High Concentrations Of Nicotine Research Articles

What pharmacists need to know about vaping and vaping-related lung illness

Thousands of lung injuries and several deaths have prompted U.S. officials to urge Americans to stop using e-cigarettes, especially those that contain tetrahydrocannabinol (THC). While much is still unknown about vaping-related lung illness, here’s some information that will be useful to pharmacists who practice on the front lines or simply want to stay informed. CDC, FDA, and other medical organizations are urging the public to stop using e-cigarettes amid the growing number of lung injury reports and deaths from e-cigarettes. E-cigarette products are not regulated, and neither the devices nor the substances used in them are known to be safe. Pharmacists should advise individuals to refrain from using e-cigarette products at this time. According to Karen Hudmon, BSPharm, DrPH, pharmacists should be prepared to inform individuals about the signs and symptoms of acute vaping-related lung disease, which include cough, shortness of breath or chest pain, nausea, vomiting or diarrhea, and fatigue, fever, or abdominal pain. “Any patient who presents to the pharmacy with respiratory illness should be queried further,” said Hudmon, who is a professor of pharmacy practice at Purdue University College of Pharmacy in West Lafayette, IN. “Specifically, they should be asked about vaping and e-cigarette use or exposure within the last 90 days. In addition, patients who report vaping or e-cigarette use within the last 90 days should be asked if they are experiencing respiratory symptoms.” E-cigarette devices can be used for inhalation of a variety of substances, including THC—the psychoactive component of cannabis. It is estimated that nearly one in five teens who report having used e-cigarettes in the past also report having used an e-cigarette device to vape cannabis. They simply substitute the nicotine solution for THC or use both drugs simultaneously. Most patients who have become ill from vaping reported using THC. “Oftentimes, the cannabis products are also not regulated and could contain other harmful substances that, when inhaled, can cause damage,” said Michelle Chaplin, PharmD, BCACP, CDE, associate professor of pharmacy at Wingate University School of Pharmacy in North Carolina. “It is especially dangerous to combine unregulated products. Products that may be safe for ingestion or other use, such as vitamin E acetate, are potentially harmful when inhaled, and so at this time it is safest to not inhale these products.” When asking patients whether they smoke or use any form of e-cigarettes or vaping devices, Hudmon said that pharmacists have an opportunity to establish themselves as a resource for patients who are interested in quitting. The same evidence-based treatments used for tobacco smoking cessation, such as counseling from a health care provider and/or FDA-approved smoking cessation medications, can be used for patients trying to quit e-cigarettes. Chaplin said pharmacists are uniquely positioned within the community to assist patients with quitting. They can help adults who are using e-cigarettes as a tool to quit smoking to titrate off these products to reduce withdrawal symptoms, making them more comfortable while they are quitting. They can also help with behavioral changes to enhance their chances of quitting. “Based on some high nicotine content in e-cigarettes, it will be difficult for patients to stop using without assistance—similar to quitting cold turkey from cigarettes. To successfully avoid the products, patients will need help to quit and may need recommendations [on the use of medications for quitting],” Chaplin said.

Appeal of JUUL among adolescents

IntroductionJUUL is a closed-system e-cigarette that uses disposable pods with high concentrations of nicotine. JUUL use among youth arose exponentially since 2015, thus, it is essential to understand youths’ reasons for liking/disliking JUUL to inform the regulation of the product. MethodsA cross-sectional survey was conducted in 4 high schools in Connecticut in 2018 (N = 3170). The survey assessed JUUL use in the past month and reasons for liking/disliking JUUL, which included pharmacological effects (e.g., subjective nicotine and/or flavor effects), product characteristics (e.g., flavors, nicotine, shape), peer influence (e.g., friends’ use), comparisons to other e-cigarettes (e.g., lower harm), and concealability (e.g., hide from authority). Results30.2% (N = 956) were past-month users who used a JUUL on an average of 13.6 days (SD = 11.7; 25% reported daily use). The top reasons for liking JUUL were: “it gives me a buzz” (52%), “I like the flavors” (43%), and “my friends use it” (36%). The top reasons for disliking JUUL were: “the pods are expensive” (57%), “nicotine is too high” (20%), and “it gives me a headache” (18%). Regression models indicated that liking JUUL because of the buzz, ability to help concentrate, nicotine level, and ease of hiding it from teachers were associated with more days of use in the past month, while peer influence was negatively associated. Furthermore, disliking the high cost of pods was associated with more frequent use. ConclusionsComprehensive policies that regulate device characteristics that appeal to youth (e.g., nicotine level, flavors) are needed to prevent JUUL use among youth.

Nicotine arms race: JUUL and the high-nicotine product market

ObjectiveUntil recently, purveyors of vaping products marketed e-liquids in the 1%–3% range of nicotine concentration with those at 3% described as ‘super high’ intended for two packs/day smokers. The goal...

Prevalence and correlates of JUUL use among a national sample of youth and young adults

ObjectiveTo estimate the prevalence of JUUL use and identify demographic and psychosocial correlates of use among youth and young adults in the USA.MethodsA national, probability-based sample was recruited via address-based...

Ascorbic acid mitigates the deleterious effects of nicotine on tendon stem cells

ABSTRACT Purpose: Nicotine causes tendon degeneration, whereas ascorbic acid imparts beneficial effects on tendon cells. Tendon stem cells (TSCs) play a vital role in maintaining tissue integrity and promoting restoration of structure and function after tendon injury. In the present study, cell culture experiments were performed to determine the effects of nicotine on TSCs and whether ascorbic acid supplementation could antagonize the action of high concentration nicotine. Methods: After treatment with nicotine and ascorbic acid, TSC proliferation, migration, stemness, apoptosis, and differentiation were analyzed. Results: TSC proliferation and expression of stem cell markers were significantly impaired by a high concentration of nicotine (1000 ng/mL), but a lower concentration (100 ng/mL) induced proliferative effects in TSCs. Moreover, the highest concentration of nicotine tested (1000 ng/mL) significantly inhibited the migratory ability of TSCs, while relatively high concentrations (100 and 1000 ng/mL) significantly (p < 0.05) up-regulated non-tenocyte genes. When ascorbic acid was added, the inhibitory effects of nicotine on the proliferation, migration, and stemness of TSCs were reversed. In addition, flow cytometry analysis showed that these nicotine concentrations could induce cell apoptosis, while the addition of ascorbic acid inhibited apoptosis. Conclusion: Addition of ascorbic acid partially reversed the inhibitory effect of a high concentration of nicotine. These findings indicate that while nicotine impairs the biological characteristics of TSCs, ascorbic acid can mitigate these deleterious effects and, therefore, may be useful for decreasing nicotine-induced tendon degeneration.

Who is JUULing and Why? An Examination of Young Adult Electronic Nicotine Delivery Systems Users

PurposeThe purpose of this study was to compare characteristics of usual JUUL users versus other electronic nicotine delivery systems (ENDS) users, examine differences in reasons for use and perceptions across ENDS user groups, and identify significant correlates of usual JUUL use. MethodsThis study used data from 510 young adult ENDS users (ages 18–29 years) from Wave 7 (Spring 2018) of the Marketing and Promotions Across Colleges in Texas Project (Project M-PACT). Chi-Square analyses, independent t-tests, and mixed-effects logistic regression analyses were conducted to identify factors associated with usual JUUL use. Four separate regression analyses were conducted based on independent variables of interest; all models included demographics and ENDS/other tobacco use behaviors as covariates. ResultsCompared with other ENDS users, usual JUUL users were more likely to be male, younger, smoke cigarettes, reported a higher socioeconomic status (SES), used ENDS on more days in the past 30 days, and reported nicotine “hit” as a reason for use. Usual JUUL users had a higher prevalence of perceiving JUUL/pod vapes as addictive compared with other ENDS users, although perceived addictiveness was not significant in the multivariable models nor were the cessation and dependence measures different between ENDS user groups. ConclusionsResults highlight concerns about the dual use of JUUL and cigarettes and raise additional concerns about the high nicotine concentration of JUUL. Future longitudinal research is needed to determine if usual JUUL users are more likely to develop symptoms of nicotine dependence compared with other ENDS users.

I wake up and hit the JUUL: Analyzing Twitter for JUUL nicotine effects and dependence

BackgroundJUUL—a novel electronic nicotine delivery system (ENDS)—comprises most of the ENDS market share. Additionally, JUUL has a high nicotine content and utilizes a patented nicotine salt formulation aimed to speed absorption. Many JUUL users are not aware of the nicotine content and therefore may not be expecting acute nicotine effects or potential for dependence. This study sought to analyze Twitter messages (“tweets”) regarding nicotine, symptoms of dependence, and withdrawal related to JUUL use. MethodsData were collected from Twitter’s Filtered Streams interface 4/11–6/16/2018 by retrieving tweets matching the terms “juul,” “juuls,” and “juuling” that also used words consistent with nicotine effects, symptoms of dependence, and withdrawal. A random 5% subsample (n = 1986) was coded by 2 independent coders. Cohen’s κ for inter-rater reliability ranged 0.62–1.00 for all coded variables. Tweets were assessed using a qualitative content analysis approach. ResultsA total of 335 tweets mentioned dependence-related themes, including use upon waking and compulsion to use. A total of 189 tweets mentioned themes related to nicotine, with almost 15% of these tweets describing physical effects. Additionally, 42 tweets mentioned themes related to quitting JUUL and/or withdrawal from JUUL. DiscussionThis qualitative analysis suggests that users of JUUL are experiencing symptoms of nicotine exposure and dependence. Considering the high nicotine content of JUUL and the rising popularity among young people, more research around initiation of and dependence on JUUL, as well as the impact of recent FDA policy changes, should be conducted.

Adolescents’ awareness of the nicotine strength and e-cigarette status of JUUL e-cigarettes

BackgroundJUUL e-cigarettes are popular among youth. However, it is unknown whether adolescents understand that 5% JUUL pods contain a high nicotine concentration or consider JUULs to be e-cigarettes. Method3170 students from 4 Connecticut high schools completed a school-based survey (May–October 2018). Students reported on lifetime and past-month JUUL use and perceived JUUL nicotine strength (low/medium/high/don’t know) when no information about nicotine concentration was provided and, subsequently, when informed JUULs contain 5% nicotine. Students reported whether they believe JUULs are e-cigarettes (no/yes/don’t know). ResultsStudents were never JUUL users (56.6%), ever users (13.2%), and past-month users (30.2%). When no information was provided, students reported that JUULs contain low (10.5%), medium (26.9%), or high nicotine levels (31.1%); 31.4% did not know. When informed JUULs contain 5% nicotine, students were more likely to believe JUUL’s nicotine strength was low (29.5%) or medium (29.3%) than high (21.3%) and less likely to report not knowing (19.9%). 39% of students believed JUULs are not e-cigarettes or did not know. DiscussionMost students were unaware of JUUL’s high nicotine concentration, with more believing that JUULs contain low or medium nicotine concentrations when informed JUULs contain 5% nicotine. Thus, youth may misinterpret the nicotine concentration printed on JUUL pod packaging, raising concerns about inadvertent exposure to high nicotine levels and dependence risk. Further, 39% of adolescents believed JUULs are not e-cigarettes or were unsure. Regulatory efforts are needed to establish understandable nicotine concentration labels, require products to be labeled accordingly, and clarify what products constitute e-cigarettes.

Tobacco-product usage as a risk factor for dental implants.

The oral cavities of tobacco smokers and users of smokeless tobacco products are exposed to high concentrations of nicotine. A limited number of animal studies have assessed the effect of nicotine on osseointegration. Results from experimental studies have reported a statistically significant decrease, at 4weeks of follow-up, in bone-to-implant contact among rats exposed to nicotine compared with unexposed rats. Nicotine increases the production of inflammatory cytokines (such as interleukin-6 and tumor necrosis factor-alpha) by osteoblasts. Waterpipe, pipe, and cigarette smokers are at increased risk of developing oral cancer, periodontal disease, and alveolar bone loss. One explanation for this is that smokers (regardless of the type of tobacco product) are exposed to similar chemicals, such as nicotine, tar, oxidants, polyaromatic hydrocarbons, and carbon monoxide. Moreover, raised levels of proinflammatory cytokines have been identified in the gingival crevicular fluid of cigarette smokers with peri-implant diseases. Therefore, it is hypothesized that nicotine and chemicals in tobacco smoke induce a state of oxidative stress in peri-implant tissues (gingiva and alveolar bone), thereby increasing the likelihood of peri-implant disease development via an inflammatory response, which if left uncontrolled, will result in implant failure/loss. In this regard, tobacco smoking (including cigarettes, waterpipe, and pipe) is a significant risk factor for peri-implant diseases. The impact of vaping electronic cigarettes using nicotine-containing e-juices remains unknown. Habitual use of smokeless tobacco products is associated with oral inflammatory conditions, such as oral precancer, cancer, and periodontal disease. However, the effect of habitual use of smokeless tobacco products on the success and survival of dental implants remains undocumented.

Young adult dual combusted cigarette and e-cigarette users’ anticipated responses to hypothetical e-cigarette market restrictions

Introduction: The aim of this exploratory study was to assess young adult dual e-cigarette (EC) and combusted cigarette (CC) users’ anticipated responses to hypothetical market restrictions regarding key EC characteristics. Methods: Data came from 240 young adult dual EC and CC users recruited via Amazon Mechanical Turk in June 2017. Descriptive statistics were used to report sociodemographic, CC smoking, and EC use characteristics. McNemar’s chi-square tests and chi-square tests were used to assess differences between groups in terms of anticipated responses to hypothetical EC market restrictions. Results: Hypothetical regulations resulted in reported intentions to reduce EC use and increase CC use; the greatest impact was found for restrictions regarding e-liquid nicotine content, followed by flavor and ability to modify EC devices. Moreover, individuals reporting use of flavored e-liquid, high nicotine content e-liquid, and customizable EC were most likely to report intentions to reduce EC use and increase CC use. Conclusions: This work provides preliminary evidence that restrictive regulations regarding key EC characteristics may increase intentions to increase CC use among young adult dual EC and CC users.

Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys

ObjectiveTo examine differences in vaping and smoking prevalence among adolescents in Canada, England, and the United States.DesignRepeat cross sectional surveys.SettingOnline surveys in Canada, England, and the US.ParticipantsNational samples of 16...

Evidence of Nicotine Dependence in Adolescents Who Use Juul and Similar Pod Devices.

Background: The use of high-nicotine content e-cigarettes (so-called pods, such as Juul) among adolescents raises concerns about early onset of nicotine addiction. Methods: In this analysis of adolescents surveyed from April 2017–April 2018, we compare survey responses and urinary cotinine of pod vs. non-pod using past-week e-cigarette users aged 12–21. Results: More pod users categorized themselves as daily users compared to non-pod users (63.0% vs. 11.0%; p = 0.001); more pod than non-pod users had used e-cigarettes within the past day (76.2% vs. 29.6%; p = 0.001). More pod users responded affirmatively to nicotine dependence questions (21.4% vs. 7.1%; p = 0.04). Urinary cotinine levels were compared among those responding positively and negatively to dependence questions: those with positive responses had significantly higher urinary cotinine levels than those responding negatively. Conclusions: Adolescents who used pod products showed more signs of nicotine dependence than non-pod users. Pediatricians should be vigilant in identifying dependence symptoms in their patients who use e-cigarettes, particularly in those using pod devices.

The role of endogenous pituitary adenylyl cyclase activating polypeptide (PACAP) in nicotine self-administration, reward and aversion

Pituitary adenylyl cyclase activating polypeptide (PACAP) and its receptors (PAC1, VPAC1, and VPAC2) are localized in brain regions implicated in stress response, reward seeking and aversive responses, raising the possibility that PACAP may be involved in motivational effects of nicotine. To test this hypothesis, we used two-bottle choice (TBC) and place conditioning paradigms and assessed if nicotine preference or conditioned place preference (CPP) or aversion (CPA) induced by nicotine would be altered in mice lacking PACAP compared to their wild-type controls. In the TBC paradigm, mice had access to two water bottles during the first week and then one of the water bottles was switched to nicotine solution (20, 40 and then 80 μg/mL). The volume of water and nicotine consumed was measured every day. In the place conditioning paradigm, mice were tested for baseline place preference on day 1, received conditioning with saline versus a low (0.25) or high (1 mg/kg) dose nicotine and, respectively, tested for CPP or CPA 24 h following the last conditioning. We discovered that mice lacking PACAP compared to their wild-type controls exhibited more preference for nicotine over water in the TBC paradigm, particularly at the two higher concentrations of nicotine. While the rewarding action of the low dose nicotine was not altered in mice lacking PACAP, the aversive effect of the high dose nicotine was blunted in these mice compared to their wild-type controls. The present results suggest that endogenous PACAP may play a functional role in nicotine preference and its aversive effect.

Co-occurrence of functional modules derived from nicotine-degrading gene clusters confers additive effects in Pseudomonas sp. JY-Q.

Pseudomonas sp. JY-Q was isolated from nicotine-rich environment and could degrade and tolerate high-content nicotine. Its specific genetic architecture comprised duplicated homologous nicotine-degrading clusters for different functional modules on the whole pathway. Its adaptive and genomic properties caused our concern whether the duplicated homologous gene clusters confer additive effects on nicotine degradation and result in strain JY-Q strong capability. After deletion of representative genes from duplicated homologous gene clusters of upstream module Nic1, midstream module Spm, and downstream module Nic2, the nicotine degradation efficiency of the wild type and mutant strains were examined. As the first genes of clusters Nic1-1 and Nic1-2, nicA2 and nox are both involved in nicotine degradation, but nox exhibited more contribution to nicotine metabolism due to the higher transcriptional amount of nox than that of nicA2. Likewise, the sub-clusters spm1 and spm2 showed additive effect on nicotine metabolism. As two hpo-like genes of clusters Nic2-1 and Nic2-2, hpo1, and hpo2 also showed additive effect on the nicotine degrading, but hpo1 provided more contribution than hpo2. The third hpo-like gene in cluster NA (nicotinic acid degrading), nicX is not necessary for 2,5-dihydroxypyridine transformation when hpo1 and hpo2 exist. A variety of transposases and integrases observed around Nic1 and Nic2 cluster genes suggests that the duplicated genes could evolve from horizontal gene transfer (HGT)-related dissemination. This study provide an insight into a novel adaptability mechanism of strains in extreme environment such as high nicotine concentration, and potential novel targets to enhance strain synthesis/degradation ability for future applications.

GC-MS Analysis and Cytotoxicity Evaluation of Shammah (Smokeless Tobacco) Samples of Jazan Region of Saudi Arabia as Promoter of Cancer Cell Proliferation

Shammah is a locally manufactured form of smokeless tobacco (ST) which is traditionally used in Middle Eastern countries including Saudi Arabia, Sudan, and Yemen. Presence of a high concentration of nicotine, in addition to various other toxic and carcinogenic constituents, makes it a serious human health threat. It is an admixture containing powdered tobacco, along with several additives, such as lime, ash, black pepper, volatile oils, and flavoring agents. This study was conducted to investigate the constituents of eight different samples of widely used shammah varieties in the Jazan region of Saudi Arabia using GC-MS and to evaluate their cytotoxic effect against three cancer cell lines representing most of the top malignancies in the region including MCF-7, A2780, and HT29 cancer cells, in addition to MRC5 cells (normal human fetal lung fibroblast) using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. GC-MS analysis showed the presence of nicotine or 3-(1-methyl-2-pyrrolidinyl)pyridine (2.1–91.9% of total constituents detected) in all ST samples, whereas its derivative (1s,2s)-nicotine-N-oxide (0.23–1.62%) was detected in four samples. In addition, several known carcinogenic constituents were also identified, and their carcinogenicity was confirmed by MTT results, in which, all the eight samples promoted the growth of MCF7, A2780, and HT29 cancer cells. The cytotoxic effects of samples against the normal cells MRC5 was proportional to the number of components detected by GC-MS. The ingestion of these constituents through saliva of shammah consumers could be the reason for many cancers including breast, ovary, and colon cancers. These results support the urgent local and international call to educate the users regarding the deleterious effects of shammah to avoid its use.

Vaping Condensate Exposure to in vitro Mouse Embryos

ObjectiveTo clarify effects of electronic cigarette carrier fluid and high nicotine concentrations on embryonic development to reduce misconceptions about vaping during pregnancy.MethodsWith a vacuum, vapor condensate was collected from a glass‐bead‐filled, copper coil submerged in ice. Recovered condensate was injected into the intraperitoneal cavity of female mice prior to hormonally induced superovulation/mating. Daily injections of condensate allowed male and female gametes as well as embryos to be exposed to the condensate. With 3 injections per day, mice were divided into control (no injections) and 3 experimental groups. Experimental groups received: 1) vaped saline; 2) vaped carrier fluid (CF); 3) or vaped 1.2% nicotine/CF. Injected volume was 0.1 mL of fluid/dose. The basis for this injection volume was based on recent literature demonstrating how vaping for 5 minutes produces up to 7.9 ng of nicotine/mL +/− 0.9 ng of blood in humans [Farsalinos et al., 2015]. Mathematically, the predetermined volume of 0.1 mL/injection of our 1.2% nicotine/CF was diluted to 1% and resulted in a blood nicotine concentration of 8.2 ng/mL based on an average mouse weight of 25 g with a blood volume of approximately 1.7 mL.ResultsThe results of our data were based on normal survival rate on a day‐6 embryo defined as embryo growth progressing to hatching or hatched blastocyst stage of development. Differences in embryo survival due to treatment were determined using ANOVA with a Least Significant Difference post hoc analysis using SPSS. Our results showed significant difference between the control group and 1.2 % nicotine group (P&lt;0.007) as well as difference between the control group and carrier fluid group (P&lt;0.049). The saline group was not significantly different from the control group.ConclusionsThese results indicate that vaping both CF and 1.2% nicotine/CF prove to be detrimental to normal embryo development, demonstrating the need for additional research into the potentially harmful effects of vaping CF, with or without nicotine.Support or Funding InformationLUCOM Center for ResearchThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Endotoxin and [Formula: see text] Contamination in Electronic Cigarette Products Sold in the United States.

Background:Cigarette smoke contains microbes and microbial toxins, such as endotoxin and , that may have adverse respiratory effects. To our knowledge, the potential for contamination of electronic cigarette (EC) products sold in the United States has not been investigated.Objectives:We aimed to determine whether popular cartridge and e-liquid EC products were contaminated with endotoxin or glucan and to examine differences according to the type and flavor of products.Methods:We selected 37 cartridges and 38 e-liquid products with the highest nicotine content from the ten top-selling U.S. brands. Flavors were classified into four groups: tobacco, menthol, fruit, and other. Endotoxin and glucan were measured using an endotoxin-specific kinetic turbidimetric assay and a Glucatell® Kinetic Assay (Associates of Cape Cod, Inc.), respectively.Results:Endotoxin concentrations were over the limit of detection (LOD) in 17 of 75 products tested (23%), and glucan concentrations were greater than LOD in 61 of 75 products (81%). After adjusting for brand and flavor, the mean glucan concentration was 3.2 times higher [95% confidence interval (CI): , 18.4] in cartridge vs. e-liquid samples. After adjusting for brand and type of product, glucan concentrations in tobacco- and menthol-flavored ECs were 10.4 (95% CI: 1.8, 44.9) and 3.5 (95% CI: 0.1, 17.3) times higher than concentrations found in fruit-flavored products.Conclusions:EC products may be contaminated with microbial toxins. Further studies with large representative samples of products are needed to confirm our findings, identify sources and routes of contamination, and evaluate health effects associated with the use of contaminated products. https://doi.org/10.1289/EHP3469

Pharmacokinetic Profile of Spectrum Reduced Nicotine Cigarettes.

Spectrum research cigarettes have been developed with varying nicotine content for use in studies evaluating the effects of a regulatory policy reducing the permissible nicotine content in cigarettes. This study aimed to characterize the nicotine pharmacokinetic profile of Spectrum cigarettes. Twelve daily smokers attended four sessions and had blood nicotine, exhaled carbon monoxide, and subjective effects measured before and after smoking either a single cigarette of their preferred brand or high (10.9 mg/cigarette), medium (3.2 mg/cigarette), or low (0.2 mg/cigarette) nicotine content Spectrum research cigarettes, in a double-blind design with order counterbalanced. The boost in blood nicotine concentration was dose-dependent, with a boost of 0.3, 3.9, and 17.3 ng/mL for low-, medium-, and high-nicotine content Spectrum cigarettes. The high dose Spectrum had a similar nicotine boost to the "preferred brand" cigarettes (19 ng/mL). Subjects took longer puffs on the low nicotine cigarettes, but smoked these cigarettes faster than other cigarette types. High nicotine Spectrum cigarettes reduced the urge to smoke more than other cigarette types. This study shows that Spectrum research cigarettes produce blood nicotine absorption in a dose-dependent manner, and therefore, are appropriate for use in studies of nicotine reduction in cigarettes. This is the first study to determine the pharmacokinetic profile of Spectrum reduced nicotine content research cigarettes following an overnight abstinence. These data could provide evidence to regulatory agencies about the effects of reduced nicotine cigarettes when considering regulations on tobacco reduction.

The Determinants of Salivary Cotinine Concentration in Smokeless Tobacco Users.

BACKGROUND:Smokeless tobacco products due to their high nicotine content are highly addictive and ultimately lead to an increased risk of oral cavity, laryngeal and oesophagal cancer.AIM:This research was conducted with the aim of assessing the relationship between the salivary cotinine concentration and demographic characteristics and smokeless tobacco use for the first time in tradespeople in Chabahar, Iran.METHODS:This descriptive cross-sectional study was conducted on 150 different tradespeople using smokeless tobacco in Chabahar who were selected through simple random sampling in 2018. In addition to the salivary cotinine measurement, data were collected using a researcher-made questionnaire with demographic and behavioural items. The data obtained were analysed in SPSS-16 using descriptive and inferential statistics.RESULTS:The mean salivary cotinine score was 887.7 ± 180.7 in men and 611.2 ± 139.7 in women, making for a significant intergroup difference (P = 0.043). The mean salivary cotinine score was higher in those who used two or more smokeless tobacco products compared to those who used one type of tobacco, and a significant difference was observed between the type of smokeless tobacco used and the salivary cotinine score in the participants (P = 0.005).CONCLUSION:Based on the results of the regression analysis, the type of smokeless tobacco used was a strong predictor of the concentration of salivary cotinine in the participants. It is, therefore, necessary for the government to adopt appropriate policies and take educational measures to reduce the vending and use of these substances.

Effect of nicotine on biofilm formation of Streptococcus mutans isolates from smoking and non-smoking subjects

ABSTRACTObjectives: To investigate effects of nicotine on biofilm formation of Streptococcus mutans isolates from oral washes of smoker and non-smoker human subjects.Materials and methods: This study was conducted using 60 S. mutans isolates with three S. mutans isolates collected from oral washes of ten smoking subjects and ten from non-smoking subjects. Biofilm was formed by culturing each S. mutans strain (10 μl) in 190 μl of TSB supplemented with 1% sucrose (TSBS) containing 0, 0.25, 0.5, 1.0, 2.0, 4.0, 8.0, 16.0, and 32.0 mg/ml of nicotine for 24 h in 5% CO2 at 37°C in 96 well microtiter plates. The absorbance values of biofilm were measured at 490 nm in a microplate spectrophotometer.Results: There was a significant effect (p-value < 0.05) of nicotine concentrations and smoking on the growth of biofilm, planktonic cells, and total absorbance, for all strains of S. mutans. Isolates from smokers had significantly more biofilm at 0–16 mg/ml of nicotine compared to those from non-smokers (p-value < 0.0001).Conclusion: S. mutans smoker isolates are more affected by high nicotine concentrations than non-smoker isolates.Clinical Relevance: The use of nicotine products increases the growth of S. mutans and may place tobacco users at risk for dental decay.