Electronic Vaping Research Articles

Gambling in Connecticut adolescents: Prevalence, socio-demographic characteristics, trauma exposure, suicidality, and other risk behaviors

Adolescent gambling is a public health concern and has been linked to suicidality, various risk behaviors, and poor health outcomes. However, there is a limited understanding of specific risk and protective factors that may influence gambling behavior in Connecticut adolescents, especially in changing gambling environments. This study examines relationships between adolescents reporting gambling in the past-year and a range of health risk behaviors including vaping, traumatic experiences, academic performance, and receipt of social support. Data from the 2019 Youth Risk Behavior Survey in Connecticut high school students stratified by gambling status were examined in bivariate and multivariate analyses. Among 1,807 adolescents, past-year gambling was reported by 453 individuals [25.4%; 95% confidence interval [CI] = 22.7–28.1%]. Gambling prevalence was higher among older males and lower in adolescents of Asian origin. Gambling was further associated with suicidality and risk behaviors including substance use, smoking [traditional tobacco and electronic vapor use], risky use of digital technologies, unsafe sex, and aggressive behaviors. Gambling was also associated with traumatic experiences, depression/dysphoria, poor academic performance, and less familial social support. The results provide an up-to-date estimate of the current prevalence and correlates of gambling among Connecticut adolescents. The results provide recent estimates of the prevalence and correlates of gambling among Connecticut adolescents. The findings highlight the need for further investigation of specific factors like social support that help with designing and implementing tailored interventions.

The Intersectionality Between Bi and Multiracial College Students' Self-identification and Their Behaviors-A Pilot Study.

Due to limited information and published research, health disparities among bi and multiracial (B/MR) groups are not as understood as other racial groups. Without this knowledge and ability to allocate resources as needed, this is another racial group that could suffer from poorer health outcomes. As a result, participants (n = 15) were placed in focus groups or individual interviews with ten qualitative questions. Each participant then completed an anonymous quantitative survey assessing their health-related behaviors. Quantitative results included 40% (n = 6) of participants who tried cigarettes, 53% (n = 8) who tried electronic vapor products, and only 20% (n = 3) of participants who got the recommended hours of sleep nightly. Qualitative results include themes of situational identity, White assimilation, and pressure to explain their identity. Many participants dealt with the insensitivity that one side of their family exhibited towards the other side of their identity through inappropriate jokes and comments. Lastly, there were expectations from both family and friends to act a certain way. Researchers identified three major categories that the participant's influences fell into. Genetics, Culture/Heritage, and the Environment are the aforementioned categories that can work together or stand alone to influence behaviors that can ultimately affect health outcomes. While these results are based on a small sample size (n = 15) of undergraduate B/MR students, it does suggest that researchers should complete a more extensive survey on this racial group to verify these findings.

The effect of heated tobacco products on metabolic syndrome: A cohort study.

Evidence concerning the health effects of using heated tobacco products is needed. The aim of the present study is to investigate the effects of conventional cigarettes (CCs), electronic vaping cigarettes (EVCs), and heated tobacco products (HTPs) on the development of metabolic syndrome. We conducted a cohort study in South Korea using data from the Korea Medical Institute. The study included 183870 people who visited the Korea Medical Institute, responded to a smoking status questionnaire in 2019, and were followed up in 2020 - ever and current use of CCs, EVCs, and HTPs. We defined the main outcome as incident metabolic syndrome among participants with at least two health checkups separated by a follow-up period of at least a year. The association of using HTPs with risk for metabolic syndrome was estimated after controlling for age, sex, exercise, drinking history, and smoking regular cigarettes and using EVCs, with the Cox proportional hazards model. The risk of incident metabolic syndrome was increased by 68% (HR=1.68; 95% CI: 1.25-2.26) for current HTP users compared to never users. Among HTP users who did not currently smoke conventional cigarettes, the risk was doubled (HR=2.17; 95% CI: 1.31-3.62) when their smoking duration was ≥3 years. The risk of metabolic syndrome increased by 33% (HR=1.33; CI: 1.18-1.49) among HTP users who used them more than 16 times a day. The use of HTP was found to increase the risk of developing metabolic syndrome, with a particularly elevated risk observed among those who used HTPs for more than three years. The risk was higher than that observed in conventional cigarette users. Our findings indicate that HTP use poses comparable risks in relation to metabolic syndrome development.

Impact of electronic cigarette vaping on the cardiovascular function in young and old rats

BackgroundWhile the acute exposure to electronic cigarette (E-cig) vapor has been associated with an increase in blood pressure, the chronic effect of E-cig vapor on blood pressure compared to standard cigarette smoke has not been extensively studied. We determined the effect of E-cig exposure on blood pressure and other measures of cardiac function in both young and old rats.MethodsYoung Sprague Dawley rats (6 weeks old, both sexes) were randomly exposed to air (n = 34), E-cig with nicotine (E-cig Nic+; n = 30), E-cig without nicotine (E-cig Nic-; n = 28) or standard cigarette smoke (n = 27). Old Fischer 344 rats (25 months old, both sexes) were randomized into 2 groups: (1) 26 rats in the purified air (negative control) group and (2) 17 rats in the electronic cigarette vapor plus nicotine group (E-cig Nic+). After 12 weeks of exposure, hemodynamics were determined by Millar catheter, echocardiography, and thermodilution catheter, a few days after their last exposure.ResultsIn young rats, cigarette smoke was associated with higher systolic, diastolic and mean blood pressures and peak LV systolic pressure, compared to air or E-cig Nic + or E-cig Nic- groups. Neither fractional shortening nor cardiac output differed among the groups. Absolute value for dp/dt min, a measure of diastolic LV function, was lowest in the E-cig Nic- group. Tau, a measure of LV relaxation was worse in this group as well. In old rats, E-cig vaping did not change heart rate, blood pressure, and cardiac function. However, E-cig Nic + exposure was associated with a greater heart weight/BW and LV weight/BW compared to air exposure in old rats.ConclusionsChronic exposure to E-cig vaping did not cause an increase in blood pressure or heart rate, nor did it change cardiac function compared to air in young rats after 12 weeks of exposure, while standard cigarette smoking was associated with an increase in blood pressure. E-cig vaping was associated with a greater heart weight/BW and LV weight/BW compared to air exposure in old rats, suggested that older animals might be more vulnerable to E-cig stimulus than younger ones.

Adult Caretaker Engagement and School Connectedness and Association with Substance Use, Indicators of Emotional Well-Being and Suicide Risk, and Experiences with Violence Among American Indian or Alaska Native High School Students - Youth Risk Behavior Survey, United States, 2023.

The strength of American Indian and Alaska Native (AI/AN) communities comes from generations of Indigenous traditions, language, culture, and knowledge. These strengths have been challenged by a complex set of systemic, structural, and social factors related to historical and intergenerational trauma that affects the health of AI/AN communities. Furthermore, AI/AN population health data often are inaccurate because of analytic coding practices that do not account for multiracial and ethnic AI/AN identification and inadequate because of statistical suppression. The 2023 national Youth Risk Behavior Survey included a supplemental sample of AI/AN high school students. Coding of race and ethnicity was inclusive of all AI/AN students, even if they also identified as another race or as Hispanic or Latino, providing comprehensive data on health behaviors and experiences among AI/AN high school students nationwide. Adult caretaker engagement and school connectedness and their association with 13 health behaviors and experiences were examined, including five types of current substance use, four indicators of emotional well-being and suicide risk, and four types of violence. Pairwise t-tests and adjusted prevalence ratios from logistic regression models identified significant associations between exposure and outcome variables. Among AI/AN students, having an adult who always tried to meet their basic needs, high parental monitoring, and high school connectedness were associated with lower prevalence of certain measures of substance use, poor emotional well-being and suicide risk, and violence. Compared with non-AI/AN students, the prevalence of current electronic vapor product use, current marijuana use, attempted suicide, and experience of sexual violence was higher among AI/AN students.This report presents the most comprehensive, up-to-date data on substance use, indicators of emotional well-being and suicide risk, and experiences with violence among AI/AN high school students nationwide. The findings suggest the importance of engaged household adults and school connectedness in promoting emotional well-being and preventing substance use, suicide-related behavior, and experiences of violence among AI/AN students. Understanding the historical context and incorporating Indigenous knowledge when developing interventions focused on AI/AN youths are critical to ensure such interventions are successful in improving AI/AN health and well-being.

Association between adverse childhood experiences and current use of e-cigarettes or electronic vaping products across sex race ethnicity and age based on 2020–2022 BRFSS data

IntroductionThe use of e-cigarettes or other electronic vaping products (EOEVP) has been on the rise since their introduction. Concurrently, Adverse Childhood Experiences (ACEs) have been linked to various negative behavioral health outcomes. We explore the association between ACEs and current EOEVP use, with a focus on variations across sex, race/ethnicity, and age.MethodsUtilizing data from the Behavioral Risk Factor Surveillance System (BRFSS) for 2020–2022, we analyzed responses from 202,126 adults in the United States in a cross-sectional study. Multivariable logistic regression models were used to evaluate the adjusted odds ratios (aORs) of current EOEVP use for different levels of ACEs. Stratified and interaction analyses were used to examine potential effect modification.ResultsAmong adults 54 years of age and younger, even a lower number of ACEs [1 (aOR 1.52), 2 (aOR 2.01), and 3 (aOR 1.51)] was associated with higher odds of current EOEVP use. Stratified analyses revealed significant differences in the odds of current EOEVP use among Non-Hispanic White adults between 1 ACE (95% CI 1.75–2.28) and 4 ACEs (2.34–3.17). Hispanic adults with ≥ 1 ACEs (p-value 0.001) and 8 ACEs (p-value 0.005) showed strong associations compared to Non-Hispanic White adults. The influence of ACEs on current EOEVP use was observed to decrease with age, particularly in older adults with fewer ACEs. The aORs did not very by sex.ConclusionThe findings emphasize the importance of considering any number of ACEs in public health strategies targeting current EOEVP use, especially among younger adults and specific minority groups. These insights are crucial for tailoring interventions and policies to address the nuanced impacts of early life adversities on health risk behaviors.

Effects of racial teasing on adolescent marijuana use and nicotine vaping: An analysis of the Virginia Youth Risk Behavior Surveillance System

BackgroundDespite adverse effects of tobacco and marijuana use on the adolescent brain, its use among youth remains high. Previous research shows associations between bullying and risks of substance use; less is known about racial teasing. This study examines associations of racial teasing, marijuana and/or electronic vapor products (EVP) use among adolescents, using 2021 Virginia Youth Risk Behavior Surveillance System (VYRBSS). MethodsVYRBSS is a self-reported survey which collects information on experiences with racial teasing and substance use. This analysis included 3,083 high school students ≥ 12 years old. Descriptive analysis and logistic regression models were performed for categorical variables. Multivariable models were adjusted for confounders. ResultsRacial teasing was associated with marijuana (AOR 1.89; CI 1.43–2.48) and EVP use (AOR 2.52; CI 1.91–3.31). Compared to Whites; Asians, Blacks, and Latinos were more likely to report racial teasing. Older heterosexual females reported higher use of marijuana and EVP. Blacks reported greater use of marijuana, whereas Whites were more likely to use EVP. EVP use was higher in females (AOR 1.73, CI 1.34–2.23), bisexual youth (AOR 1.68, CI 1.23, 2.30) and poor mental health (AOR 1.49, CI 1.16, 1.92). Marijuana use was associated with bisexuality (AOR 1.75, CI 1.28–2.39) and poor mental health (AOR 1.62, CI 1.27–2.07) as well. ConclusionsEvery effort should be made by public health professionals in Virginia to prevent racial teasing among adolescents because it increases the odds of substance use, particularly in older females, youth who identify as bisexual, and those reporting poor mental health.

Adverse Cardiovascular Effects of Nicotine Delivered by Chronic Electronic Cigarettes or Standard Cigarettes Captured by Cardiovascular Intrinsic Frequencies.

Electronic cigarettes have gained popularity as a nicotine delivery system, which has been recommended by some as an aid to help people quit traditional smoking. The potential long-term effects of vaping on the cardiovascular system, as well as how their effects compare with those from standard cigarettes, are not well understood. The intrinsic frequency (IF) method is a systems approach for analysis of left ventricle and arterial function. Recent clinical studies have demonstrated the diagnostic and prognostic value of IF. Here, we aim to determine whether the novel IF metrics derived from carotid pressure waveforms can detect effects of nicotine (delivered by chronic exposure to electronic cigarette vapor or traditional cigarette smoke) on the cardiovascular system. One hundred seventeen healthy adult male and female rats were exposed to purified air (control), electronic cigarette vapor without nicotine, electronic cigarette vapor with nicotine, and traditional nicotine-rich cigarette smoke, after which hemodynamics were comprehensively evaluated. IF metrics were computed from invasive carotid pressure waveforms. Standard cigarettes significantly increased the first IF (indicating left ventricle contractile dysfunction). Electronic cigarettes with nicotine significantly reduced the second IF (indicating adverse effects on vascular function). No significant difference was seen in the IF metrics between controls and electronic cigarettes without nicotine. Exposure to electronic cigarettes with nicotine significantly increased the total IF variation (suggesting adverse effects on left ventricle-arterial coupling and its optimal state), when compared with electronic cigarettes without nicotine. Our IF results suggest that nicotine-containing electronic cigarettes adversely affect vascular function and left ventricle-arterial coupling, whereas standard cigarettes have an adverse effect on left ventricle function.

Cannabis Use and Associated Risk Behavior Factors among High School Students in Mississippi: Youth Risk Behavior Surveillance System 2021.

Cannabis is the most used illicit drug among youths in the United States. The objectives of this study were to identify the association between cannabis use and other risk behaviors, including suicidality, among high school students. This is a cross-sectional study using the 2021 Mississippi Youth Risk Behavior Surveillance System (YRBS). The 2021 YRBS data sets were combined for this study. The crude odds ratio (OR) and adjusted odds ratio (AOR) with a 95% confidence interval were generated using the survey packages in R to account for weights and the complex sampling design of the YRBS data. Univariate analysis identified seven risky behaviors that were significantly associated with current cannabis use, including carrying weapons on school campuses, suicidal attempts, electronic vapor use, current smoking, current drinking, sexual behaviors, and unsupervised children. In multivariable analysis, after adjusting for gender, race, students' grades, and other risky behaviors, statistically significant variables for cannabis use included current use of electronic vapor, current smoking, current drinking, and sexual behaviors. Cannabis use is evenly burdened between males and females and between all race categories among Mississippi high school students. The identified associations seem to indicate that electronic vapor, tobacco products, and alcohol use could be the forerunners for drug use and should be treated accordingly in drug use prevention programs.

Programmable Graphene e-Nose Sensor Arrays for Fast, Sensitive, and Label-Free Identification of Chemical Vapors

Conventional nanoelectronic chemical vapor sensors are mostly based on charge transfer mechanisms. The presence of vapor molecules interacts with the sensing material, resulting in changes in charge density in the channel; the resulting conductance change can subsequently be detected as changes in the current signals. This charge transfer-based mechanism naturally requires strong molecule-sensor interaction in order to achieve high sensitivity. However, the strong binding of analytes to the sensor surface will inevitably lead to slow response time and slow sensor recovery, making it unsuitable for applications requiring rapid monitoring of chemical vapors.To address this challenge, our groups previously demonstrated a new type of fast, sensitive, and broad-spectrum electronic vapor sensor by exploiting the fringing field capacitance effect in the graphene field-effect transistor (GFET). The typically trivial fringing field capacitance change due to analyte absorption is greatly amplified by both the graphene transistor and a micro-flow channel covering the surface of graphene. Different from the charge-transfer process in traditional sensors, when molecules of analytes flow through the surface of the graphene transistor, its local dielectric environment is altered which results in changes in the fringing capacitance. This molecular fringing gate effect can be amplified intrinsically by the large transconductance of the GFET. Instead of using AC spectroscopy, this capacitance change can be measured conveniently as a peak in DC current.1 In this work, a programmable graphene e-nose sensor array with electrical gates design and enhanced packaging will be demonstrated to achieve true label-free sensing and identification of chemical vapors. Individual graphene sensors within the 1D sensor array (up to 1 x 9) can be optimized to offer sensitive (down to picogram) and fast (sub-second) detection toward a variety of analytes. Figure 1 demonstrates the prototype of the graphene sensor array. Each sensor chip consists of two parts: an array of nine GFETs with a dimension of 15mm by 15mm (Figure 1(A)), and a 40cm long micro-column chip with a column width of 20-60 μm fabricated on a silicon wafer with 200nm of SiO2 by using DRIE (Deep Reactive Ion Etching) (Figure 1(B)). These two components were then bonded by epoxy and the assembled sensor chip is shown in Figure 1(C). The graphene transistor array was fabricated by transferring CVD graphene onto a silicon substrate with 200nm of thermally grown SiO2. Individual gold metal back gates were fabricated underneath the graphene film with 200nm Al2O3 deposited by ALD (atomic layer deposition) as the gate dielectric. Devices with single or multi-layer (up to 4 layers) graphene films were fabricated and tested.The fabricated graphene sensors have near-perfect device yield and a resistance range within 2 ~ 10 kΩ. Figure 1(D) and 1(E) shows the DC current signal changes of a typical sensor within the array when vapor-phase analytes of different masses were injected through a benchtop gas chromatography (GC) setup. 9 ng and 6 ng of Hexanal injection generated current peaks with peak heights of 0.8 μA and 0.5 μA, and peak width (full width at half maximum) of 1.8 seconds and 2 seconds, respectively. The high signal-to-noise ratio (~ 80 to 1) and the short response time demonstrate the high sensitivity and fast detection capability of the graphene sensor. Figure 1(E) shows a detailed sensitivity test from the injections of hexanal vapor of five different masses. The graphene sensor exhibits good linearity with a sensitivity of 79nA per nanogram of Hexanal and a 3σ detection limit of 380 picograms.We further tested the electrical gate tunability of the graphene sensor’s response. In order to eliminate the effect of graphene conductance modulation by the gate voltage, we normalize the peak height with the baseline current. As shown in Figure 1(F), when the gate voltage is programmed from -10V to +10V, the hexanal peak height is strengthened by approximately 30 percent. Similar gate voltage tuning is also observed on other analytes, such as acetone and hexanol.Our results clearly show the gate voltage tunability of the graphene sensor, suggesting a novel graphene sensor array using electrical programming rather than chemical functionalization to achieve selectivity. Combined with advanced data analysis tools, the graphene e-nose array has the potential to offer label-free chemical vapor sensing without the need to individually functionalize each sensor as in traditional e-nose devices. Furthermore, we will discuss the integration of the graphene e-nose sensor array with a micro-gas chromatography chip and a smartphone-sized custom PCB board for programming, readout, and Bluetooth data communication. W. Zang et al., Nano Lett., 21, 10301–10308 (2021). Figure 1

Cytotoxic impact of nicotine products on periodontal ligament cells

ObjectivesThe primary objective of this in vitro experiment was an assessment of proliferative capacity, metabolic activity, and potential cellular detriment of human periodontal ligament cells (hPDL) exposed to cigarette smoke (CS), electronic cigarette vapor (eCV), and heated tobacco product aerosol (HTP), or air (control).Materials and methodsUsing a CAD/CAM-designed exposition chamber, hPDL were exposed to CS, eCV, HTP, or air (control) based on the Health Canada Intense Smoking Regime. Cell proliferation, metabolic activity, and cellular detriment were assessed at various time points.ResultsCompared to the control, hPDL exposed to CS exhibited significantly decreased cell numbers at all time points. HTP exposure led to reduced cell numbers 48 h and 72 h post-exposure, while eCV-exposed cells showed no significant decrease. The metabolic activity of eCV-treated hPDL was slightly reduced at 7 h but recovered at 24 h and 48 h. In contrast, CS-treated cells exhibited significantly decreased metabolic activity at 24 h and 48 h, and HTP-exposed cells showed a significant decrease after 48 h. Flow cytometry indicated both apoptotic and necrotic cell death following CS exposure, with necrotic cell death being more pronounced.ConclusionseCV and HTP demonstrated comparatively reduced detrimental effects on hPDL compared to CS.Clinical relevance: The findings suggest that conventional cigarette smoke poses a substantial risk to periodontal health by significantly impairing cell proliferation and metabolic activity. However, alternatives such as eCV and HTP may offer a comparatively reduced risk.

An Internet Snapshot Survey Assessing the sale of Synthetic Cannabinoid Receptor Agonists for use with Electronic Vaping Devices

IntroductionSynthetic cannabinoid receptor agonists (SCRAs) are associated with significant toxicity and are increasingly used in electronic vaping devices. We assessed the availability of SCRA vaping products to UK purchasers on the surface web.MethodsAn internet snapshot survey was performed between October 2022 and January 2023 on ‘google.com’ using the search terms “buy c-liquid vape”, “buy herbal incense vape liquid”, “buy cannabis vape liquid”, “buy hashish vape liquid”, “buy K2 vape liquid”.Results62 websites selling 128 SCRA vaping brands were identified. Most were purportedly based in the USA (41 websites, 66%) and most sold other controlled substances. Purchase incentives offered included discreet packaging (38, 61%), discounts for bulk purchase (34, 55%) and tracked delivery (30, 48%). Many websites stated SCRA products were: not for human consumption (41, 66%), for research purposes only (15, 24%), or legal (28, 45%). Websites sold a median (IQR) of 16 (7–25) SCRA vaping brands. Almost all were bottles of vaping liquid (1220/1225, 99.6%). The most common bottle size was 5mL (60%), the median (IQR) total volume of SCRA liquid per sale was 50mL (10–200mL). Median (IQR) price was £3.39/mL (£2.01/mL– £5.29/mL). Price decreased with increasing volume purchased (£6.58/mL for ≤ 5mL, £1.60/mL for > 200mL).ConclusionSCRA vaping products are easily obtainable online, in both small and bulk quantities. Information provided to purchasers on safety and legality is lacking or misleading. Further studies are needed to confirm the chemistry of these products. Policymakers should consider steps to limit the potential harm caused by the purchase and use of these products.

Health literacy and adolescents' substance use behaviors and correlates: a scoping review.

From 2011 to 2023, substance use increased by 23% worldwide. Given that substance use initiation is highest during adolescence, it is crucial to identify amenable correlates of substance use prevention [e.g. health literacy (HL)], which, if embedded in interventions, may improve uptake and outcomes. Hence, this study conducted a scoping review to answer the question: What is known from the existing literature about the relationship between HL and substance use correlates and behaviors in adolescents? Five electronic databases and the bibliography of review articles were searched and a total of 1770 records were identified. After removing duplicates and engaging in three levels of screening to identify studies that included adolescents ≤ 25 years old and assessed the relationship between general HL (vs. behavior/disease-specific health knowledge) and substance use behaviors and correlates, 16 studies were retained. Studies assessed alcohol-related (n = 11), tobacco-related (n = 12), electronic vapor product use-related (n = 4), cannabis-related (n = 1), and amphetamines/methamphetamines-related (n = 1) outcomes. Studies spanned Africa, Asia, Europe, and North and Central America. Most studies included substance use as an outcome and found an inverse relationship between HL and use. Few studies examined substance use correlates (e.g. risk perception). There were no longitudinal or intervention studies. This review highlighted that the topic of adolescent HL and its relationship with substance use remains inadequately researched. Notable gaps for future studies include intervention and longitudinal designs, expansion of outcomes (e.g. more studies on marijuana, prescription drug misuse, vaping, substance use-related correlates), and examining HL as a mediator or moderator of substance use and its correlates.

Food insecurity and use of electronic vapor products among high school students.

Background: Studies have shown that food insecurity is associated with electronic vapor products (EVP) use in adults; however, an understanding of this relationship in adolescents is needed to inform prevention efforts in this age group. Aim: Examine the relationship of food insecurity with EVP use patterns, frequency and source of acquisition in high school students. Methods: This cross-sectional study used Youth Risk Behavior Survey (YRBS) 2019 data from states that incorporated the YRBS' optional food insecurity question. The data included 42,154 high school students with complete information on food insecurity and two EVP-related questions. Responses to EVP-related questions identified "ever users," "current users," "former users," "current dual EVP-cigarette users," and assessed "frequency of EVP use among current users" and "source of EVP acquisition." Logistic regression examined associations of food insecurity with EVP-related outcomes. Results: The proportion of high school students who ever used EVP was 48.3% and the proportion of food-insecure students was about 12%. Food security status significantly differed by race/ethnicity of students, such that the proportion of food insecure students classified as "non-Hispanic White" was lower than the proportion of food secure students classified as "non-Hispanic White." Food insecurity was significantly associated with greater odds of ever EVP use (odds ratio (OR) = 1.75; 95% confidence interval (CI) = (1.55, 1.96)), current EVP use (OR = 2.07; 95% CI = (1.80, 2.37); using never users as reference category) and current dual use of EVP and cigarettes (OR = 2.91; 95% CI = (2.38, 3.55)). Food insecurity also was associated with greater odds of current EVP use (OR = 1.54; 95% CI = (1.28, 1.84)) when former users were used as reference category. In current users, food insecurity was related to greater odds of daily EVP use (OR = 1.40; 95% CI = (1.14, 1.70)) compared to occasional use. Conclusions: Study findings imply that efforts targeting prevention/cessation of EVP use should consider reducing food insecurity in high school students.

Sex and Racial/Ethnic Patterns of Tobacco Product Use Among Students at a U.S. University in 2021–2023

Background : Although the prevalence of conventional tobacco product use among U.S. college students has declined, an increasing number of students use various novel tobacco products. Objectives : This study aims to examine up-to-date sex and racial/ethnic patterns of tobacco use among students at a U.S. university in 2021–2023. Methods : Data of 2,732 students at an urban university in the Southeast of the U.S. were collected in 2021–2023 as part of the National College Health Assessment of the American College Health Association. Self-reported past 3-month use of five tobacco products (cigarette, electronic vapor products, water pipe/hookah, smokeless tobacco, and cigars) was dichotomized. We conducted multinomial logistic regression analysis to examine sex (male or female) and racial/ethnic (non-Hispanic White, non-Hispanic Black, Hispanic, or non-Hispanic Other) differences in single and dual/poly (con-current use of two or more tobacco products) tobacco use compared to nonuse, adjusting for age, student status, parent education level, obese status, psychological distress level, and survey year. Results : Male students had higher odds of being dual/poly tobacco user than female students, adjusting for covariates (adjusted odds ratio [AOR] = 2.00, 95% confidence interval [CI] = 1.42, 2.82). Non-Hispanic Black students had lower odds of being single (AOR = 0.43, 95% CI = 0.26, 0.69) and dual/poly (AOR = 0.09, 95% CI = 0.02, 0.37) tobacco user compared to non-Hispanic White students, adjusting for covariates. Conclusions : Considering higher health risk of con-current use of multiple tobacco products, dual/poly tobacco use prevention strategies targeting male and non-Hispanic White students may be considered.

Adaptation and Validation of the Hooked on Nicotine Checklist (HONC) with Spanish Adolescents

IntroductionThe expansion of new tobacco consumption formats and electronic vapor products threatens to reverse the trend of declining smoking rates that had been observed among younger people in recent decades. Early detection in the health sector requires screening tools that have been adapted and validated in our context. This study aims to translate, culturally adapt, pilot and empirically validate the Hooked on Nicotine Checklist (HONC) with Spanish adolescents. MethodsThe process of translation and cultural adaptation included the following stages: direct translation, synthesis of translations, back translation, consolidation with a committee of experts and pre-test, along with a cognitive interview, which served as pilot testing. Empirical validation was conducted with a sample of 1027 adolescents aged between 12 and 18 (M=15.40; SD=1.638). ResultsThe results obtained confirm that the HONC is a brief, clear and easy-to-understand tool, with appropriate psychometric properties. A Cronbach's alpha value of 0.90 was obtained. Sensitivity, specificity, PPV and NPV indices reached values of 0.56, 0.94, 0.79 and 0.83, respectively. Cut-off point 1 is the one reaching the best balance between the two values. CFA showed a model good overall fit. ConclusionThis study makes the Spanish version of the HONC available to researchers and clinicians, so that it can be used with sufficient psychometric guarantees.

Chemical Composition of Electronic Vaping Products From School Grounds in California.

The use of electronic vaping products (EVPs) containing nicotine, marijuana, and/or other substances remains prominent among youth; with EVPs containing nicotine being the most commonly used tobacco product among youth since 2014. However, a detailed understanding of the chemical composition of these products is limited. From February 25th to March 15th, 2019, a total of 576 EVPs, including 233 e-cigarette devices (with 43 disposable vape pens) and 343 e-liquid cartridges/pods/bottled e-liquids, were found or confiscated from a convenience sample of 16 public high schools in California. Liquids inside 251 vape pens and cartridges/pods/bottled e-liquids were analyzed using a gas chromatography/mass spectrometry (GC/MS). For comparison, new JUUL pods, the most commonly used e-cigarette among youth during 2018-2019, with different flavorings and nicotine content were purchased and analyzed. For e-cigarette cartridges/pods/bottled e-liquids, nicotine was detected in 204 of 208 (98.1%) samples. Propylene glycol and vegetable glycerin were dominant solvents in nicotine-containing EVPs. Among 43 disposable vape pen devices, cannabinoids such as tetrahydrocannabinol (THC) or cannabidiol (CBD) were identified in 39 of 43 (90.1%) samples, of which three contained both nicotine and THC. Differences in chemical compositions were observed between confiscated or collected JUULs and purchased JUULs. Measured nicotine was inconsistent with labels on some confiscated or collected bottled e-liquids. EVPs from 16 participating schools were found to widely contain substances with known adverse health effects among youth, including nicotine and cannabinoids. There was inconsistency between labeled and measured nicotine on the products from schools. This study measured the main chemical compositions of EVPs found at 16 California public high schools. Continued efforts are warranted, including at the school-level, to educate, prevent, and reduce youth use of EVPs.

Electronic vape fluid activates the pulmonary endothelium and disrupts vascular integrity in vitro through an ARF6-dependent pathway

The use of e-cigarettes or vapes is increasingly popular amongst a range of different demographics however the research in this area is surprisingly sparse. Clinical reports of e-cigarette- or vaping use-associated lung injury (EVALI) and vascular disruption, in both nicotine-containing and nicotine-free e-cigarette smokers, prompts the need for further research with a focus on the pulmonary endothelium. Using a common brand of e-cigarette (eVape) and an in vitro model of the human lung microvasculature, we investigated the effect of nicotine-free eVape fluid on pulmonary endothelial barrier integrity, oxidative stress and inflammation profile. Findings demonstrate reactive oxygen species-dependent breakdown of the pulmonary endothelium and release of inflammatory cytokines. These phenotypic changes, following exposure to nicotine-free eVape fluid, were accompanied by dysregulation of a number of adheren junctions-related genes of which ARF6 was most abundantly overexpressed. Further investigation of ARF6 identified it as a key regulator in eVape-induced barrier disruption and ROS accumulation. This study demonstrates, for the first time, the barrier disruptive effect of nicotine-free e-cigarette fluid on the pulmonary microvasculature and the ARF6 and ROS-dependent molecular mechanisms underlying this damage. Whilst these studies focus on a human in vitro model of the pulmonary microvasculature, the results support clinical case studies on EVALI and demonstrate a need for further investigation of the impact of nicotine-free e-cigarettes on the lung.

Electronic cigarettes for smoking cessation.

Electronic cigarettes for smoking cessation.

Inhalation of nicotine-containing electronic cigarette vapor exacerbates the features of COPD by inducing ferroptosis in βENaC-overexpressing mice.

Chronic obstructive pulmonary disease (COPD) is currently listed as the 3rd leading cause of death in the United States. Accumulating data shows the association between COPD occurrence and the usage of electronic nicotine delivery systems (ENDS) in patients. However, the underlying pathogenesis mechanisms of COPD have not been fully understood. In the current study, bENaC-overexpressing mice (bENaC mice) were subjected to whole-body ENDS exposure. COPD related features including emphysema, mucus accumulation, inflammation and fibrosis are examined by tissue staining, FACS analysis, cytokine measurement. Cell death and ferroptosis of alveolar epithelial cells were further evaluated by multiple assays including staining, FACS analysis and lipidomics. ENDS-exposed mice displayed enhanced emphysema and mucus accumulation, suggesting that ENDS exposure promotes COPD features. ENDS exposure also increased immune cell number infiltration in bronchoalveolar lavage and levels of multiple COPD-related cytokines in the lungs, including CCL2, IL-4, IL-13, IL-10, M-CSF, and TNF-α. Moreover, we observed increased fibrosis in ENDS-exposed mice, as evidenced by elevated collagen deposition and a-SMA+ myofibroblast accumulation. By investigating possible mechanisms for how ENDS promoted COPD, we demonstrated that ENDS exposure induced cell death of alveolar epithelial cells, evidenced by TUNEL staining and Annexin V/PI FACS analysis. Furthermore, we identified that ENDS exposure caused lipid dysregulations, including TAGs (9 species) and phospholipids (34 species). As most of these lipid species are highly associated with ferroptosis, we confirmed ENDS also enhanced ferroptosis marker CD71 in both type I and type II alveolar epithelial cells. Overall, our data revealed that ENDS exposure exacerbates features of COPD in bENaC mice including emphysema, mucus accumulation, abnormal lung inflammation, and fibrosis, which involves the effect of COPD development by inducing ferroptosis in the lung.