E-cigarettes Research Articles

E-Cigarettes in Smoking Cessation and Harm Reduction: A Comprehensive Review of Recent Evidence and Potential Risks

The global prevalence of tobacco use has significantly decreased over the years, with projections indicating further decline. However, the rise of new nicotine products suggests that nicotine addiction will remain a major public health issue. Electronic cigarettes (e-cigarettes) are increasingly recognized as potential tools for smoking cessation and harm reduction. This review evaluates the safety and effectiveness of e-cigarettes both as standalone treatments and in combination with other therapies, such as nicotine replacement therapy (NRT), varenicline, cytisine, and behavioral approaches. A comprehensive analysis of studies published over the past decade, including systematic reviews, meta-analyses, and randomized controlled trials, shows that e-cigarettes can enhance smoking cessation rates and reduce tobacco-related harm. They exhibit comparable short-term efficacy to traditional treatments, with promising results in alleviating withdrawal symptoms and lowering smoking rates. However, the long-term safety and effectiveness of combining e-cigarettes with other therapies remain uncertain and require further investigation. Despite their potential benefits, e-cigarettes pose significant safety concerns, underscoring the need for ongoing research to refine cessation strategies and ensure their safe, long-term use. Rigorous evaluation and regulatory oversight are essential to optimize e-cigarettes' role in reducing tobacco harm.

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.

E-cigarette retail outlets in Mexico: a country that bans the sale.

Restrictive e-cigarette policies have not allowed for the characterization of the sale of these tobacco products in the countries where they are implemented. This is because it is believed that there are no stores. However, the use of e-cigarettes persists in these countries. A content analysis of electronic cigarette points of sale through the internet in Mexico was conducted. Cross-sectional study. Structured searches were performed in the Google Maps search engine with the terms "electronic cigarette store" and "vape store" in combination with the name of each state of Mexico, in the period from October 2021 to February 2022. A total of 695 e-cigarette stores were located, of which 481 (69.2%) were physical stores, 207 hybrid stores (29.8%), 4 online stores (0.6%) and 3 (0.4%) vending machines. A total of 316 e-cigarette brands and 578 vape liquid brands were identified. The sales attraction strategy they used the most was free shipping of products (85.8%). Stores used WhatsApp (92.5%), Facebook (86.3%) and Instagram (74.4%) to promote their products. Only 35.1% of stores checked the age of their customers, of which, 95.9% asked if the customer was of legal age and 4.1% asked for the date of birth. In addition, 25.6% of the stores warned about nicotine addiction and 24.2% specifically about the ingredients of the liquids. E-cigarettes are widely available and marketed in a variety of retail outlets in Mexico. The high number of stores, brands of liquids, and e-cigarettes indicates non-compliance with existing regulations. E-cigarette consumption has increased globally, even in countries with restrictive regulations. However, there is limited data on the density and characteristics of vape stores in low- and middle-income countries with restrictive regulations. This study found no significant differences in e-cigarette sales between countries with permissive and restrictive regulations. Therefore, it is suggested that, in addition to establishing restrictive policies on the sale of e-cigarettes, their enforcement should also be monitored. Countries with restrictive measures should regulate Internet sales and promotion of e-cigarettes with greater emphasis.

Beyond the Vape: The Perils of electronic nicotine delivery systems (ENDS) in Pregnancy

Beyond the Vape: The Perils of electronic nicotine delivery systems (ENDS) in Pregnancy

Digitized Acceptance and Commitment Therapy (ACT): Based intervention for vaping cessation in youth (ACT-TO-STOP)

Digitized Acceptance and Commitment Therapy (ACT): Based intervention for vaping cessation in youth (ACT-TO-STOP)

The Role of Dietary Ingredients and Herbs in the Prevention of Non-Communicable Chronic Liver Disease

Background: Liver diseases are among the most commonly diagnosed conditions, with the main risk factors being inappropriate lifestyles, including poor diet, excessive alcohol consumption, low physical activity and smoking, including electronic cigarettes. Non-communicable chronic liver diseases also often develop as a result of accompanying overweight and obesity, as well as type 2 diabetes. Methods: The literature on risk factors for non-communicable chronic liver diseases, which show a high strong influence on their occurrence, was analysed. Results: Measures to prevent non-communicable chronic liver disease include the selection of suitable food ingredients that have proven protective effects on the liver. Such ingredients include dietary fibre, probiotics, herbs, various types of polyphenols and fatty acids (omega-3). Conclusions: Because of their liver-protective effects, nutritionists recommend consuming vegetables, fruits, herbs and spices that provide valuable ingredients with anti-inflammatory and anti-cancer effects. These components should be provided with food and, in the case of probiotics, supplementation appears to be important. As a preventive measure, a diet rich in these nutrients is therefore recommended, as well as one that prevents overweight and other diseases that can result in liver disease.

A mixed-method exploration of #vapingcessation videos on TikTok.

E-cigarette use has risen rapidly, especially among young people. TikTok is one of the most commonly used social media platforms among young people. The representation of vaping cessation messages in TikTok content remains unexplored. We aimed to address this gap by analyzing the vaping cessation content prevalent on TikTok. This cross-sectional mixed methods study analyzed the top 100 TikTok videos-determined based on view-counts-related to vaping cessation. Our quantitative analysis examined video characteristics, while our qualitative analysis identified key thematic representations. The final sample included 87 videos, with a combined total of over 100 billion views. Most videos were created by regular users (general TikTok content creators) rather than those identifying as health experts or professionals such as doctors, acupuncturists or dental hygienists. Very few posts mentioned evidence-based cessation aids or support. Videos scored high on understandability but low on actionability based on standardized criteria. Qualitative analysis identified nine key themes: motivations for quitting, barriers to quitting, use of aids and strategies, relapse experiences, identity and self-image, celebrating cessation success, emotional journey of quitting vaping, seeking social support, and limited mentions of healthcare providers. TikTok appears to be a useful influential forum for studying quitting behavior through the sharing of personal experiences and perspectives on vaping cessation. Opportunities exist to integrate evidence-based messaging and support into this platform. Findings can inform social media interventions designed to counter pro-vaping content and promote quitting e-cigarette use. Partnerships among health professionals, public health experts, and social media influencers may be leveraged to disseminate proven vaping cessation techniques on leading social media platforms such as TikTok.

Identification of Specific Hemoglobin Adduct Patterns in Users of Different Tobacco/nicotine Products by Nontargeted GC-MS/MS Analysis.

Tobacco smoke contains several electrophilic constituents which are capable of forming adducts with nucleophilic sites in DNA and proteins like hemoglobin (Hb) and albumin. New nicotine and tobacco products are discussed as less harmful forms of tobacco use compared to smoking combustible cigarettes (CC) due to reduced exposure to harmful constituents. Hence, the adduct profile in users of various tobacco/nicotine products is expected to differ characteristically. In this article, we present a novel nontargeted screening strategy using GC-MS/MS for Hb adducts based on the analysis of the respective derivatized N-terminal valine adducts after modified Edman degradation. We analyzed blood samples from a clinical study with habitual users of CCs, electronic cigarettes, heated tobacco products (HTPs), oral tobacco, nicotine replacement therapy products and nonusers of any tobacco/nicotine products. Our nontargeted approach revealed significant differences in the Hb adduct profiles of the investigated tobacco/nicotine product user groups. Adduct identification was performed by means of an internal database, retention time estimations based on the theoretical boiling points, as well as in-house synthesized reference compounds. Several chemicals that form adducts with Hb could be identified: methylating and ethylating agents, ethylene oxide, acrylonitrile, acrylamide, glycidamide and 4-hydroxybenzaldehyde. Levels were elevated in smokers compared to all other groups for Hb adducts from methylating agents, ethylene oxide, acrylonitrile, acrylamide and glycidamide. Our approach revealed higher concentrations of Hb adducts formed by ethylation, acrylamide and glycidamide in users of HTPs compared to nonusers. However, concentrations for the latter two were still lower than in smokers. Due to their long half-lives, Hb adducts related to acrylonitrile, acrylamide (glycidamide), and ethylene oxide exposure may be useful for the biochemical verification of subjects̀ compliance in longitudinal and cross-sectional studies with respect to smoking and HTP use/abstinence.

O IMPACTO DO USO DE CIGARROS ELETRÔNICOS NA SAÚDE MENTAL DOS ADOLESCENTES: UMA REVISÃO SISTEMÁTICA

Objective: To analyze the impact of electronic cigarette use on adolescent mental health, identifying motivational and risk factors associated with the use of these devices. Method: A systematic literature review was conducted using the PubMed and Virtual Health Library (BVS) databases, with descriptors in Portuguese and English. Studies published between 2019 and 2024 that analyzed the relationship between electronic cigarette use and the mental health of adolescents aged 12 to 24 years were included. After applying inclusion and exclusion criteria, 10 studies were selected for analysis. Results: The main motivational factors for the use of electronic cigarettes include curiosity, the perception of lower risk compared to traditional cigarettes, sensory appeal, and social influence. Risk factors include adverse childhood experiences, mental health problems, substance use, and poor academic performance. The review indicated a strong association between the use of electronic cigarettes and increased symptoms of depression, anxiety, and other mental disorders in adolescents. Additionally, the importance of stricter public policies and psychological support programs is emphasized to mitigate the negative effects of electronic cigarette use among young people.

Vaping behavior among adolescent and young adult cancer survivors: A scoping review.

Adolescent and young adult (AYA) cancer survivors are vulnerable to future health complications and engage in risky health behaviors. Vaping or electronic cigarette use is increasing among AYA, yet little is known about the prevalence in AYA cancer survivors and associated morbidities. The objective of this research was to analyze the current state of the literature on vaping among AYA cancer survivors with scoping review methodology. Eligibility criteria included any vaping among people aged 13-39years with cancer or a history of cancer. Database searches from PubMed, Web of Science, PsycINFO, and Scopus yielded eight cross-sectional studies. Results suggest significant variability, with studies finding 2%-46% of AYA survivors have ever or currently vape. Medical (e.g., late effects), psychosocial (e.g., depression), and demographic correlates (e.g., younger age, male gender), as well as other risky health behaviors (e.g., cigarette smoking) were shown to be associated with vaping. Though the extant research is beginning the task of understanding comorbidities with vaping, few research has focused on those most vulnerable to vaping (survivors under age 18). More research is required to understand AYA survivors' vaping behavior to better understand the significance and implications regarding the growing incidence of vaping among this vulnerable population.

Electronic cigarettes and peri-implantitis: an umbrella review.

Electronic cigarettes (e-cigarettes) are offered to consumers as a healthier option than traditional tobacco. However, the long-term effect of non-heat-burning tobacco and e-cigarettes on periodontal and peri-implantitis is unknown. The present review evaluates the impact of electronic cigarettes on peri-implantitis and compares the results with traditional cigarettes and non-smokers. Systematic/meta-analysis studies were searched in PubMed, MEDLINE, EMBASE, Cochrane Library, and Google Scholar until December 30, 2022. Five systematic/meta-analysis studies were identified based on the search strategy in the selected databases. The overall quality assessment of the studies showed acceptable evidence with high quality. All systematic review studies showed that compared to traditional tobacco smoke, electronic cigarettes might reduce or not change the clinical inflammatory symptoms of periodontitis and peri-implantitis, such as bleeding on probing, probing depth, peri-implant bone loss, and response to treatments. Electronic cigarettes contain nicotine, which can harm periodontal and implant health. On the other hand, a wide range of oral health consequences may be associated with using e-cigarettes. E-cigarette is a potential risk factor for the healing process and the results of implant treatment.

Effects of freebase/protonated nicotine concentration, liquid composition and electrical power on throat hit in direct-to-lung vaping: theory and clinical measurements

BackgroundFor decades, the tobacco industry has engineered the sensory characteristics of combustible tobacco products including the degree of harshness experienced at the back of the throat. Commonly referred to as...

EVALI SYNDROME IN A PATIENT WITH HYPERSENSITIVITY PNEUMONITIS

Smoking electronic cigarettes, or vaping, is considered by many to be a safe alternative to smoking tobacco. It was only relatively recently that reports began to appear about the development of lung damage caused by electronic cigarettes - EVALI syndrome. Currently, the morphological manifestations of this syndrome have not been studied sufficiently due to the small number of cases described in the literature. These facts, as well as the fact that the changes that occur are not specific, and may vary in different patients, make it difficult to diagnose the disease in a timely manner. We have described a clinical case of death in a patient who has repeatedly received inpatient treatment for interstitial lung disease, who was admitted to the pulmonology department with signs of decompensated respiratory failure after prolonged and intensive use of electronic cigarettes. The autopsy revealed and substantiated clinical and morphological signs of chronic hypersensitive pneumonitis in combination with EVALI syndrome. The article also provides a brief literature review of the literature on EVALI and hypersensitive pneumonitis with their diagnostic criteria. Like EVALI, hypersensitive pneumonitis is difficult to recognize and diagnose by doctors, which is often associated with low awareness, as well as the absence of pathognomonic symptoms.

Electronic cigarettes and their impact on oral health - review

Nowadays, the popularity of e-cigarettes is growing rapidly. Manufacturers of e-cigarettes advertise them as a less harmful option than traditional cigarettes, suggesting that their use can help reduce nicotine dependence and reduce the risk of smoking-related diseases. However, studies indicate that inhaling the chemicals in liquids can carry serious health consequences, particularly concerning the oral cavity Many of these preparations contain substances about whose effects we do not yet know enough, which raises concerns among public health professionals. The aim of this study was to provide an overview of e-cigarettes, including their popularity, the origins of their development, the substances they contain and the impact they have on oral health, which is most at risk from the harmful effects of e-cigarettes.

Knowledge and Perceived Benefits of Electronic Cigarette Among Users In Klang Valley, Malaysia

Knowledge and Perceived Benefits of Electronic Cigarette Among Users In Klang Valley, Malaysia

E-Cigarette and Vaping Perspectives: Recommendations for Occupational Health Nurses.

Statistics from the Centers for Disease Control indicate that the use of e-cigarettes, vaping, and other electronic nicotine delivery systems (ENDS) are increasing although data on their safety is limited. While most employers ban smoking in the workplace, tobacco-free policies do not always extend specifically to e-cigarette products. An IRB approved exploratory, cross-sectional study was conducted to investigate occupational health professionals' (OHPs) knowledge of e-cigarettes, vaping and ENDS and the ability to create change in tobacco-free workplace policies. A 91-item electronic survey was sent via email to 3248 OHPs who were members of the American Association of Occupational Health Nurses. A total of 299 surveys were returned, but only 230 completed the entire survey. Of those who completed the entire survey, those with advanced education had higher attitude toward change summary scores (p = .043) and those with lower years of practicing had low scores for transformational leadership (p = .039). Approximately 40% of individuals did not have or were unsure that a tobacco-free program was in place that included e-cigarettes, but the majority (90%) perceived their organizational leaders as interested in safety changes. The majority of respondents understood the health issues inherent in e-cigarettes, were open to implementing policies that included e-cigarettes but needed education and both managerial and employee support to implement policy changes. OHPs are well positioned to be advocates for workplace education, policy development, and worker health promotion for smoking and vaping cessation by leading organizational change.

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

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

Food insecurity and substance use among young adults in the United States

PurposeThe purpose of this study was to examine the association between food insecurity and substance use among young adults aged 18–25 in the U.S. MethodsA cross-sectional online survey was completed by a diverse sample of 1024 young adults (50.2 % female; 62 % non-white; m age = 21.7[SD = 2.26]) between January–April 2022. Logistic regression analyses were used to examine the association between food insecurity and current cigarette use, Electronic Nicotine Delivery System (ENDS) use, cannabis use, alcohol use, and binge drinking controlling for socio-demographic and economic factors, mental health, and experiences of discrimination. ResultsNearly 70 % of participants reported being food insecure over the past year. Substance use was also common: 45.9 % of participants reported current cigarette use, 50.9 % ENDS use, 57 % cannabis use, 65.9 % alcohol use, and 50.4 % engaged in binge drinking in the past two weeks. Being food insecure was associated with greater odds of cigarette use (OR = 2.49, 95 % CI = [1.77, 3.50]), ENDS use (OR = 2.18, 95 % CI = [1.58, 3.01]), cannabis use (OR = 1.73, 95 % CI = [1.26, 2.37]), alcohol use (OR = 1.60, 95 % CI = [1.16, 2.19]) and binge drinking (OR = 1.98, 95 % CI = [1.44, 2.72]), controlling for all other factors. ConclusionFood insecurity may serve as an important indicator of substance use among young adults. Practitioners should consider screening for food insecurity, providing information about food access, and developing interventions to address food insecurity among the young adults with whom they work. Future research should examine these associations prospectively to better understand how food insecurity may contribute to the initiation and/or escalation of substance use.

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

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

Effects of Message Frames and Sources in TikTok Videos for Youth Vaping Cessation: Emotions and Perceived Message Effectiveness as Mediating Mechanisms

PurposeThe objective of this study was to evaluate the effect of message frames (gain vs. loss) and sources (formal expert: a health-care professional vs. informal expert: an individual who successfully quit vaping) on the persuasiveness of TikTok videos among youth who currently use e-cigarettes. Additionally, the study examined how emotional responses and perceived message effectiveness (PME) mediate the framing effect on youth intention to quit vaping. MethodsA 2 (gain frame vs. loss frame) × 2 (formal expert vs. informal expert) factorial design experiment was conducted with 378 youth aged 13 to 18 who currently use e-cigarettes. The study measured participant's emotional responses, PME of the messages, and intention to quit vaping after the video exposure. ResultsMessages from a formal expert resulted in stronger intention to quit vaping compared to messages from an informal expert. Gain-framed messages were associated with higher PME when delivered by an informal expert, whereas loss-framed messages showed stronger effects on PME from a formal expert. Positive emotional responses and increased PME mediated the relationship between gain-framed messages and youth intention to quit vaping. DiscussionTikTok could serve as an effective tool for formal experts to promote vaping cessation among youth who use e-cigarettes. Additionally, the findings suggest that gain frames may be more influential than loss frames in promoting vaping cessation among youth, by eliciting positive emotional responses from the audience. The differential impact of message frames depending on source type indicates a nuanced interaction between content and messenger.