Impact Of E-cigarette Use Research Articles

Causal Inference with Complex Surveys: A Unified Perspective on Sample Selection and Exposure Selection

Probability surveys are a major source of population representative data for policy research and program evaluation. However, the data come with the added complications of being observational and selected with unequal probabilities. Propensity score adjustments have become increasingly popular for inferring causal relationships in non-randomized studies, but when using survey data, estimates of the population level causal effect may be biased if the sampling design is not adequately adjusted for. The current practice of using propensity score estimators with complex surveys is somewhat ad-hoc. We propose a potential-outcome super-population framework to streamline the causal analysis. We also develop propensity-score-and-survey weighted estimators and corresponding variance estimators, as well as their asymptotic properties. Our framework clarifies the confusion regarding the use of survey weighted propensity score in practice. The choice actually depends on the available sampling weights. Various estimators are compared in a simulation study, which shows that the proposed estimators perform better than the competing methods in terms of bias and confidence interval coverage when treatment effects are heterogeneous. To address an important public health issue, we evaluate the impact of e-cigarette use on future tobacco use intention in teens, using a large nationally representative survey in the United States.

B cell immune repertoire sequencing in tobacco cigarette smoking, vaping, and chronic obstructive pulmonary disease in the COPDGene cohort.

Cigarette smoking (CS) impairs B cell function and antibody production, increasing infection risk. The impact of e-cigarette use ('vaping') and combined CS and vaping ('dual-use') on B cell activity is unclear. To examine B cell receptor sequencing (BCR-seq) profiles associated with CS, vaping, dual-use, COPD-related outcomes, and demographic factors. BCR-seq was performed on blood RNA samples from 234 participants in the COPDGene study. We assessed multivariable associations of B cell function measures (immunoglobulin heavy chain (IGH) subclass expression and usage, class-switching, V-segment usage, and clonal expansion) with CS, vaping, dual-use, COPD severity, age, sex, and race. We adjusted for multiple comparisons using the Benjamini-Hochberg method, identifying significant associations at 5% FDR and suggestive associations at 10% FDR. Among 234 non-Hispanic white (NHW) and African American (AA) participants, CS and dual-use were significantly positively associated with increased secretory IgA production, with dual-use showing the strongest associations. Dual-use was positively associated with class switching and B cell clonal expansion, indicating increased B cell activation, with similar trends in those only smoking or only vaping. We observed significant associations between race and IgG antibody usage. AA participants had higher IgG subclass proportions and lower IgM usage compared to NHW participants. CS and vaping additively enhance B cell activation, most notably in dual-users. Self-reported race was strongly associated with IgG isotype usage. These findings highlight associations between B cell activation and antibody transcription, suggesting potential differences in immune and vaccine responses linked to CS, vaping, and race.

Single-cell transcriptomics reveals e-cigarette vapor-induced airway epithelial remodeling and injury

BackgroundIn recent years, e-cigarettes have been used as alternatives among adult smokers. However, the impact of e-cigarette use on human bronchial epithelial (HBE) cells remains controversial.MethodsWe collected primary HBE cells of healthy nonsmokers and chronic obstructive pulmonary disease (COPD) smokers, and analyzed the impact of e- cigarette vapor extract (ECE) or cigarette smoke extract (CSE) on HBE cell differentiation and injury by single-cell RNA sequencing, immunostaining, HE staining, qPCR and ELISA. We obtained serum and sputum from healthy non- smokers, smokers and e-cigarette users, and analyzed cell injury markers and mucin proteins.ResultsECE treatment led to a distinct differentiation program of ciliated cells and unique patterns of their cell–cell communications compared with CSE. ECE treatment caused increased Notch signaling strength in a ciliated cell subpopulation, and HBE cell remodeling and injury including hypoplasia of ciliated cells and club cells, and shorter cilia. ECE-induced hypoplasia of ciliated cells and shorter cilia were ameliorated by the Notch signaling inhibition.ConclusionsThis study reveals distinct characteristics in e-cigarette vapor-induced airway epithelial remodeling, pointing to Notch signaling pathway as a potential targeted intervention for e-cigarette vapor-caused ciliated cell differentiation defects and cilia injury. In addition, a decrease in SCGB1A1 proteins is associated with e- cigarette users, indicating a potential lung injury marker for e-cigarette users.

Knowledge, Attitudes, and Practices of University Students Regarding the Impact of Smokeless Tobacco, Areca Nut, E-cigarette Use on Oral Health.

The prevalence of smokeless tobacco, areca nut, and e-cigarette use among university students has raised concerns regarding their potential impact on oral health. Assessing students' knowledge, attitudes, and practices toward these substances is necessary. Understanding these factors can inform targeted interventions and policies promoting oral health among this population. This study aims to investigate the awareness levels, attitudes, and behaviors of university students regarding smokeless tobacco, areca nut, and e-cigarette use and their potential effects on oral health. Identifying gaps in knowledge and misconceptions will help guide educational initiatives and public health interventions tailored to the needs of university students. The study employed a designed questionnaire, comprising 20 closed-ended queries, administered via the Google Forms platform. This survey was disseminated among college students in Chennai to gather insights for the study. Of the 500 college students included in the study, almost 85.5% (427) were aware of the harmful effects of smokeless tobacco on oral health. Additionally, 74.6% (373) recognized that chewing areca nut contributes to poor oral health, while 59.8% (299) acknowledged the negative impact of e-cigarette use. The present study concluded that 11.1% (6) used smokeless tobacco, 18.9% (94) chewed areca nut, and 1.9% (10) used areca nut along with tobacco. Regarding e-cigarettes, 3.9% (19) indulged in vaping as a substitute for smoking regular cigarettes and 12.1% (61) used it along with tobacco cigarettes. It was also noted that 27.8% (139) were trying to quit and 12.6% (63) have tried but could not succeed. Therefore, although there was awareness of the ill effects of these deleterious habits on oral health and the increased risk of oral cancer, there remains a need to educate individuals and provide support for quitting these habits. Our study will provide insights into the present scenario of the awareness of the association between oral health and tobacco/areca nut consumption among college students in Chennai city.

Association Between E-Cigarettes, Cognition and Mood in Adolescents

Objective Research has indicated potentially neutral or even positive cognitive effects of e-cigarette usage in adults, but whether these findings extend to adolescents remains uncertain. This study aimed to examine the interplay between e-cigarette use, mind wandering and self-efficacy, and mood. Method The responses of 432 adolescents aged 11-18 years from an online survey were analyzed. Among them, 88 adolescents had used e-cigarettes. Results Adolescents who have used e-cigarettes reported poorer academic self-efficacy, t (430) = 3.26, 95% CI [1.12, 4.51], p < 0.001; greater mind-wandering tendencies t(430) = −3.38, 95% CI [-4.14, −1.10], p < 0.001; and greater severity of depression, t(430) = −3.38, p < 0.001, anxiety t(430) = −2.67, p = 0.01, and stress t(430) = −3.32, p < .001. Increased frequency of e-cigarette use was also associated with attitudes toward e-cigarette use, r (86) = 0.31, p = 0.003 and lower academic self-efficacy, r (86) = −0.27, p = .010. However, there was no significant correlation between frequency of use and mind-wandering. Further network analysis suggested negative relationships between frequency of e-cigarette use, academic self-efficacy and mind-wandering. Conclusion Our findings suggest a potential adverse impact of e-cigarette use on mind-wandering and academic confidence among adolescents. However, the direct or indirect relationship between e-cigarette use and these effects could not be definitively determined due to the cross-sectional survey design employed in our study. Nonetheless, our findings underscore the importance of considering developmental differences and the unique vulnerabilities of adolescents when assessing the impact of e-cigarette use.

Chronic e-cigarette use in young adults is associated with reduced cardiopulmonary function at rest and during exercise

E-cigarette aerosols produce contaminant particles that have the potential to impair cardiopulmonary function. However, the current understanding of the impact of e-cigarette use on cardiopulmonary function remains inconclusive. Exercise represents a stress on the cardiopulmonary system and may help identify cardiopulmonary dysfunction in chronic e-cigarette users. Consequently, the purpose of this study was to investigate if e-cigarette users exhibit cardiopulmonary abnormalities under physiological stress of exercise. To further investigate pulmonary vascular responses, the secondary purpose of the study was to examine how diffusing capacity (DLCO), pulmonary capillary blood volume (VC), and membrane diffusing capacity (DM) respond to positional changes, as the transition from the upright to supine position should increase DLCO, VC, and DM, secondarily to increased perfusion pressure. We hypothesized that e-cigarette users would exhibit impaired cardiopulmonary function during exercise and reduced pulmonary vascular responsiveness to postural changes. Six chronic e-cigarette (e-cig) users (age: 24±5yrs, 5±2 years of e-cigarette use) with &lt;5 pack years of traditional cigarette smoking history and six non-smoking controls who were age-, height-, and sex-matched completed two experimental trials. Day 1: Pulmonary function test and cardiopulmonary exercise test. Day 2: multiple fraction of inspired oxygen DLCO technique to quantify DLCO, VC, and DM at rest in the upright and supine positions. Resting pulmonary function was not significantly different between groups. The change in DLCO from upright to supine was significantly lower in e-cig users compared to controls (Control: 7.61±2.32 ml/min/mmHg vs. E-cig: 3.17±2.09 ml/min/mmHg; p=0.01), due to a smaller change in VC ( p=0.03), which suggests reduced pulmonary vascular distention in e-cig users. V̇O2peak was significantly lower in e-cig users compared to controls (Control: 4.4±1.2 L/min vs. E-cig: 2.6 ±0.7 L/min; p=0.01). E-cig users exhibited significantly elevated V̇E/ V̇CO2nadir ( p=0.02) indicating worse ventilatory effciency, and greater dyspnea relative to power output ( p=0.02) compared to controls. Preliminary findings suggest that e-cigarette use is associated with normal resting lung function but reduced pulmonary vascular distensibility. Further, e-cigarette users demonstrate ventilatory ineffciency and greater exertional dyspnea along with exercise intolerance. Canadian Institutes of Health Research. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

E-cigarettes – influence on our bodies and sports performance

E-cigarettes are widely regarded as seemingly safe way to take nicotine. Advertised as products devoid of the harmful effects of traditional cigarettes, for many years have been increasing in popularity among younger generation, including budding athletes. The purpose of this paper is to summarize and discuss the growing number of scientific publications published recently regarding harmful effects of vaporizers use on the body, especially among young people, including athletes. Without sufficient knowledge of the dangers of e-cigarette use, they require substantive support from their guardians, tutors and coaches. Learning about the consequences of e-cigarette use on the cardiovascular system, the respiratory system, quality and length of sleep and athlete’s recovery, as well as the results of research on the impact of e-cigarette use on athletic performance, will be invaluable support for those responsible for the health education of today’s youth. It can also make budding athletes rethink their previous harmful habits, often resulting from the belief that e-cigarette use is not very harmful. In this paper, we will try to prove the falsity of the myths created by the media and popular culture about the use of e-cigarettes, enabling athletes to make an informed decision about the use of this product based on knowledge of the dangers of electronic cigarettes and the potential impact of using these devices on sports performance.

The impact of e-cigarette use in health comumunication on individual perceptions: a psychological analyisis of Islamic education

The use of e-cigarettes as a topic in health communication creates significant debate and challenges in crafting prevention strategies and public health interventions. E-cigarettes, which are considered a safer alternative to conventional cigarettes, have caused controversy over their health benefits and risks. This article outlines the impact of e-cigarette use in health communication on individual perceptions, focusing on psychological aspects. His research methods can involve a combination of qualitative and quantitative approaches. The results of this study explain that the impact of individual perceptions of e-cigarettes identifies health behaviors that can be positive (avoiding or quitting) or negative (using or increasing consumption). Emphasis on developing communication approaches that consider Islamic values includes steps such as developing health messages that are consistent with Islamic thought, engaging religious leaders, paying attention to cultural context, and crafting messages that can be internalized by Muslim societies. Therefore, this analysis provides valuable insights for health practitioners and educators to design effective and acceptable health communication strategies in Muslim societies.

The impact of chronic electronic cigarette use on endothelial dysfunction measured by flow-mediated vasodilation: A systematic review and meta-analysis.

Despite electronic cigarettes (e-cigarettes) being marketed as a safer alternative to combustible cigarettes, the effects of chronic e-cigarette use on vascular health remain uncertain. Our meta-analysis aimed to assess the health implications of chronic exclusive e-cigarette use on endothelial dysfunction, as measured by flow-mediated vasodilation (FMD). PubMed, Embase and Scopus were searched for studies from 1 January 2004 to 31 March 2024. Four cross-sectional studies (n=769) were pooled using a random-effects model. The mean differences (MD) of FMD were reported by comparing exclusive e-cigarette use versus non-use; exclusive e-cigarette use versus combustible cigarette use; and combustible cigarette use versus non-use. A non-significant reduction in FMD in exclusive e-cigarette use compared to non-use was reported (MD of FMD: -1.47%; 95% CI: -3.96 - 1.02; I2= 84%). Similar MD of FMD in exclusive e-cigarette use and exclusive combustible cigarette use (vs non-use) suggested that both of these products might have comparable adverse influences on endothelial health. The limited availability of studies assessing the chronic impact of e-cigarette use restricted our ability to provide definitive findings. We emphasize the importance of additional research that explores the long-term impact of e-cigarette use on endothelial dysfunction, and identify key areas and give suggestions for further study.

Association of e-Cigarette Use and Postpartum Depression: Pregnancy Risk Assessment Monitoring System 2016-2019.

Background: Postpartum depression (PPD) is a prevalent public health concern. Combustible cigarette use is associated with increased risk of PPD. While electronic cigarette (e-cigarette) use during pregnancy is linked to increased risk of depressive symptoms during pregnancy, the relationship between e-cigarette use and PPD is not well understood. We sought to examine the association of e-cigarette use with PPD. Materials and Methods: Using Pregnancy Risk Assessment Monitoring System 2016-2019 data, unadjusted and adjusted logistic regression analyses for PPD were conducted via three analyses where e-cigarette use (any vs. none) was retrospectively self-reported (1) in past 2-year, (2) prepregnancy (i.e., 3 months before pregnancy), and (3) during pregnancy (i.e., last 3 months of pregnancy). We conducted an additional past 2-year e-cigarette use analysis excluding those who used combustible cigarette and/or hookah. Covariates included age, race, ethnicity, combustible cigarette, and/or hookah use, prenatal care during the last trimester, health insurance coverage during pregnancy, physical abuse during pregnancy, income, and survey type. Results: Only unadjusted odds ratios from past 2-year e-cigarette use (1.63, 95% confidence interval [CI]: 1.42-1.87) and past 2-year e-cigarette use excluding individuals with cigarette and/or hookah use (1.78, 95% CI: 1.30-2.38) were statistically associated with PPD. No adjusted analyses were statistically significant. Conclusion: Any e-cigarette use, as compared to no use, does not appear to be an independent risk factor of PPD, though it may be a useful clinical marker of increased risk of PPD. Future studies are warranted to advance our knowledge of impact of e-cigarette use on PPD.

Dependence motives and use contexts that predicted smoking cessation and vaping cessation: A two-year longitudinal study with 13 waves

IntroductionPrior studies examining the impact of e-cigarette use, dependence, cessation motivation/goals, and environmental restriction on smoking cessation were based on cross-sectional or shorter-term longitudinal data with binary outcomes. There is also a critical knowledge gap in corresponding impact on vaping cessation. This study aims to fill in these gaps by investigating these factors’ effects on speed of progression to smoking and vaping cessation. MethodsThis study conducted secondary analysis of data from 13 waves of assessment of adult cigarette users in Wisconsin from October 2015 through July 2019. Cox regression was employed to examine baseline predictors’ effects on speed of progression to smoking cessation (past-month abstinence) among 405 exclusive combustible cigarette users and dual users of combustible and electronic cigarettes, as well as progression to vaping cession among 178 dual users. ResultsDual use of e-cigarettes with cigarettes, lower primary dependence motives of smoking, higher secondary dependence motives of smoking, higher motivation to quit smoking, more ambitious future goals to quit smoking, and more restrictive environment for smoking all contributed to quicker progression to smoking cessation. Dual users with higher secondary dependence motives of smoking or with lower primary dependence motives of vaping progressed faster to vaping cessation. ConclusionsThe findings support that nicotine dependence is product-specific with two distinct constructs: the primary dependence motives are associated with more difficulty to quit, whereas the secondary dependence motives have the opposite effect. Dual users with strong instrumental reasons for smoking may not find e-cigarettes as an effective substitute for cigarettes.

The public health impact of e-cigarette use: Revisiting Geoffrey Rose's prevention strategies

The public health impact of e-cigarette use: Revisiting Geoffrey Rose's prevention strategies

An Overview of E-Cigarette Impact on Reproductive Health

Electronic cigarettes (e-cigarettes) are often considered a "safe substitute" for conventional cigarette cessation. The composition of the fluid is not always clearly defined and shows a large variation within brands and manufacturers. More than 80 compounds were detected in liquids and aerosols. E-cigarettes contain nicotine, and the addition of flavorings increases the toxicity of e-cigarette vapour in a significant manner. The heat generated by the e-cigarette leads to the oxidation and decomposition of its components, eventually forming harmful constituents in the inhaled vapour. The effects of these toxicants on male and female reproduction are well established in conventional cigarette smokers. Although toxins were measured at much lower levels in e-cigarette aerosols compared to smoke from a conventional cigarette, there are concerns about their potential impact on male and female reproduction. The information available was mainly obtained from studies conducted in animal models, and investigations in humans are scarce. However, the effects observed in animal models suggest that caution should be taken when vaping and that more research needs to be conducted to identify its potential adverse effects on fertility. The prevalence of e-cigarette usage is alarming, and warnings should be made about the impact of vaping on reproductive health. This document reviews the data regarding the impact of e-cigarette use on male and female reproduction.

Vaping and Mental Health Conditions in Children: An Umbrella Review

The e-cigarette (EC) epidemic began in the United States (US) in 2007; since 2014 EC is the most commonly used form of tobacco. However, the mental health implications of vaping are grossly unknown. The aim of this umbrella review is to provide astate-of-the-art summary of existing research concerning vaping and mental health conditions in children. Following the PRISMA Statement 2020 guidelines, a systematic search was conducted across PubMed, Cochrane Library, and Google Scholar up to April 15th, 2022 to locate relevant studies. The Joana Briggs Institute (JBI) methodology for umbrella reviews and quality appraisal tool was utilized. Six studies, pooling a total of 846,510 adolescents aged 21 years or below, were included by collating 85 primary clinical studies. Of these, 58.8% of the primary clinical studies originated in the US, with 4.7% from Canada, South Korea, and the United Kingdom each; 3.5% each from England and Taiwan; 2.4% each from Australia, France, Hawaii, Mexico, and Russia; and 1.2% each from Denmark, Greece, Hong Kong, Iceland, New Zealand, Poland, and Switzerland. Overall, significant associations were found between mental health outcomes, including depression and suicidality, among current EC users and those who had ever used EC. Compared to adolescents who had never used EC, both depression and anxiety were reportedly higher among EC users. Impulsive behaviors, reported as impulsivity, were also found to be correlated with the adoption of EC use. However, there is a lack of evidence regarding the impact of EC use on mental health outcomes in children. This umbrella review highlights the urgent need to further explore the effects of current EC use from a psychiatric and public health perspective.

Inflammation and Oxidative Stress from E-cigarette Exposure: Implications for COPD and Asthma

Currently, little is known about the effects of e-cigarette use on chronic respiratory diseases, due to their relative novelty. This review compiles data on the cellular effects of e-cigarette use with population data on disease incidence to determine potential risk for COPD and asthma development, two of the most prevalent respiratory diseases. We searched the Google Scholar database for studies on e-cigarette exposure and levels of inflammation and oxidative stress in human cells and e-cigarette users, as well a population studies analyzing e-cigarette use and respiratory disease incidence. All reviewed studies found significant increases in inflammatory biomarkers, as well as pro-inflammatory cytokines, demonstrating a correlation between e-cigarette use and a pro-inflammatory affect. Our findings suggest e-cigarette vapor contains reactive oxygen species, and that exposure increases cellular oxidation and lowers antioxidant power. Every population study we reviewed found significant correlations between COPD and e-cigarette use, and asthma and e-cigarette use. These population studies cannot provide causational data, though the basic cellular data provides support for causative effects. Further research should investigate the link between the cellular and population data to identify causation and understand the impact of e-cigarette use on disease rates.

Effect modification of legalizing recreational cannabis use on the association between e-cigarette use and future cannabis use among US adolescents

BackgroundMany states have legalized recreational cannabis use for adults. However, no study has examined how this policy may interact with youth vaping to influence cannabis use among US adolescents. This study investigates whether the association between baseline e-cigarette use and subsequent cannabis use differs by state recreational cannabis legalization status. MethodsThis study analyzed data from the first four waves (2013–2018) of the Population Assessment of Tobacco and Health Study, a nationally representative longitudinal survey. The study sample included adolescents (aged 12–17) who reported never used cannabis at baseline. Generalized estimating equations were used to analyze the effect modification of state recreational cannabis law on the association between baseline e-cigarette use and cannabis use at 12-month follow-up, controlling for individual characteristics. ResultsAmong adolescents who have never used cannabis at baseline, baseline past-30-day e-cigarette use was significantly associated with past-30-day cannabis use at 12-month follow-up (aOR=5.92, 95% CI: 3.52–9.95). This association was different by state recreational cannabis legalization status, as indicated by the significant interaction term. Subgroup analysis showed that the aOR was 18.39 (95% CI: 4.25–79.68) for adolescents living in states that legalized adult recreational cannabis use and 5.09 (95% CI: 2.86–9.07) for adolescents living in states without such laws. ConclusionsE-cigarette use is associated with cannabis initiation among youth. This association is stronger among those living in states that legalized adult recreational cannabis use. Further examination of the impact of e-cigarette use on cannabis initiation in relation to state cannabis laws is warranted.

Pulmonary Function Testing in Patients With E-Cigarette, or Vaping, Product Use-Associated Lung Injury.

In 2019 there was an outbreak of respiratory illnesses amongst people who used E-cigarettes. This phenomenon was labeled 'EVALI' which stands for "Electronic cigarette (E-cigarette), or Vaping, Product Use-Associated Lung Injury" and is a life-threatening illness of the lungs associated with E-cigarette use. It is believed to be caused by certain chemicals in E-cigarette cartridges, such as vitamin E acetate, but the exact pathophysiological mechanism is yet to be elucidated. Since 2019, the CDC has recorded over 2800 cases in the United States with over 60 deaths. Though many people recover from EVALI, the long-term implications on pulmonary health are unknown. The purpose of this retrospective study was to demonstrate the pulmonary function test (PFT) findings in a group of patients who recovered from a diagnosis of EVALI. We reviewed the cases of 23 adult patients who presented to two major academic hospitals of the Northwell Health System with confirmed EVALI and followed up in our outpatient clinics with PFTs. Most patients had significantly reduced diffusion capacity (DLCO) demonstrating loss of functioning alveolar units. Given that average follow-up was over a month after discharge, this leads us to believe that EVALI can lead to persistent lung damage. However, further follow-up would be necessary to identify the full impact of E-cigarette use on the pulmonary function.

ASSESSMENT OF VAPING PRACTICES IN PATIENTS WITH CYSTIC FIBROSIS

SESSION TITLE: Diffuse Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Smoking prevalence has decreased over the last several decades in the United States. However, new generations of tobacco and non-tobacco products such as electronic cigarettes (e-cigarettes) are being increasingly used, particularly in the young adult population. E-cigarettes are battery-powered devices that heat a liquid in order to develop vaporized products, including nicotine and marijuana. While originally thought to be less harmful than traditional cigarettes, e-cigarettes have been shown to have significant consequences including hospitalization and mechanical ventilation. Beginning in July 2019, there have been reports of previously healthy, young individuals developing respiratory failure, with e-cigarette use being identified as an antecedent factor. This new entity, E-cigarette or Vaping Associated Lung Injury (EVALI) has resulted in bans in several states. While the prevalence of e-cigarette use, and the rise of EVALI has been studied in the general population, to our knowledge there is no existing data about the prevalence of e-cigarette use among young adults with chronic lung disease. Individuals with Cystic Fibrosis (CF) offer a unique perspective on the impact of e-cigarette use on the young adult population with lung disease. METHODS: We administered a voluntary survey for patients with CF seen at the Rhode Island Cystic Fibrosis Center, as well as for adolescent and young adult primary care patients seen in the Medicine-Pediatrics Primary Care Clinic. The survey addressed patient experience with cigarettes and e-cigarettes, perceptions of substance use, validated quality of life scales (CFQR for CF patients, RAND-SF36 for non-CF patients), and an assessment of social desirability in order to assess risk of bias. RESULTS: Preliminary results from this observational study demonstrate avoidance of tobacco products and smoking amongst patients with CF compared to an age-matched cohort of the general population (Table 1). CONCLUSIONS: Patients with CF overwhelmingly described e-cigarette use as likely to cause significant lung damage within a brief period of time. A small portion of CF patients had tried smoking in the past, but no patients were identified as having a recent smoking history. Patients without CF averaged higher quality of life measures. While feelings of anxiety, sadness, and isolation were roughly comparable between the groups, physical symptoms were notably more bothersome in the CF patient group. CLINICAL IMPLICATIONS: This study demonstrates different social behaviors among CF and non-CF individuals in regards to cigarette and e-cigarette use. Adult CF patients were specifically able to verbalize risks associated with recreational inhalational products implying that a targeted educational program about EVALI is likely not necessary. DISCLOSURES: No relevant relationships by Roger Auth, source=Web Response no disclosure submitted for Debasree Banerjee; No relevant relationships by Michael Blundin, source=Web Response No relevant relationships by Sarah Rhoads, source=Web Response

Electronic cigarettes and health with special focus on cardiovascular effects: position paper of the European Association of Preventive Cardiology (EAPC).

Tobacco use is the single largest preventable risk factor for premature death of non-communicable diseases and the second leading cause of cardiovascular disease. In response to the harmful effects of tobacco smoking, the use of electronic cigarettes (e-cigarettes) has emerged and gained significant popularity over the past 15 years. E-cigarettes are promoted as safe alternatives for traditional tobacco smoking and are often suggested as a way to reduce or quit smoking. However, evidence suggests they are not harmless. The rapid evolution of the e-cigarette market has outpaced the legislator's regulatory capacity, leading to mixed regulations. The increasing use of e-cigarettes in adolescents and young individuals is of concern. While the long-term direct cardiovascular effects of e-cigarettes remain largely unknown, the existing evidence suggests that the e-cigarette should not be regarded as a cardiovascular safe product. The contribution of e-cigarette use to reducing conventional cigarette use and smoking cessation is complex, and the impact of e-cigarette use on long-term cessation lacks sufficient evidence. This position paper describes the evidence regarding the prevalence of e-cigarette smoking, uptake of e-cigarettes in the young, related legislations, cardiovascular effects of e-cigarettes and the impact of e-cigarettes on smoking cessation. Knowledge gaps in the field are also highlighted. The recommendations from the population science and public health section of the European Association of Preventive Cardiology are presented.

The Impact of "Vaping" Electronic Cigarettes on Spine Health.

“Vaping” or the use of electronic cigarettes (e-cigarettes) has greatly increased within the past decade, with growing popularity among adolescents. E-cigarettes have many harmful effects on multiple organ systems, but more research is needed to fully understand the extent of possible risks. Our narrative literature review aims to provide comprehensive insight into the impact of e-cigarette use on spinal health with a specific focus on intervertebral disc (IVD) health, bone health, and spinal fusion. There are many metallic compounds and chemical flavoring additives within e-cigarette liquids that are associated with human toxicity. These chemical toxins have been linked to increased oxidative stress leading to systemic inflammation. E-cigarette carcinogens have shown to have a toxic effect on osteoblast cells, and long-term use may decrease bone mineral density and increase the future risk for osteoporosis. Additionally, nicotine in e-liquids negatively impacts IVD health by creating hypoxic environments that degenerate the IVD vasculature and cellular matrix. While studies have demonstrated the inhibitory effects of nicotine use on spinal fusions in animal models, the impact of e-cigarette use on spinal fusion operations in human patients is currently lacking. Future research should focus on the influence of e-cigarette use on spinal health, particularly in adolescents with long-term follow-up, as childhood is a critical time for bone growth and development. Additionally, studies exploring the effects of e-cigarettes on spinal surgery outcomes, such as spinal fusions, are sparse in the literature. Further prospective research studies with a focus on the variety of e-cigarette chemical toxins and flavoring agents is needed to assess the impact on spinal health.