Nicotine E-cigarettes Research Articles

Association of Perceived Neighborhood Disorder with Substance Use Behaviors and Retail Access Among Southern California Adolescents.

Neighborhood disadvantage is associated with a higher concentration of tobacco, cannabis and alcohol retailers and greater risk of certain substance use behaviors among youth. Less is known about the impact of subjective neighborhood disorder, which captures distinct exposures that may be relevant to substance use outcomes, including neighborhood social processes, safety, physical characteristics, and neighborhood drug use. Data are from two waves (Feb-Dec 2022) of a prospective cohort of Southern California high school students (n = 2,139; mean[SD] age = 15.7.[0.6]). We examined associations of perceived neighborhood disorder at baseline with (a) perceived ease of purchase (continuous scale 0-100) for alcohol, cannabis, e-cigarettes, cigarettes, hookah, cigars/cigarillos, and oral nicotine at baseline and follow-up, and (b) repeated measures of past 6-month and past-30-day alcohol, vaped cannabis, smoked cannabis, cannabis edibles, e-cigarette, cigarette, cigarillo, hookah, and oral nicotine use. E-cigarettes were perceived to be the easiest product to purchase. Participants in the highest (vs. lowest) quartile of neighborhood disorder reported greater mean ease of purchasing scores for all products (mean difference range = 5.43 [95%CI: 1.64-9.21] for mint/menthol oral nicotine products to 9.40 [95%CI: 6.16-12.64] for hookah) and greater odds of e-cigarette, smoked cannabis, edibles, vaped THC, and alcohol use (odds ratio range = 1.52 [95%CI: 1.05 to 2.18] for past 6-month alcohol to 5.40 [95% CI: 3.46 to 8.42] for 30-day smoked cannabis). Interventions that shape youth perceptions of their neighborhood and reduce youth retail access in disadvantaged neighborhoods are needed and may help to prevent youth substance use.

E-CIGARETTE SWITCHING AND FINANCIAL INCENTIVES TO PROMOTE COMBUSTIBLE CIGARETTE CESSATION AMONG ADULTS ACCESSING SHELTER SERVICES: A PILOT STUDY

BackgroundSmoking prevalence among U.S. adults experiencing homelessness is ≥70%. Interventions are needed to address persisting tobacco disparities. MethodsAdults who smoked combustible cigarettes (CC) daily (N=60) were recruited from an urban day shelter and randomly assigned to an e-cigarette switching intervention with or without financial incentives for carbon monoxide (CO)-verified CC abstinence (EC vs. EC+FI). All participants received an e-cigarette device and nicotine pods during the first 4 weeks post-switch; and those in the EC+FI group also received escalating weekly incentives for CC abstinence during the same period. Key follow-ups were conducted at 4- and 8-weeks post-switch. ResultsParticipants were predominantly male (75%), 50% were racially/ethnically minoritized, with an average age of 48.8 years. Descriptive analyses indicated that CC smoking abstinence rates among EC and EC+FI were 3.3% vs. 13.3% at 4 weeks (8.3% overall) and 10.0% vs. 13.3% at 8 weeks (11.7% overall) in the intent-to-treat analyses (missing considered smoking). Among those who completed follow-ups (51.7% and 45.0% at 4- and 8-weeks), CC abstinence rates in EC and EC+FI were 6.3% vs. 26.7% at 4 weeks (16.1% overall) and 21.4% vs. 30.8% at 8 weeks (25.9% overall). EC+FI participants reported fewer days of smoking, more days of e-cigarette use, and greater reductions in CO at 4-week follow-up. Most participants reported a high likelihood of switching to e-cigarettes (67.7%). ConclusionE-cigarette switching with financial incentives for CC cessation is a promising approach to tobacco harm reduction among adults accessing shelter services. Refinements are needed to improve engagement.

Biomarkers of Nicotine and Toxicant Exposure by E-liquid Nicotine Concentration Level among U.S. Adult Exclusive E-cigarette Users.

The current e-cigarette market has been rapidly evolving with an increase in the share of high nicotine concentration vaping products. This study examined urinary biomarkers of exposure (BOEs) by nicotine concentration level among exclusive e-cigarette users. Data were drawn from Wave 5 (December 2018-November 2019) of the Population Assessment of Tobacco and Health (PATH) Study. Between-subject differences in BOEs of nicotine, metal, tobacco-specific nitrosamine (TSNA), and volatile organic compounds (VOC) were examined across e-cigarettes containing nicotine or not (yes [n=300] vs. no [n=31] vs. non-tobacco use [n=3021]) and different nicotine concentration levels (0.1-1.7%, 1.8-4.9%, and 5.0%+). Among 3353 participants, exclusive e-cigarette users exhibited higher mean concentrations of nicotine metabolites than non-tobacco users. Nicotine e-cigarette users had higher concentrations of TNE2 (mean [95% CI]=21.8 [15.2-31.2] vs. 0.2 [0.1-0.6] nmol/mg creatinine, p<.0001) and cotinine (1418.2 [998.0-2015.4] vs. 12.2 [0.1-0.6], p<.0001) ng/mg creatinine, p<.0001) than non-nicotine e-cigarette users. Users of e-cigarette products with nicotine levels of 1.8-4.9% had higher TNE2 and cotinine levels than those using 0.1-1.7%, though differences were insignificant after adjusting for covariates. As compared to non-tobacco users, nicotine vapers had higher concentrations of lead (adjusted p=0.01). Nicotine containing e-cigarette users exhibited elevated levels of nicotine metabolites than non-nicotine containing vapers and non-tobacco users. Future research needs to investigate health effects of e-cigarette use across different nicotine levels Impact: Regulating the nicotine content in e-cigarettes could be crucial in managing nicotine exposure and potentially mitigating associated health risks.

Effect of packaging with versus without candy-oriented marketing themes on the appeal and sensory attributes of flavoured e-cigarettes

SignificanceE-cigarettes with candy-themed marketing are implicated in decisions to first try e-cigarettes but have unknown effects on the experience of vaping. We compared adults’ perceived appeal and sensory attributes after...

Perceptions of Harm and Addictiveness for Nicotine Products, THC e-Cigarettes, and e-Cigarettes with Other Ingredients Among Adolescents, Young Adults, and Adults

Background Perceptions of health harms and addictiveness related to nicotine products, THC e-cigarettes, and e-cigarettes with other ingredients are an important predictor of use. This study examined differences in perceived harm and addiction across such products among adolescents, young adults, and adults. Methods We conducted a cross-sectional survey (N = 6,131, ages 13–40 years old) in which participants reported perceived harm and addictiveness for 11 products (cigarettes, disposable nicotine e-cigarettes, pod-based nicotine e-cigarettes, other nicotine e-cigarettes, THC e-cigarettes, e-cigarettes with other ingredients, nicotine pouches, nicotine lozenges, nicotine gums, nicotine tablets, nicotine toothpicks). We applied adjusted regression models and conducted pairwise comparisons between age groups (13–17, 18–20, 21–25, and 26–40) and product use status (never, ever, and past-30-day use), adjusting for gender, race/ethnicity, sexual orientation, and financial comfort. Results Overall, participants in younger age groups perceived products to be more harmful and addictive than those in older age groups, with the exception of e-cigarettes with other ingredients. For all products, participants who never used perceived each product to be more harmful than those who ever used. For all products, participants who used the products in the past 30-days had lower perceived harm and addictiveness compared to never and ever use. Certain sociodemographic groups, such as people who identify as LGBTQ+, Non-Hispanic Black, or Hispanic, had lower perceived harm and addictiveness for most products. Discussion Efforts should be made to educate all age groups and minoritized groups on harms and addictiveness of all nicotine products, THC e-cigarettes, and e-cigarettes with other ingredients.

Health Warnings on Instagram Advertisements for Synthetic Nicotine E-Cigarettes and Engagement

Synthetic nicotine is increasingly used in e-cigarette liquids along with flavors to appeal to youths. Regulatory loopholes have allowed tobacco manufacturers to use social media to target youths. To analyze the extent to which synthetic nicotine e-cigarette brands have implemented US Food and Drug Administration (FDA) health warning requirements and to evaluate the association between health warnings and user engagement on Instagram. In this cross-sectional study, posts from 25 brands were analyzed across a 14-month period (August 2021 to October 2022). A content analysis was paired with Warning Label Multi-Layer Image Identification, a computer vision algorithm designed to detect the presence of health warnings and whether the detected health warning complied with FDA guidelines by (1) appearing on the upper portion of the advertisement and (2) occupying at least 20% of the advertisement's area. Data analysis was performed from March to June 2024. Synthetic nicotine e-cigarette advertisement on Instagram. The outcome variables were user engagement (number of likes and comments). Negative binomial regression analyses were used to evaluate the association between the presence and characteristics of health warnings and user engagement. Of a total of 2071 posts, only 263 (13%) complied with both FDA health warning requirements. Among 924 posts with health warnings, 732 (79%) displayed warnings in the upper image portion, and 270 (29%) had a warning covering at least 20% of the pixel area. Posts with warnings received fewer comments than posts without warnings (mean [SD], 1.8 [2.5] vs 5.4 [11.7] comments; adjusted incident rate ratio [aIRR], 0.70; 95% CI, 0.57-0.86; P < .001). For posts containing warnings, a larger percentage of the warning label's pixel area was associated with fewer comments (aIRR, 0.96; 95% CI, 0.93-0.99; P = .003). Flavored posts with health warnings placed in the upper image portion received more likes than posts with warnings in the lower portion (mean [SD], 34.6 [35.2] vs 19.9 [19.2] likes; aIRR, 1.48; 95% CI, 1.07-2.06; P = .02). In this cross-sectional study of synthetic nicotine brand Instagram accounts, 87% of sampled posts did not adhere to FDA health warning requirements in tobacco promotions. Enforcement of FDA compliant health warnings on social media may reduce youth engagement with tobacco marketing.

"Why should care workers be any different from prison workers?" A qualitative study of second-hand smoke exposure during home-care visits and potential measures to eliminate exposure.

Despite world-leading measures in place to protect employees from second-hand smoke exposure in workplaces in the United Kingdom, workers who deliver health and social care in private homes remain unprotected legally in this setting from second-hand smoke exposure (SHS). Fourteen individuals took part in either an in-depth telephone interview (n = 11) or an online focus group discussion (n = 3), including home-care workers (n = 5) and managers (n = 5) based in Lanarkshire (Scotland) and local/national policy makers (n = 4). Participants were asked about the extent to which exposure to SHS is an issue during home visits and possible additional measures that could be put in place to eliminate exposure. Participants highlighted the difficulties in balancing the provision of care in a person's own home with the right of workers to be able to breathe clean air and be protected from SHS. Current strategies to reduce staff exposure to SHS during home visits were often reported as inadequate with SHS not a hazard considered by managers beyond protecting pregnant staff or those with pre-existing respiratory conditions such as asthma. Simple respiratory protective equipment (as used during the COVID-19 pandemic) was rightly identified as being ineffective. Methods such as nicotine replacement therapy and e-cigarettes were identified as potential ways to help people who smoke achieve temporary asbstinence prior to a home visit. Implementing appropriate and proportionate measures to protect home-care workers from the harms posed by SHS should be a priority to help protect the health of this often overlooked occupational group.

The relationship between cannabis and nicotine use: A systematic review and meta-analysis.

Cannabis and nicotine (tobacco or e-cigarettes) use commonly co-occurs and understanding their relationship can help to inform public health strategies to prevent their harms. We conducted a systematic review and meta-analysis to estimate the association of cannabis use given prior nicotine use and vice versa. PubMed, Embase, PsycINFO, Google Scholar and a hand-search were conducted in 2023 for longitudinal studies of the general population with no restrictions in settings (locations). Random-effects meta-analysis was conducted to estimate odds ratios between cannabis and nicotine use in both directions. The impact of unmeasured confounding was assessed using E-values. From 5387 identified records, we included 20 studies. Among cannabis-naïve youths, baseline use of any nicotine products was positively associated with initiation of any cannabis use at follow-up [odds ratio (OR) = 5.39, 95% confidence interval (CI) = 3.19, 9.11; adjusted OR (aOR) = 2.59, 95% CI = 2.01, 3.32]. In nicotine-naïve participants (youths + adults), baseline cannabis use was positively associated with the initiation of any nicotine use at follow-up (OR = 4.08, 95% CI = 2.05, 8.11; aOR = 2.94, 95% CI =1.54, 5.61). There were no significant associations between baseline cannabis use and subsequent initiation of any nicotine (aOR = 3.29, 95% CI = 0.85, 12.76) or daily nicotine use (aOR = 2.63, 95% CI = 0.41, 16.95) among youths. The median E-values were 5.5 for nicotine exposure and cannabis use initiation and 4.1 for cannabis exposure and nicotine use initiation, indicating that substantial unmeasured confounding would need to have a strong association with both outcomes to fully explain away the cannabis and nicotine relationship. Although the evidence for associations between cannabis use and tobacco use is mixed, a majority of studies to date have found that cannabis use is associated with prior nicotine use and vice versa.

E-Cigarette Nicotine Delivery Among Young Adults by Nicotine Form, Concentration, and Flavor

Concerns have been raised about the abuse liability of modern e-cigarettes that use acidic additives to form nicotine salts, making the inhalation of nicotine smoother than freebase nicotine. To examine the effects of nicotine form and concentration and e-liquid flavor on subjective effects ratings, vaping behavior, and nicotine uptake among young adults who use e-cigarettes. In this single-blind, within-participant, crossover randomized clinical trial, a convenience sample of young adults aged 21 to 25 years who currently used e-cigarettes was recruited from December 2021 to August 2023, for in-person research laboratory visits in Columbus, Ohio. Participants completed up to 9 vaping sessions, starting with their usual e-cigarette brand in the first session followed by 1 of 8 laboratory-prepared e-liquids in a randomly assigned order in each subsequent session. Prepared e-liquids varied by nicotine form (salt-based vs freebase), nicotine concentration (5% vs 1% weight per weight), and flavor (menthol vs tobacco). Each session included a 5-minute, 10-puff standardized vaping period followed by 30 minutes of ad libitum vaping. At 4 time points (0, 5, 10, and 35 minutes) during each vaping session, plasma samples were collected for assessing nicotine uptake, and self-reports of urges, craving, and withdrawal were collected via questionnaires. Positive subjective effects were self-reported after 35 minutes of vaping using a visual analog scale; urges and cravings were reported using the Questionnaire of Smoking Urges (QSU). Puff topography data were collected throughout each vaping session. Seventy-two participants (mean [SD] age, 22.4 [1.4] years; 42 [58.3%] female) who sampled at least 1 laboratory-prepared e-liquid composed the analytic sample. Salt-based (vs freebase) nicotine e-liquids increased nicotine intake, with 5% salt-based e-liquids delivering the highest mean plasma levels of nicotine (11.2 ng/mL [95% CI, 9.3-13.2 ng/mL] at 5 minutes; 17.2 ng/mL [95% CI, 14.3-20.1 ng/mL] at 35 minutes) irrespective of flavors. Higher positive subjective effect ratings (eg, for liking) were received by salt-based (42.8; 95% CI, 39.4-46.1) vs freebase (32.0; 95% CI, 28.6-35.3) nicotine, 1% (43.4; 95% CI, 40.2-46.6) vs 5% (31.2; 95% CI, 27.7-34.6) nicotine, and menthol-flavored (43.2; 95% CI, 39.7-46.7) vs tobacco-flavored (31.5; 95% CI, 28.4-34.7) e-liquids. Salt-based and 1% but not menthol-flavored nicotine elicited more intense puffing (eg, 25% [95% CI, 12%-40%] more total puffs for nicotine salts vs freebase). All study e-liquids reduced urges and cravings, with 5% vs 1% nicotine being more effective (mean [SE] QSU-Desire score at 35 minutes, 15.4 [0.5] vs 16.7 [0.5]). In this crossover randomized clinical trial among young adult e-cigarette users, salt-based (vs freebase) nicotine e-liquids increased nicotine intake and yielded more positive subjective effects ratings and intense puffing behaviors, suggesting higher abuse potential. Restricting the level of acidic additives and menthol flavoring may reduce the addictiveness of e-cigarettes. ClinicalTrials.gov Identifier: NCT05458895.

The Effects of Nicotine Pouches and E-Cigarettes on Oral Microbes: A Pilot Study.

It remains uncertain whether nicotine pouches and electronic cigarettes alter the oral environment and result in a high presence of periodontopathogenic bacteria in saliva, compared to that among cigarette users or non-tobacco users. In this study, saliva samples were collected from respondents using nicotine pouches, electronic cigarettes, and conventional cigarettes, alongside a control group of non-tobacco users. Polymerase chain reaction was used to identify clinical isolates of the following periodontal bacteria: Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Fusobacterium nucleatum, Fusobacterium periodonticum, Porphyromonas endodontalis, and Rothia mucilaginosa. The presence of some periodontal pathogens was detected in the saliva samples from users of nicotine pouches, electronic cigarettes, and conventional cigarettes but not in samples taken from the control group. Therefore, the initial results of this pilot study suggest that the presence of periodontopathogenic bacteria in the saliva of nicotine pouch and electronic cigarette users could alter the oral microbiome, leading to periodontal diseases. However, further quantitative investigation is needed.

Association between cannabis use and nicotine use persistence among adolescents

IntroductionProspective associations of adolescent cannabis use with nicotine use persistence are not well characterized but are important for informing prevention and policy. This study examined the association of 4 types of cannabis product use with subsequent persistent nicotine product use among adolescents. MethodsWe used prospective data from an adolescent cohort (14–17 years) from Southern California surveyed at baseline and at approximately 6-month follow-up (2022–2023). We incorporated three mutually non-exclusive analytic samples comprised of individuals with baseline past 6-month use of: (1) any nicotine product (N=308 [mean[SD] age = 16.3[0.6] years]), (2) e-cigarettes (n = 276), and (3) any combustible tobacco product (n = 137). Baseline past 6-month cannabis smoking, vaping, edible use, cannabidiol [CBD] or hemp product use, and any cannabis product use (yes/no) were separately modeled as predictors of past 6-month persistent use of any nicotine products, e-cigarettes, and combustible tobacco at follow-up. ResultsBaseline use of any cannabis product was associated with increased odds of persistent use of e-cigarettes or any nicotine product (adjusted odds ratio[OR] range: 1.96–2.66). Cannabis smoking was positively associated with persistent any nicotine product use (adjusted OR=2.19, 95 % CI=1.20–4.02). Cannabis smoking, vaping, and edible use predicted persistent use of e-cigarettes (adjusted OR range: 2.22–2.79). Cannabis product use did not predict combustible tobacco use persistence. Associations of CBD/hemp product use with nicotine use persistence outcomes were all non-significant. ConclusionsAdolescents who use cannabis may be at elevated risk for persistent nicotine use.

Products and patterns through which adolescents, young adults, and adults initiate co-use of tobacco and cannabis

BackgroundCo-use of tobacco and cannabis is common. However, few studies have examined the temporal sequencing through which individuals initiate co-use, and how these patterns vary across age. This study addresses this gap by examining the specific products and temporal sequencing through which adolescents, young adults, and adults initiate co-use of tobacco and cannabis. Among adolescents, young adults, and adults who co-used tobacco and cannabis in the past 30 days, we examined (a) whether tobacco or cannabis was used first in their lifetime and (b) which specific tobacco or cannabis product (e.g., nicotine e-cigarettes, cannabis edibles) was the first used. MethodsData were from a cross-sectional national survey (N = 6,131, 13–40 years old) in which participants reported ever use, past-30-day-use, and order of use for 17 different tobacco and cannabis products. Results were analyzed overall and by age group (13–20; 21–24; 25–40). Results38.4% of participants reported use of both tobacco and cannabis in the past 30 days. Among these participants, 70.9% used tobacco first in their lifetime (66.6% < 21; 71.7% 21–24; 76.6% > 24). Approximately 60% of participants who initiated co-use with tobacco reported nicotine e-cigarettes as their first tobacco product (63.3% < 21; 66.7% 21–24; 49.6% > 24). ConclusionsThe majority of participants who used both tobacco and cannabis used tobacco first in their lifetime, and nicotine e-cigarettes were the most common form of tobacco initiation, particularly among adolescents and young adults. Findings emphasize the need for co-use prevention programs to target common products of initiation.

Partial Nicotine Reduction and E-Cigarette Users’ Puffing Behaviors Among Adults Aged 21 to 35 Years

The advent of salt-based, high-nicotine electronic nicotine delivery systems [e-cigarettes] has contributed to their epidemic use among young people in the US, necessitating the need for policies to address the addictiveness of these products. To evaluate the effect of partial nicotine reduction on new-generation e-cigarette users' puffing behaviors. This randomized crossover clinical trial was conducted at the Clinical Research Lab for Tobacco Smoking at Florida International University in Miami between April 15, 2022, and October 17, 2023. Using a volunteering sampling method by distributing flyers and advertisements, current e-cigarette users (who preferred 5% nicotine concentration), aged 21 to 35 years, were included. In a crossover design, participants completed 2 sessions of the same product (JUUL or NJOY) that differed by nicotine concentration (3% [JUUL] or 2.4% [NJOY] and 5% [JUUL or NJOY]) in random order. In each session, participants vaped up to 60 minutes ad libitum, preceded by 12 hours of nicotine abstinence. The primary outcomes were puffing topography parameters (eg, total session time, puffing time, total puffing number, interpuff interval, total inhaled volume, average puff volume, duration, and flow rate) measured during each session and plasma nicotine measured before and after each session. Among 735 participants who were approached for eligibility, 675 were excluded, and 10 did not complete session 2. Of the 50 remaining current e-cigarette users (mean [SD] age, 23 [3] years; 56% men), 23 (46%) were low nicotine dependent. The median topography parameters were significantly higher during the e-cigarette use sessions with 3% or 2.4% nicotine concentration compared with 5% nicotine concentration for 3 outcomes: puffing time (1.3 minutes [IQR, 0.3-9.4 minutes] vs 1.2 minutes [IQR, 0.2-5.6 minutes]; P = .02), puff duration (2.6 seconds [IQR, 0.8-6.9 seconds] vs 2.4 seconds [IQR, 0.4-6.6 seconds]; P = .02), and total inhaled volume (1990.0 mL [IQR, 279.0-24 400.0 mL] vs 1490.0 mL [IQR, 148.0-14 300.0 mL]; P = .05). The median plasma nicotine boost observed in the 5% nicotine concentration condition (0.0060 mg/L [IQR, 0.0001-0.0249 mg/L]) was significantly higher than that in the 3% or 2.4% session (0.0043 mg/L [IQR, 0.0008-0.0225 mg/L]) (P = .001). Additionally, deeper puffing (increased average puff duration and average puff volume) was observed in participants with higher nicotine dependence (1.42 seconds [95% CI, 1.12-1.80 seconds]; P = .03) and male users (1.38 mL [95% CI, 1.09-1.75 mL]; P = .04) in response to nicotine reduction. This randomized crossover clinical trial provides direct evidence that partial nicotine reduction in salt-based e-cigarettes was associated with acute compensatory puffing and the potential for increased exposure to toxicants. However, given the reduced nicotine delivery associated with nicotine reduction, the acute compensatory response observed in this study may not preclude a population benefit due to the marketing of less addictive products. These results suggest that at least for current e-cigarette users, partial nicotine reduction can lead to enhanced exposure to some toxicants in the short term. ClinicalTrials.gov Identifier: NCT05205382.

The Impact of Conventional Cigarettes, Nicotine-containing and Nicotine-free Electric Cigarettes on Testicular Weight of Male Wistar Rats

E-cigarettes are gaining increasing popularity worldwide. The World Health Organization (WHO) estimates that there are nearly one billion (984 million) smokers globally, accounting for approximately one-fifth of the adult population. The use of e-cigarettes in Southeast Asian countries has also seen a rise since 2015, although at a slower pace compared to high-income countries. Presently, Indonesia has the highest prevalence of e-cigarette use in Southeast Asia at 11.8%, while Thailand has the lowest prevalence at 3.3%. Testes play a crucial role in male reproductive function. Decreased testicular size can lead to disruptions in testicular function, resulting in infertility. Testicular size is significantly correlated with sperm density in both fertile and infertile men. The objective of this study is to investigate changes in testicular weight due to exposure to conventional cigarettes, nicotine-containing, and nicotine-free e-cigarettes. This experimental research utilizes a post-test control only design. The sample comprises 24 male Wistar rats divided into four groups: Group A (control), Group B (exposed to conventional cigarettes), Group C (exposed to nicotine e-cigarettes), and Group D (exposed to non-nicotine e-cigarettes). Exposure to cigarettes lasts for 30 days, after which the rats undergo surgery to remove their testes. The research findings indicate a decrease in testicular size due to exposure to conventional cigarettes, nicotine e-cigarettes, and non-nicotine e-cigarettes. There is no significant difference observed among the three types of exposure. In conclusion, conventional cigarettes, nicotine-containing, and nicotine-free e-cigarettes elicit similar effects in reducing testicular weight in male Wistar rats.

Associations between e-cigarette marketing exposure and vaping nicotine and cannabis among U.S. adults, 2021

IntroductionLittle is known about the influence of e-cigarette marketing on cannabis vaping behaviors. This study examined the associations between e-cigarette marketing exposure and nicotine and cannabis vaping among adults. MethodsThis cross-sectional study included a U.S. nationally representative sample of adults from the Wave 6 survey of the Population Assessment of Tobacco and Health Study. We used multinomial logistic regressions to examine the associations between past 30-day e-cigarette marketing exposure and past 30-day vaping behavior (sole- and dual-vaping of nicotine and cannabis) overall and stratified by age. ResultsOverall, 52.0 % of respondents reported e-cigarette marketing exposure, and 89.8 %, 5.6 %, 3.2 %, and 1.4 % reported no vaping, sole-nicotine vaping, sole-cannabis vaping, and dual-vaping, respectively. E-cigarette marketing exposure was associated with increased odds of reporting sole-cannabis vaping versus no vaping (adjusted risk ratio [aRR], 1.31; 95 % confidence interval [CI], 1.09–1.57) and dual-vaping versus no vaping (aRR, 1.26; 95 % CI, 1.01–1.57). This association was found among those aged 18–24 and 25–34 years. It was also associated with increased odds of reporting sole-cannabis vaping versus sole-nicotine vaping (aRR, 1.28; 95 % CI, 1.04–1.58). This association was found among those aged 18–24 years. DiscussionE-cigarette marketing exposure was associated with sole-cannabis vaping and dual-vaping, not sole-nicotine vaping among U.S. adults. Such associations were mainly driven by young adults aged 18–24 and 25–34 years. Greater restrictions on tobacco marketing may have reduced the influence of e-cigarette marketing on nicotine vaping, while gaps in marketing restrictions for cannabis may contribute to e-cigarette marketing influence on cannabis vaping.

Sex differences in appeal, reward, and sensory experience of E-cigarette flavors among adults who smoke cigarettes

ObjectiveFlavors enhance nicotine e-cigarette appeal by altering sensory experience. Females may be more sensitive to tobacco-associated cues and uniquely affected by flavor. The current study is an exploratory analysis to examine differences by sex on reward, appeal, and sensory experience of popular e-cigarette flavors. MethodsAdults (N = 121) who use cigarettes (≥1 cigarette/day) were enrolled in a laboratory study in which they vaped four e-cigarette flavors (tobacco, cherry, menthol, vanilla; in separate lab sessions) in one of two freebase nicotine concentrations (6 mg/ml,18 mg/ml). Following exposures, participants rated e-cigarette reward using the Drug Effects Questionnaire (DEQ), flavor and overall e-cigarette appeal using Labeled Hedonic Scales (LHS), and intensity of flavor, irritation, coolness, fruitiness, and sweetness using Generalized Labeled Magnitude Scales (gLMS). Linear mixed models were conducted for outcomes to analyze effects of sex, flavor, and sex x flavor interaction. ResultsFor DEQ ratings, there was a trend (p = .08) toward a sex x flavor interaction, in which menthol flavor produced more reward than other flavors for females, but not males. For LHS ratings, there was a significant sex x flavor interaction (p = .03) for overall e-cigarette experience with females but not males rating menthol higher than other flavors. All gLMS scales but irritation showed that females generally had greater differences between flavors compared to males (ps ≤ 0.03). ConclusionMenthol in e-cigarettes may play an important role in mediating appeal and/or reward among females. This may be due in part to their ability to better detect sensory effects of e-cigarettes.

Depression screening outcomes among adolescents, young adults, and adults reporting past 30-day tobacco and cannabis use

BackgroundFew studies examine the relationship between depression and use of specific tobacco and/or cannabis products among adolescents, young adults, and adults. We determined whether the odds of depression are greater among those who used specific tobacco and/or cannabis products and among co-users of tobacco and cannabis. MethodCross-sectional online survey of a national convenience sample of 13–40-year-olds (N = 6,038). The survey included depression screening and past 30-day use of specific tobacco and cannabis products (cigarettes; e-cigarettes, vaped cannabis, little cigars, cigarillos, cigars, hookah, chewing tobacco, smoked cannabis, edible cannabis, blunts). Analyses correspond to the total sample, and 13–17-, 18–24-, and 25–40-year-olds. ResultsAmong 5,281 individuals who responded to the depression screener and nine product use questions, 1,803 (34.1 %) reported co-use of at least one tobacco product and one cannabis product in the past 30 days. Past 30-day co-use was associated with higher likelihood of screening positive for depression compared to past 30-day use of tobacco-only (aOR = 1.32, 1.06–1.65; 0.006) or cannabis-only (aOR = 1.94, 1.28–2.94; <0.001). Screening positive for depression was more likely among those who reported past 30-day use of e-cigarettes (aOR = 1.56; 1.35–1.80; <0.001), cigarettes (aOR = 1.24, 1.04–1.48; 0.016), chewed tobacco (aOR = 1.91, 1.51–2.42; <0.001), and blunts (aOR = 1.22, 1.00–1.48; 0.053) compared to those who did not report past 30-day use of these products. Among the 2,223 individuals who screened positive for depression, the most used two-product combination was nicotine e-cigarettes and smoked cannabis (614 individuals, 27.6 %). ConclusionsScreening positive for depression was more likely among past 30-day co-users versus past 30-day users of tobacco-only or cannabis-only. Findings suggest that prevention programs for depression and substance use address tobacco and cannabis co-use.

Low-field NMR spectroscopic study of e-cigarettes: Is determination of only nicotine and organic carrier solvents possible?

Electronic cigarettes (e-cigarettes) have become popular worldwide with the market growing exponentially in some countries. The absence of product standards and safety regulations requires urgent development of analytical methodologies for the holistic control of the growing diversity of such products. An approach based on low-field nuclear magnetic resonance (LF-NMR) at 80 MHz is presented for the simultaneous determination of key parameters: carrier solvents (vegetable glycerine (VG), propylene glycol (PG) and water), total nicotine as well as free-base nicotine fraction. Moreover, qualitative and quantitative determination of fourteen weak organic acids deliberately added to enhance sensory characteristics of e-cigarettes was possible. In most cases these parameters can be rapidly and conveniently determined without using any sample manipulation such as dilution, extraction or derivatization steps. The method was applied for 37 authentic e-cigarettes samples. In particular, eight different organic acids with the content up to 56 mg/mL were detected. Due to its simplicity, the method can be used in routine regulatory control as well as to study release behaviour of nicotine and other e-cigarettes constituents in different products.

Opportunistic smoking cessation interventions for people accessing financial support settings: A scoping review.

The aim of this work was to systematically scope the evidence on opportunistic tobacco smoking cessation interventions for people accessing financial support settings. We searched MEDLINE, Embase, PsycINFO and the Cochrane Tobacco Addiction Group specialized register to 21 March 2023. We duplicate screened 20% of titles/abstracts and all full texts. We included primary studies investigating smoking cessation interventions delivered opportunistically to people who smoked tobacco, within settings offering support for problems caused by financial hardship, for example homeless support services, social housingand food banks. Data were charted by one reviewer, checked by anotherand narratively synthesized. We included 25 studies conducted in a range of financial support settings using qualitative (e.g. interviews and focus groups) and quantitative (e.g. randomized controlled trials, surveys and single arm intervention studies) methodologies. Evidence on the acceptability and feasibility of opportunistic smoking cessation advice was investigated among both clients and providers. Approximately 90% of service providers supported such interventions; however, lack of resources, staff training and a belief that tobacco smoking reduced illicit substance use were perceived barriers. Clients welcomed being asked about smoking and offered assistance to quit and expressed interest in interventions including the provision of nicotine replacement therapy, e-cigarettes and incentives to quit smoking. Six studies investigated the comparative effectiveness of opportunistic smoking cessation interventions on quitting success, with five comparing more to less intensive interventions, with mixed results. Most studies investigating opportunistic smoking cessation interventions in financial support settings have not measured their effectiveness. Where they have,settings, populations, interventions and findings have varied. There is more evidence investigating acceptability, with promising results.

Evaluating trends in recruitment challenges in vape shop research, e-cigarette product characteristics and use among shop customers from 2019 to 2023: A mixed-methods study.

Brick-and-mortar vape shops specialize in the sale of e-cigarettes and remain a primary source for purchasing emerging e-cigarette products. New regulatory policies have been implemented at local-, state- and federal-level; the retail environment at vape shops and product preferences among vape shop customers shifted accordingly. From 2019 to 2023, we collected anonymous interview data from vape shop customers (n=572) from 83 vape shops in Southern California. We aggregated the data by month and treated each month as the unit of analysis to document changes in recruitment efforts among the vape shops in relation to major policy implementations over 4 years. We also examined the systematic fluctuations and trends in customers' e-cigarette product preferences and nicotine content in these products. The monthly average shop-level consent rate was 52.9% (SD=8.7), with an overall decreasing trend over time. It was necessary for our data collection team to approach a greater number of vape shops to obtain consent with implementation of various state and federal tobacco regulations and following COVID-19. We observed an increase in the purchase of disposable products and nicotine concentrations in the products, while the average use frequency remained the same. Our findings demonstrated that user preferences, product characteristics and challenges in research involving vape shops are closely associated to changes in regulations. We documented a dramatic increase in nicotine concentration in products. Future policies restricting the amount of nicotine in tobacco products at the federal level are necessary to protect consumers from further nicotine addiction. This study provides documentation over time of the drastic increases in nicotine concentration among e-cigarette users as a result of the fluctuations in the product market. Regulating nicotine content in tobacco products could safeguard against further unsafe modifications in e-cigarettes and other types of tobacco products.