a descriptive cross-sectional study with a pretested, structured, close- and open-ended self-administered questionnaire used for collection of data on knowledge, attitude and use of e-cigarettes. Data from 183 respondents were analysed. The mean age of respondents was 24.8 ± 3.38 years, most (63%) of whom were males. The prevalence of ever-use of e-cigarettes was 15.3% of which 60.7% reported increased use of e-cigarettes since the COVID-19 pandemic. Age, education, tribe and religion (p 0.001) were significantly associated with higher odds of use of e-cigarettes. This study found an increase in the quantity of e-cigarettes used and online purchase of the same by respondents since the COVID-19 pandemic. Paying attention to the rate of use and having control measures in place for online purchase of e-cigarettes by youths in Nigeria may be necessary in the years to come.Contribution: This study addresses a gap in the availability of knowledge of use of e-cigarettes among a growing population of youths in Nigeria.

Saliva and Exhaled Breath Condensate Correlate With Serum in 4-12-Year-Olds Exposed to Secondhand Electronic Cigarette Vapors: A Pilot Study.

Electronic cigarette use is highest among adults of child-bearing age. Many parents that use electronic cigarettes believe that secondhand exposure of electronic cigarette vapors for their children is not dangerous and is less harmful than secondhand exposure to traditional cigarette smoke. These beliefs may prompt excessive secondhand exposure to electronic cigarette vapors for their children. Little research has been done to document exposure in children. The traditional biological method of exposure detection is through a blood draw, which is difficult and undesirable in children. The purpose of this study was to assess the feasibility of using saliva and exhaled breath condensate as non-invasive biomatrices for detecting secondhand electronic cigarette vapor exposure in children. In this cross-sectionally designed study, we recruited 22 children exposed to electronic cigarette vapors and 26 non-exposed between the ages of 4-12 years. We compared metabolic features across three biomatrices, blood, saliva, and exhaled breath condensate. We noted moderate to strong pairwise, sample-specific, and feature-specific adjusted correlations. Annotated features associated with direct and secondhand electronic cigarette exposure were noted. These results demonstrate that less invasive biomatrices may be used to detect features associated with secondhand electronic cigarette vapor exposure in children.

Development and implementation of the ECHO model in a school setting to address youth electronic cigarette use in Kansas: A protocol.

Schools remain at the frontlines of addressing issues, such as e-cigarette use, that impact students. Despite e-cigarette use remaining a significant public health concern in the U.S., schools have limited resources (e.g., staff, capacity, programming) to address it, especially in rural and frontier areas. This ECHO Pilot Project aimed to build capacity and equip schools and school staff in the state of Kansas to address high rates of youth e-cigarette use by providing prevention support and information on best practices for e-cigarette cessation. The pilot used the established Project ECHO model to disseminate evidence-based strategies for e-cigarette prevention and cessation among youth to schools across Kansas. The pilot selected 20 interdisciplinary school teams representing both rural and urban middle and high schools across the state to participate in seven ECHO sessions. ECHO sessions proceeded throughout Fall 2021, with the final session in Spring 2022. School participants completed pre-post surveys as well as component-specific surveys following each ECHO session. In addition, each school team created an individualized action plan to comprehensively address e-cigarette use at their school based on the information provided throughout the ECHO. Survey data, school tobacco/nicotine policies, and action plans will be analyzed to assess process and final outcomes. If successful, this pilot will demonstrate that the ECHO model is an effective platform for building school staff knowledge and skills to implement evidence-based strategies in both urban and rural settings. It is anticipated that the pilot will build capacity and equip schools and school staff to address high rates of youth e-cigarette use by providing support for school-based prevention programs and referrals for e-cigarette cessation which will lessen the burden of nicotine-related problems in Kansas schools and communities. Finally, the pilot will provide evidence that the ECHO model can be successfully and equitably applied in a school setting and may be a viable method for addressing other public health-related issues faced by schools.

Use of electronic cigarettes and hookah in Brazil: a new and emerging landscape. The Covitel study, 2022.

To estimate the prevalence of current commercial cigarette smoking, as well as those of e-cigarette and hookah experimentation and current use among adults (≥ 18 years of age) in Brazil. This study was based on a countrywide cross-sectional telephone-based survey conducted in 2022. The sample was designed to be representative of the five macroregions in Brazil and included 1,800 individuals from each of the regions. Telephone numbers, using a random digit dialing procedure, were proportionally selected for each direct distance dialing code in each region and then electronically validated (i.e., 900 cell and 900 landline phone numbers per region). Information on current commercial cigarette smoking (regardless of frequency/amount), as well as lifetime history of or current e-cigarette and hookah use (regardless of amount), were collected. The prevalence of lifetime history of e-cigarette and hookah use was identical (7.3%; 95% CI: 6.0-8.9), whereas the prevalence of current commercial cigarette smoking was 12.2% (95% CI: 10.4-14.1). Young adults (18-24 years) had the highest prevalence of e-cigarette experimentation (19.7%; 95% CI: 15.1-17.0) and hookah experimentation (17%; 95% CI: 12.2-23.2). E-cigarette and hookah use was more common in the Central-West region and among those with a high level of education, whereas current commercial cigarette smoking was more common among those with a lower level of education. Individuals who used the three forms of nicotine delivery corresponded to 1.5% of the sample (nearly 2 million individuals based on the estimated size of the Brazilian adult population). Surveillance is essential for the monitoring and prevention of these new forms of nicotine consumption.

Impact of e-cigarettes as cancer risk: A protocol for systematic review and meta-analysis

The use of electronic cigarettes is one of the current public health problems on increasing alert, has been growing at an accelerating rate, and has become a public health emergency. Its importance is explained by the continuous growth and acceleration of oncological rates among all ages versus the absence of high-quality evidence, correlated to the use of nicotine derived products, being at their regular versions or the new ones. Available preclinical data indicate that activation of the sympathetic nervous system by nicotine inhaled from e-cigarettes may stimulate cancer development and growth by several mechanisms, which results can significantly reduce life's quality. This systematic review and meta-analysis protocol aims to clarify the connection between the use of electronic cigarettes by adults over the age of 18 and the development of malignant neoplastic diseases. The proposed systematic review and meta-analysis will be reported conforming to the preferred reporting items for systematic reviews and meta-analyses guidelines. Will include the following studies: case-control or cohort studies showing adults (18 years old age) using e-cigarettes. There will be no language or publication period restrictions. Articles published, but not peer-reviewed, will not be included in the review. Data will be entered in the Review Manager software (RevMan5.2.3). For dichotomous outcomes, we extracted or calculated the OR and 95% CI for each study. In case of heterogeneity (I²>50%), the random-effects model will be used to combine the studies to calculate the OR and 95% CI.

Healthcare Provider Screening for Tobacco Product and Electronic Cigarette Use Among Youth in the United States

PurposeHealthcare providers play a critical role in curbing youth tobacco use through screening and counseling. Current rates of tobacco use screening by healthcare providers among US youth are unknown. MethodsWe used 2020 National Youth Tobacco Survey data to examine the prevalence of healthcare provider screening for tobacco and e-cigarette use among US youth. Using multivariable logistic regression, we examined the factors associated with being screened for tobacco use. ResultsOf 13,434 individuals who reported past 12-month visits to any healthcare professional, 47.5% (44.8%–50.1%) reported being screened for any tobacco use, while 31.5% (29.2%–40.0%) reported e-cigarette–specific screening. The odds of tobacco use screening were lower among males (odds ratio [OR]: 0.81 [0.73–0.89]) and middle schoolers (OR: 0.39 [0.33–0.44]) compared to females and high schoolers, respectively. In addition, non-Hispanic Black (OR: 0.71 [0.56–0.89]), Hispanic (OR: 0.76 [0.63–0.92]), and Asian youth (OR: 0.48 [0.37–0.63]) had lower odds of being screened than non-Hispanic White youth. DiscussionThere are missed opportunities in tobacco screening by healthcare providers, particularly among males, middle schoolers, and racial/ethnic minority youth.

The influence of electronic cigarette use on the development of periodontitis in young people

The electronic cigarette is a nicotine delivery device that appears as an alternative to the traditional cigarette. As for its epidemiology, the incidence is higher among young males aged 15 to 24 years, especially those who are still in the school environment. Thus, prolonged use of this electronic system can cause periodontitis, which is a multifactorial disease aggravated by smoking, since salivary nicotine levels alter the oral microbiota and gingival blood flow, decreasing the immune response. Therefore, this study aimed to make a bibliographic survey on the correlation between the use of electronic cigarettes and the development of periodontitis in young people. As for the methodology used, it consists of a narrative literature review, through searches in the Google Scholar, Scopus, PubMed, MEDLINE and LILACS databases via VHL in the period from 2013 to 2022. Through this, it was found that the causes that lead young people to use these devices are, above all, social and that the vapor of the electronic cigarette is an aggravating factor for the formation of periodontitis in young people due to the changes caused at the cellular level. However, the population still does not have total knowledge of the clinical findings that prove this relationship, making it difficult to raise awareness, and therefore, to minimize this habit. In view of this, the dental surgeon has the role of preventing the evolution of periodontitis by warning about the risks of continuing to use electronic cigarettes.

First tobacco product tried and current use of cigarettes and electronic cigarettes among adolescents from Guatemala City.

To assess how first experimenting with ciga-rettes or e-cigarettes is associated with current use in Gua-temala, a middle-income country with weak tobacco control and no e-cigarette regulations. We surveyed students from private schools in Guatemala City, limiting analyses to ever users (n=1 026). Multinomial logistic models regressed current product use on first product used, adjusting for sociodemographics and friends and family use. The most common first product used was e-cigarettes (56%), followed by flavored cigarettes (24%) and regular cigarettes (20%). At the time of the survey, 4% were exclusive smokers, 37% were exclusive e-cigarette users, 18% dual users, and 40% had ever tried either but were not current users. Compared to those who first tried cigarettes, students who first tried e-cigarettes were less likely to be current smokers (RR=0.19 [CI: 0.11,0.31]) or dual users (RR=0.26 [CI: 0.14,0.49]) and students who first tried flavored cigarettes were more likely to be current smokers (RR=1.66 [CI=1.13,2.42]). In our sample, Guatemalan adolescents from private schools more frequently experiment and continue to use e-cigarettes than cigarettes. There is urgent need to implement e-cigarette restrictions in addition to tobacco control policy implementation.

Young Adults' Electronic Cigarette Use and Perceptions of Risk.

In the United States, 18.6% of college students between 19-and 22-years old report e-cigarette use in the last 30 days. Information regarding e-cigarette use and perceptions in this age group may assist in understanding how to decrease initiation of e-cigarettes in a population that may otherwise not use nicotine. The purpose of this survey was to determine current e-cigarette use and how e-cigarette use history relates to a college student's perceptions of health risks associated with e-cigarettes. A 33-item questionnaire was sent to students at a Midwestern university in Fall 2018. Overall, 3754 students completed the questionnaire. More than half of the respondents (55.2%) had used e-cigarettes and 23.2% identified as current users of e-cigarettes. Current e-cigarette users were more likely to agree that e-cigarettes are a safe and effective option to quit smoking, while never users were more likely to disagree (safe P < .001, effective P < .001). Current users were less likely to agree that e-cigarettes may harm a person's overall health than never users (P < .001). Young adults continue to be frequent users of e-cigarettes. There are significant differences in perceptions of e-cigarettes associated with use history. Additional research is needed to see how perceptions and use of e-cigarettes have changed considering lung injury reports and increased regulations in the U.S.

Assessing Electronic Cigarette Use and Depressive Symptoms among Adolescents in Kansas.

Purpose: The use of electronic cigarette has been increasing among adolescent in the United States population. With depression as a major risk factor for suicide in adolescent, this study examined depressive symptoms and electronic cigarette dependence in this age group. Methods: The authors conducted a retrospective patient chart review at a pediatric clinic in the Midwestern United States, from May 2021 to September 2021. The clinic used the adapted Penn State Nicotine Dependency Index to evaluate the patients' electronic cigarette dependence and the PHQ-9 modified for adolescents to screen for depressive symptoms of the patients. Charts on 69 patients were reviewed for this study. The authors used standard descriptive statistics and a generalized linear mixed model to analyze the data on the 69 adolescents. Results: The mean age of the adolescents was 17.6 (SD=2.3), 46.4% (n=32) were female, and 53.6% (n=37) were male. Approximately 30% (20 of 69) of the adolescent screened positive for depression and more than 88% (n=61) met criteria for high electronic cigarette dependence. Findings of the mixed model analyses indicated that there was not a significant association between electronic cigarette dependence and depressive symptoms (OR=1.07; 95% confidence interval, 0.93-1.23; P=.0365). Conclusions: Our finding shows that while a third of adolescents screened positive for depression and majority (88%) depended on electronic cigarettes, there was no association between the outcomes. Future larger studies are needed to better understand the association between electronic cigarettes dependence and depressive symptoms as reported in the literature.

Factors associated with the use of electronic cigarettes among youths

Factors associated with the use of electronic cigarettes among youths

Association between Electronic Cigarettes Use and Asthma in the United States: Data from the National Health Interview Survey 2016–2019

This article aimed to investigate 1) whether electronic cigarette (EC) users are more likely to experience asthma attacks or emergency room (ER) visits due to asthma than non-users and 2) how age and smoking behaviors moderate the effect size of the association. We used National Health Interview Survey data from 2016-2019. Multiple logistic regression analysis was performed to identify the association between current EC use and having an asthma attack and ER visitation due to asthma. Interaction terms were included to explore the moderation effects of age and cigarette smoking status. Subgroup analysis was conducted according to age group. Of the 218911 participants, 2.0% of them experienced an asthma attack, and 0.5% visited the ER due to asthma. Current EC use was associated with higher odds of having an asthma attack. In interaction analysis, age and smoking status were identified as a moderator in the relationship between EC use and asthma attacks. Participants in their 20s or 30s showed the highest interaction effect. Our analysis indicates the potential impact of EC use on public health and the moderating effects of smoking behavior.

Associations of Combustible Cigarette, Electronic Cigarette, and Dual Use With COVID Infection and Severity in the U.S.: A Cross-sectional Analysis of the 2021 National Health Information Survey.

Given the potential respiratory health risks, the association of COVID infection and the use of combustible cigarettes, electronic nicotine delivery systems (ENDS), and concurrent dual use is a priority for public health. Many published reports have not accounted for known covarying factors. This study sought to calculate adjusted odds ratios for self-reported COVID infection and disease severity as a function of smoking and ENDS use, while accounting for factors known to influence COVID infection and disease severity (i.e., age, sex, race and ethnicity, socioeconomic status and educational attainment, rural or urban environment, self-reported diabetes, COPD, coronary heart disease, and obesity status). Data from the 2021 U.S. National Health Interview Survey, a cross-sectional questionnaire design, were used to calculate both unadjusted and adjusted odds ratios for self-reported COVID infection and severity of symptoms. Results indicate that combustible cigarette use is associated with a lower likelihood of self-reported COVID infection relative to non-use of tobacco products (AOR = .64; 95% CI [.55, .74]), whereas ENDS use is associated with a higher likelihood of self-reported COVID infection (AOR = 1.30; 95% CI [1.04, 1.63]). There was no significant difference in COVID infection among dual users (ENDS and combustible use) when compared with non-users. Adjusting for covarying factors did not substantially change the results. There were no significant differences in COVID disease severity between those of varying smoking status. Future research should examine the relationship between smoking status and COVID infection and disease severity utilizing longitudinal study designs and non-self-report measures of smoking status (e.g., the biomarker cotinine), COVID infection (e.g., positive tests), and disease severity (e.g., hospitalizations, ventilator assistance, mortality, and ongoing symptoms of long COVID).

Cardiac arrest and severe encephalopathy following e-cigarette nicotine intoxication: a case report

Traditionally, most cases of nicotine poisoning have been due to ingestion of nicotine pesticides. However, the increasing use of electronic cigarettes (e-cigarettes) has resulted in both intentional and unintentional exposure to concentrated liquid nicotine or “eliquid” leading to an increase in nicotine poisoning cases. However, fatalities following the ingestion of the e-liquid are extremely rare. We report a rare case of cardiac arrest and severe encephalopathy following the intentional ingestion of e-liquid. We present the case of a 20-year-old woman who intentionally ingested liquid nicotine intended for e-cigarette use. She was found in asystole and experienced a return of spontaneous circulation (ROSC) after undergoing approximately 46 mins of cardiopulmonary resuscitation. Her plasma nicotine levels were &gt;500 ng/ml. Despite aggressive supportive care, she was found to have encephalopathy consistent with severe anoxic brain injury on magnetic resonance imaging. In recent times, there have been some reports of deaths following liquid nicotine ingestion. Our case illustrates the potential for fatal nicotine toxicity from ingestion of e-cigarettes.

Electronic cigarettes use in COVID-19 era among students of a tertiary institution in Nigeria

Background: Electronic cigarette (e-cigarette) use is becoming popular among undergraduate students in Nigeria with a tendency for escalation because of the coronavirus disease 2019 (COVID-19) pandemic. Aim: The aim of this study was to assess electronic cigarette use in COVID-19 era among undergraduate students of a tertiary institution in Lagos state, Southwestern Nigeria. Setting: A tertiary institution in Southwestern Nigeria. Methods: The study design was a descriptive cross-sectional study with a pretested, structured, close- and open-ended self-administered questionnaire used for collection of data on knowledge, attitude and use of e-cigarettes. Results: Data from 183 respondents were analysed. The mean age of respondents was 24.8 ± 3.38 years, most (63%) of whom were males. The prevalence of ever-use of e-cigarettes was 15.3% of which 60.7% reported increased use of e-cigarettes since the COVID-19 pandemic. Age, education, tribe and religion ( p &lt; 0.001) were significantly associated with higher odds of use of e-cigarettes. Conclusion: This study found an increase in the quantity of e-cigarettes used and online purchase of the same by respondents since the COVID-19 pandemic. Paying attention to the rate of use and having control measures in place for online purchase of e-cigarettes by youths in Nigeria may be necessary in the years to come. Contribution: This study addresses a gap in the availability of knowledge of use of e-cigarettes among a growing population of youths in Nigeria.

Electronic cigarette use as an aid to quit smoking: Evidence from PASSI survey, 2014–2021

This paper updates a previous cross-sectional study on the effectiveness of electronic cigarettes (e-cigarettes) as an aid to quit smoking.In the 2014–2021 PASSI survey, the ongoing Italian behavioural risk factor surveillance system, on a total of 239,812 subjects representative of the Italian adult population respondents who smoked and made at least one quit attempt in the previous 12 months (i.e., 19,234 subjects) were categorized into four groups according to the method used in their most recent quit attempt: no aid, e-cigarettes, standard pharmacological support (medications) and/or smoking cessation services (SCSs), other unspecified methods.The primary outcome was self-reported abstinence for a period ≥6 months.Thirteen percent of participants used e-cigarettes to quit, 83% no aid, 2% medications/SCSs, 3% other unspecified methods. Smoking abstinence was reported among 10% of those using no aid; 11% among e-cigarette users; 16% among those using medications/SCSs; and 13% among those using other unspecified methods. No significant difference in abstinence was observed for those reporting no aid compared with e-cigarette users (adjusted Prevalence Ratio [aPR] = 0.93; 95% confidence interval [CI] = 0.79–1.10). Those using medications/SCSs were significantly more likely to report abstinence than e-cigarette users (aPR = 1.35; 95% CI = 1.01–1.81).E-cigarettes as consumer products are not associated with higher quitting rates than those recorded using no aid, therefore there is no health benefit for allowing them to be marketed to smokers.

Trajectories of ENDS and cigarette use among dual users: analysis of waves 1 to 5 of the PATH Study

IntroductionConcurrent electronic nicotine delivery system (ENDS) and cigarette (dual) use is harmful. Identifying longitudinal trajectories of ENDS and cigarette use among dual users can help to determine the public health...