E-cigarettes Research Articles

Identifying Predictors of Smoking Switching Behaviours Among Adult Smokers in the United States: A Machine Learning Approach.

Completely abstaining from cigarette smoking or fully switching to e-cigarette (EC) use may be beneficial for reducing the global burden of smoking-related diseases. This study aimed to identify and compare the top 10 prospective predictors of smokers switching away from smoking in the United States. Data from adult exclusive cigarette smokers at Wave 4 of the Population Assessment of Tobacco and Health (PATH) study, who were followed up at Wave 6, were analysed. An Xgboost-based machine learning (ML) approach with a nested cross-validation scheme was utilised to develop a multiclass predictive model to classify smokers' behavioural changes from W4 to W6, including smoking cessation, full and partial switching to EC, and cigarette non-switching. The SHapley Additive exPlanations (SHAP) algorithm was deployed to interpret the top 10 predictors of each switching behaviour. A total of 396 variables were selectedto generate the four-class prediction model, which demonstrated a micro- and macro-average area under the receiver operating characteristics curve (ROC-AUC) of 0.91 and 0.81, respectively. The topthreepredictors of smoking cessation were prior regular EC use, age, and household rules about non-combusted tobacco. Forfull switching to EC use, the leading predictorswere age, type of living space, and frequency of social media visits. Forpartial switching to EC use, the key predictorswere dailycigaretteconsumption, the time from waking up to smoking the first cigarette, and living with tobacco users. ML is a promising techniqueforprovidingcomprehensive insights into predicting smokers' behavioural changes. Public health interventions aimed athelping adults switch away from smoking should consider the predictors identified in this study.

Use of cannabis among youth who vape nicotine

BackgroundYouth e-cigarette use remains a public health concern and many youth want to quit. However, cannabis use is common among youth who use e-cigarettes, which may interfere with nicotine cessation efforts. This study aimed to investigate cannabis use among youth who vape nicotine and are motivated to quit nicotine. MethodsConnecticut youth (N=223, Mage = 17.3 [SD=1.7] years) who completed an intake for a vaping cessation study reported on their nicotine vaping, cannabis products used, reasons for use, frequency of use, and readiness to quit cannabis. Descriptives characterized population. Regressions were used to examine association of cannabis use and nicotine vaping. ResultsMost reported cannabis use (lifetime: 92.4 %; past-month: 68.6 %). Cannabis smoking and vaping were highly prevalent (smoking: lifetime − 90.8 %, current − 63.6 %; vaping: lifetime − 90.8 %, current − 63.1 %). Most reported preferring smoking cannabis (58.7 %) over other routes of administration. Common reasons for cannabis use, were psychoactive (e.g., getting high), physical (e.g., improving sleep), and social (e.g., partying). Cannabis use frequency and preferring smoking cannabis (vs. other modes) was positively associated with more frequent nicotine vaping (ps < 0.05). Participants averaged 6.3 (of 10) on a readiness to quit cannabis scale, a moderate desire to quit. ConclusionsCannabis use across multiple routes of administration was common among youth seeking help quitting vaping nicotine. Heaviness of cannabis and nicotine use appear to be associated, raising interesting harm-reduction challenges for those seeking to quit nicotine vaping. Understanding cannabis and nicotine co-use is important for targeting treatment for use of both substances.

P01-33 Toxicity induced by cigarette smoke and electronic cigarette aerosols

P01-33 Toxicity induced by cigarette smoke and electronic cigarette aerosols

Perception of Ain Shams University Students Related to Electronic Cigarette Smoking

Perception of Ain Shams University Students Related to Electronic Cigarette Smoking

Perceptions Regarding the Use of E-cigarettes Among Smokers in Saudi Arabia.

Background Adults and young people selectelectronic cigarettes (ECs) due to their perceived lower risk compared to traditional combustible cigarettes. Objective This study aimed to measure the perceptions of the use of electronic cigarettes as a smoking cessation tool among the population of Saudi Arabia. Methods Between October 2023 and November 2023, we conducted a cross-sectional study of Saudi Arabia's general population over prominent social media platforms. We strictly adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines to reportour results. Results Of the 376 total participants, the majority (89.6%) were male, with a median age of 35 years, and 96.3% were of Saudi nationality. Nearly half (47.3%) held Bachelor's degrees. Approximately 55.6% reported having previously attempted to quit smoking on multiple occasions. The predominant method for quitting was the use of ECs, which was reported by 88.7% of the participants. Nearly two-thirds (70%) perceived ECs as an effective cessation tool. Among those who had used EC to quit smoking, 62.5% had succeeded, while one-third (37.5%) were unsuccessful. The most frequently reported side effects were sore throat, changes in appetite, and headache, each of which affected ~50% of the participants. Conclusion This study highlights the complex relationship between ECuse and smoking cessation among Saudi Arabian smokers. Although many users perceive ECs as effective cessation tools, their actual success rates in terms of long-term abstinence from smoking are questionable.

Determination of four tobacco-specific nitrosamines in electronic cigarette liquids and aerosols by UPLC-QTOF-HRMS

To elucidate the concentrations of four tobacco-specific nitrosamines (TSNAs) in commercial e-cigarettes, analyze the correlation between TSNAs and Nicotine, and clarify the main sources of TSNAs in e-cigarettes. Ultra-high performance liquid chromatography with quadrupole time-of-flight high-resolution mass spectrometry (UPLC-QTOF-HRMS) was employed to determine the concentrations of four TSNAs in thirty-two commercially available e-cigarettes. The results demonstrated that the method exhibits excellent linearity and high mass accuracy. The limits of quantification (LOQ) of four TSNAs in e-cigarettes were 0.0010 –0.0165 (e-liquids) and 0.0032–0.0554 (aerosols) ng·g−1. The limits of detection (LOD) of four TSNAs in e-cigarettes were 0.0011–0.0165 (e-liquids) and 0.0033–0.0537 (aerosols) ng·20 puffs−1. The recovery of four TSNAs ranged from 73.06 % to 109.95 %. The e-liquids contained: 0–33.970 (NNN), 0.063–15.654 (NNK), 0–10.033 (NAT), and 0–0.251 (NAB) ng·g−1. The aerosols contained: 0–60.662 (NNN), 0.021–9.435 (NNK), 0.202– 29.866 (NAT), and 0–2.841 (NAB) ng·20 puffs−1. The correlation analysis results have shown that there was no significant correlation between the concentrations of four TSNAs and nicotine in e-cigarettes. The concentrations of four TSNAs in e-liquid containing tobacco extract were significantly higher than that in e-liquid without tobacco extract, suggested that the main source of TSNAs was tobacco extract. This method is fast, simple, highly sensitive, and has low detection limits. The approach taken can provide data support for the actual supervision of e-cigarettes, and evaluation of safety components, contributing to effective quality evaluation systems.

Exclusive and dual use of electronic cigarettes among European youth in 32 countries with different regulatory landscapes

BackgroundThe Tobacco Products Directive (2014/40/EU) partially harmonised the regulation of electronic cigarettes (e-cigarettes) in Europe, but individual countries maintain jurisdiction over bans on use in public places, domestic advertising, taxation...

Applications of an Electrochemical Sensory Array Coupled with Chemometric Modeling for Electronic Cigarettes.

This study investigates the application of an eNose (electrochemical sensory array) device as a rapid and cost-effective screening tool to detect increasingly prevalent counterfeit electronic cigarettes, and those to which potentially hazardous excipients such as vitamin E acetate (VEA) have been added, without the need to generate and test the aerosol such products are intended to emit. A portable, in-field screening tool would also allow government officials to swiftly identify adulterated electronic cigarette e-liquids containing illicit flavorings such as menthol. Our approach involved developing canonical discriminant analysis (CDA) models to differentiate formulation components, including e-liquid bases and nicotine, which the eNose accurately identified. Additionally, models were created using e-liquid bases adulterated with menthol and VEA. The eNose and CDA model correctly identified menthol-containing e-liquids in all instances but were only able to identify VEA in 66.6% of cases. To demonstrate the applicability of this model to a commercial product, a Virginia Tobacco JUUL product was adulterated with menthol and VEA. A CDA model was constructed and, when tested against the prediction set, it was able to identify samples adulterated with menthol 91.6% of the time and those containing VEA in 75% of attempts. To test the ability of this approach to distinguish commercial e-liquid brands, a model using six commercial products was generated and tested against randomized samples on the same day as model creation. The CDA model had a cross-validation of 91.7%. When randomized samples were presented to the model on different days, cross-validation fell to 41.7%, suggesting that interday variability was problematic. However, a subsequently developed support vector machine (SVM) identification algorithm was deployed, increasing the cross-validation to 84.7%. A prediction set was challenged against this model, yielding an accuracy of 94.4%. Altered Elf Bar and Hyde IQ formulations were used to simulate counterfeit products, and in all cases, the brand identification model did not classify these samples as their reference product. This study demonstrates the eNose's capability to distinguish between various odors emitted from e-liquids, highlighting its potential to identify counterfeit and adulterated products in the field without the need to generate and test the aerosol emitted from an electronic cigarette.

E-cigarettes and social media: prevalence of fact or “fake”?

As a useful product for overcoming the addiction to smoking present in society, the electronic cigarette (EC) was presented as a less harmful alternative. Thus, it is assumed that social networks are a means of influence for the population, including YouTube as a means of propagandizing the use of ECs. To this end, 161 videos from the YouTube platform that refer to ECs were analyzed, of which 37 were in favor of their use, 28 neutral and 96 against; of the total views, 45% of the videos were in favor of using CE, 16% against, and 39% neutral; as for graduation, of the videos in favor of the use of ECs, only 2.7% have a degree in higher education, while of those who were neutral 39.28% have it, and of those against the use, 70.83% had higher education; As for the propagation rate, 44.18% were in favor of the use, 16.48% against and 39.34% with a neutral opinion. Thus, it is concluded that regardless of the veracity of the information transmitted, it is propagated by social networks, especially those with questionable veracity, which have a high rate of propagation; a fact that ratifies the public's tendency to consume content that confirms their ideas and supports their positions, which includes the theme of ECs.

A Study on the Relationship between Liquid Electronic Cigarette Use and Allergic Rhinitis in South Korean Adolescents

A Study on the Relationship between Liquid Electronic Cigarette Use and Allergic Rhinitis in South Korean Adolescents

The Attitudes of South African Respiratory Physicians towards the Use of Electronic Cigarettes as Smoking Cessation Adjuncts

The Attitudes of South African Respiratory Physicians towards the Use of Electronic Cigarettes as Smoking Cessation Adjuncts

Impact of electronic nicotine delivery systems (ENDS) on fetal outcomes: A systematic review and meta-analysis

Impact of electronic nicotine delivery systems (ENDS) on fetal outcomes: A systematic review and meta-analysis

E-Cigarettes induce expression of procoagulant tissue factor in cultivated human endothelial cells.

E-cigarettes (ECIG) are proposed as an alternative for regular tobacco users with less dangerous effects for health. Several studies demonstrated that ECIG exert deleterious cardiovascular effects and promote platelet dependent thrombosis. However, ECIG role on Tissue Factor-dependent thrombosis is still unknown. Dysfunctional endothelial cells (ECs) are known to express Tissue Factor (TF) on their surface. Aim of the present study was to investigate whether ECIG might promote TF expression in ECs, shifting them to a pro thrombotic phenotype. Human Umbilical Vein Endothelial Cells (HUVEC) were incubated with increasing doses of ECIG (commercially available and mix of propylene glycol/vegetable glycerine/nicotine 18mg/mL) up to 1.8mg/mL. TF gene expression and protein levels were assessed at different time points by Real Time PCR and Western Blot, respectively. TF surface expression and activity were also measured by FACS analysis and coagulation assay. Finally, NF-kB translocation was investigated as possible mechanism of action. Potential protective effects by Rosuvastatin were also investigated. ECIG significantly increased TF expression at both gene and protein levels in a time and dose dependent manner. Surface expression and procoagulant activity were increased as well. These phenomena appeared modulated by the NF-κB pathway. Rosuvastatin reduced ECIG effects on TF-mRNA. Although in vitro, we indicate that ECIG promote a pro thrombotic phenotype in ECs via expression of functional TF. Data of the present study permit to shed a brighter light on the still partially unresolved issue about the role of ECIG in development of cardiovascular diseases suggesting that they might represent a potential risk factor for thrombotic cardiovascular events.

Rethinking rural: Public health advocates' views on ENDS cessation for young adults in rural areas.

Electronic nicotine delivery systems (ENDS, commonly referred to as e-cigarettes), have become popular among young adults (YAs, 18-24 years) in the United States. YAs in rural areas increasingly consume more ENDS than those in urban areas. However, there is a knowledge gap regarding the perspectives of public health advocates (PHAs) on ENDS use and cessation among YAs in rural areas. The objectives of the study are to describe the perspectives of PHAs and identify strategies to strengthen the capacity for promoting the cessation of ENDS among YAs in rural communities. A qualitative study and interpretive description were used with semi-structured interviews. The content analysis was used to analyze the data. Twenty-two PHAs, including public health officers, nurses, and tobacco-free educators, from Wisconsin, Minnesota, and North Dakota, were invited to the semi-structured interviews. Four themes emerged: (a) Perceived ENDS use and cessation; (b) rural contexts and infrastructure influencing ENDS use; (c) essential public health responsibilities controlling ENDS use in rural areas; and (d) regulating ENDS use: Policies and law. PHAs stressed the importance of increased awareness of ENDS use in YAs, improved regulation, and tailored policies to tackle rural communities' distinct challenges. The study emphasizes the urgency for specialized programs to aid YAs in quitting ENDS in rural areas. A comprehensive strategy is needed to effectively address ENDS use among YAs in rural areas, involving education, policy adjustments, and community-based initiatives.

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

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

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.

Contingent Effects of E-Cigarette Warning Label Messages on Cognitive Elaboration and Fear Among U.S. Youth Ages 14-17 by Vaping Experience and Peer Vaping Behavior.

The U.S. Food and Drug Administration (FDA) currently requires a warning about the addictive nature of nicotine to be placed on electronic cigarette advertisements and packaging. To consider the value of additional warning messages on public health outcomes, this study examines the additive effect of new warnings that are based on recent claims from U.S. federal authorities. We conducted a secondary analysis of recent data from 1,202 U.S. youth ages 14-17 to test the impact of exposure to additional warnings placed on advertisements for vaping products on cognitive elaboration, fear, and willingness to vape and smoke. This investigation also looked closely at effects on youth who may have increased risk of future vaping due to prior vaping experiences or having friends who vape. Exposure to the alternative warnings did not amplify cognitive elaboration compared to the current FDA warning alone, but it did increase fear. Youth elaboration on both the benefits and risks of vaping was associated with willingness to both vape and smoke, but fear was not associated with either outcome. The effects of warning label exposure and cognitive elaboration varied by prior vaping experience and having at least one friend who vapes. We conclude by discussing the implications of this contingent pattern of effect and association.

Association of conventional and electronic cigarette use with suicidality in Chinese adolescents: The moderating effect of sex and school type

BackgroundTo estimate the prevalence of lifetime e-cigarette use and explore the association between lifetime conventional and electronic cigarette use with suicidality among Chinese adolescents, focusing on sex and school-type differences. MethodsA total of 22,509 students from 432 classes in 80 schools were recruited in Guangdong Province using a multistage, stratified cluster, random sampling method in 2021. Self-report questionnaires were used to collect information. Multivariable logistic regression models were performed and stratification analysis was conducted. All analyses were weighted and adjusted for the complex survey design. ResultsThe weighted prevalence of lifetime e-cigarette use among adolescents in Guangdong Province was 8.7 % (4.3 % were dual users and 4.4 % were e-cigarette-only users) and 2.6 % were conventional-cigarette-only users. Lifetime e-cigarette-only users (AOR [Adjusted OR] =1.46, 95 % CI = 1.21–1.76), conventional-cigarette-only users (AOR = 1.97, 95 % CI = 1.58–2.46) and dual users (AOR = 1.67, 95 % CI = 1.38–2.02) were at a higher risk of suicidal ideation than non-users. Lifetime e-cigarette-only users (AOR = 2.03, 95 % CI = 1.53–2.70), conventional-cigarette-only users (AOR = 1.97, 95 % CI = 1.42–2.73), and dual users (AOR = 2.76, 95 % CI = 2.10–3.61) had a significantly higher risk of suicide attempts than non-users. After further analysis stratified by sex and school type, the associations of lifetime cigarette use patterns with suicidality slightly varied. LimitationThe cross-sectional study design and self-report information. ConclusionThe prevalence of e-cigarettes among Chinese adolescents is concerning. Lifetime conventional and e-cigarette use were associated with suicidality among Chinese adolescents, with sex and school type moderating these associations. Targeted measures to restrict cigarette use, including new tobacco product (e-cigarette) use, among adolescents are warranted.

Kick Vaping: Feasibility, acceptability, and preliminary impact of a vaping cessation text messaging intervention for Latino young adults

Objective To assess the feasibility, acceptability, and preliminary impact of Kick Vaping among Latino young adults. Methods Forty Latino young adults (ages 18 to 25) who were currently vaping received Kick Vaping, a vaping cessation text messaging intervention available in English and Spanish. Feasibility was measured by the eligibility, enrollment, and follow-up rates. Acceptability was measured by overall satisfaction with the intervention. Preliminary impact was measured by self-reported 7-day point prevalence abstinence and changes in self-efficacy. Results Two hundred three individuals were identified, 61 were assessed for eligibility, and 55 were eligible. Forty individuals consented to participate and were enrolled in Kick Vaping. At baseline, most participants used disposable devices (70%), vaped daily (97.5%), had low (37.5%) or medium (35.0%) e-cigarette dependence, and had attempted to quit in the past year (72.5%). At Month 3, the follow-up rate was 90% (36/40). Treating those lost to follow-up as participants who continued vaping, 75% (30/40) of participants self-reported 7-day point prevalence abstinence. Self-efficacy mean scores significantly increased from 30.65 (SD 8.07) at baseline to 50.11 (SD 10.57) at follow-up (p < 0.01). Most participants (88.9%, 32/36) reported being satisfied/extremely satisfied with Kick Vaping. Conclusion It is feasible to recruit and retain Latino young adults in a vaping cessation text messaging intervention. Kick Vaping generated high satisfaction among Latino young adults, significantly increased self-efficacy, and resulted in a notable vaping cessation rate at Month 3. Additional testing in a randomized controlled trial is warranted to assess the efficacy of the intervention.

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

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