Role Of E-cigarettes Research Articles

Smoking cessation program preferences of individuals with chronic obstructive pulmonary disease: a qualitative study.

To explore the views of tobacco-smoking chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO) patients on telehealth-based cessation programs and the role of e-cigarettes as an aid to quit smoking. Tobacco smoking accelerates the progression of COPD. Traditional smoking cessation programs often do not entirely address the unique needs of COPD patients, leading to suboptimal effectiveness for this population. This research is aimed at describing the attitudes and preferences of COPD and ACO patients toward innovative, telehealth-based smoking cessation strategies and the potential application of e-cigarettes as a quitting aid. A qualitative exploratory approach was adopted in this study, employing both focus groups and individual interviews with English-speaking adults with diagnosed COPD or ACO. Participants included both current smokers (≥ 5 cigarettes/day) and recent ex-smokers (who quit < 12 months ago). Data were systematically coded with iterative reliability checks and subjected to thematic analysis to extract key themes. A total of 24 individuals participated in this study. The emergent themes were the perceived structure and elements of a successful smoking cessation program, the possible integration of telehealth with digital technologies, and the strategic use of e-cigarettes for smoking reduction or cessation. The participants stressed the importance of both social and professional support in facilitating smoking cessation, expressing a high value for insights provided by ex-smokers serving as mentors. A preference was observed for group settings; however, the need for individualized plans was also highlighted, considering the diverse motivations individuals had to quit smoking. The participants perceived online program delivery as potentially beneficial as it could provide immediate access to support during cravings or withdrawals and was accessible to remote users. Opinions on e-cigarettes were mixed; some participants saw them as a less harmful alternative to conventional smoking, while others were skeptical of their efficacy and safety and called for further research.

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

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

Tobacco cessation - the underused potential in clinical routine

Tobacco control, psychosocial and medical assistance regarding tobacco cessation is still a hidden potential within the German health care system. So far doctors rarely talk to their patients about their smoking status and physical and psychological benefits of quitting.This paper focusses on recommended current diagnostic and treatment standards, as well as evidence-based methods to address the topic on how to stop smoking and its association with certain diseases such asCOPD,lungcancer and COVID-19 infection. The role of e-cigarettes as a cessation tool and its health related risks are critically examined. Consequences and advice how to implement smoking cessation procedures into daily practice are presented.

‘Why do we have to be the gatekeepers?’ Australian general practitioners’ knowledge, attitudes and prescribing intentions on e-cigarettes as a smoking cessation aid

BackgroundA significant policy change impacting the availability of nicotine for use in electronic cigarettes (e-cigarettes) in Australia took effect from October 1, 2021. This change meant that nicotine containing liquids for use with e-cigarettes would only be available by prescription from a medical practitioner as part of a smoking cessation plan. This study aimed to explore general practitioners (GPs) perceptions about the role of e-cigarettes, and understand factors informing their intentions to prescribe e-cigarettes as part of a smoking cessation plan.MethodsIn-depth semi-structured interviews were conducted with thirteen GPs. Purposeful sampling was used to recruit participants. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used to classify, describe and report themes in the data. QSR NVivo was used to aid coding, thematic analysis and retrieval of quotes.ResultsParticipants had diverse views on recommending and prescribing e-cigarettes as smoking cessation aids to patients. Some participants were willing to prescribe e-cigarettes to patients if other methods of smoking cessation had not worked but there were concerns, and uncertainty, about the safety and efficacy of e-cigarettes for smoking cessation. There was poor understanding of the current policy and legislation about e-cigarettes in Australia. Mostly the participants in this sample did not feel confident or comfortable to prescribe, or have discussions about e-cigarettes with patients.ConclusionThe participants of this study held diverse attitudes on recommending and prescribing e-cigarettes for smoking cessation. Clarity in guidelines and consumer product information are required to enable GPs to provide consistent and accurate advice to patients that wish to use e-cigarettes as a smoking cessation aid.

The E-Cigarette dilemma: Balancing risks and benefits for health

Electronic cigarettes, or e-cigarettes, have gained popularity as an alternative to traditional tobacco smoking. This article examines the current evidence on the role of e-cigarettes in health. While proponents argue that they are a safer alternative, concerns remain regarding nicotine addiction, respiratory health, cardiovascular effects, and youth initiation. E-cigarettes contain nicotine, an addictive substance, and their aerosols may contain harmful chemicals. Studies suggest potential adverse effects on cardiovascular and respiratory health, especially among young individuals. The long-term health consequences and efficacy as smoking cessation tools are still under investigation. Comprehensive regulation, education, and targeted interventions are crucial to address the potential health implications of e-cigarette use.

General practitioners’ knowledge, attitudes, beliefs and practices surrounding the prescription of e-cigarettes for smoking cessation: a mixed-methods systematic review

BackgroundGeneral practitioners (GPs) play an important role in providing patients who smoke with health information, support and treatment to encourage them to quit smoking. Despite conflicting evidence on the effectiveness of electronic cigarettes (e-cigarettes) as a smoking cessation aid, there is growing interest in the role e-cigarettes might play as an alternative to smoking tobacco. This systematic review aims to synthesise evidence from qualitative, quantitative and mixed-methods studies of the knowledge, attitudes, beliefs and social norms of GPs with respect to the use of e-cigarettes as smoking cessation aids.MethodsThis study adhered to the PRISMA guidelines. Studies from MEDLINE, CINAHL, SCOPUS, PsycINFO, EMBASE and grey literature were searched. Two independent reviewers screened abstracts and full-text articles to identify studies that met the inclusion criteria. A data extraction form was used to extract relevant data from included papers and were quality appraised using the MMAT checklist. A PRISMA flow diagram was used to record the flow of papers and reasons for exclusion. Studies were included if they collected quantitative, qualitative or mixed methods data to determine knowledge, attitudes, beliefs and social norms of GPs for use of e-cigarettes as smoking cessation aids.ResultsA total of 4056 abstracts were screened and 25 articles were included. Our findings showed that GPs had mixed views on recommending e-cigarettes as a smoking cessation aid. Some GPs were optimistic and had recommended e-cigarettes to their patients. Others were reluctant and disagreed that e-cigarettes are an effective method to quit smoking. Most GPs lacked knowledge and confidence in having discussions with patients around e-cigarette safety and efficacy as smoking cessation alternatives.ConclusionThis systematic review shows there are mixed views on e-cigarettes as smoking cessation aids. Clear guidance on the role of e-cigarettes is needed to inform and upskill GPs about e-cigarettes for smoking cessation.PROSPERO registrationCRD42021227612.

Awareness, Perception and Behaviors Related to Electronic Cigarettes in Lebanon: A Survey Study

Background: Electronic cigarettes (E-cigarettes) are gaining momentum worldwide. They are looked at as an effective way to cease smoking with reduced harm. Since Lebanon is a country with a high smoking prevalence, it is of interest then to analyze the current and expanding role of E-cigarettes among the Lebanese population. Aim: The objective of our study was to evaluate the awareness, perception, and behaviors related to E-cigarettes in Lebanon. Methods: A cross-sectional survey of Lebanese pedestrians chosen from random sectors of Beirut was recruited in our sample study. A self-administered questionnaire was distributed to examine their awareness, perception, and behaviors related to E-cigarettes. SPSS was used for analysis. The main outcome was to assess the awareness of E-cigarettes in the Lebanese population and evaluate their perception as an effective smoking cessation tool. Results: Of the 364 respondents, 53% were males, 84% were aware of E-cigarettes, and 16% never-tried them. E-cigarettes helped 56% of users to cut down on tobacco smoking, and among all respondents, 60% believed that it is less harmful than tobacco cigarettes. Moreover, 30% perceived it as an effective way to quit smoking. The majority of participants (61%) who tried it were between 18 and 25 years of age, and 36% of them were nonsmokers. Conclusion: Our study is the first in Lebanon to assess the awareness, perception, and behaviors related to E-cigarettes. The majority of our population was aware of E-cigarettes, and some perceived them as a less harmful replacement compared to tobacco smoking. Additionally, non-smokers may be attracted to E-cigarette smoking which may lead to developing a new attraction and gateway for smoking. Therefore, awareness about E-cigarette's correct use, benefits, and harms need to be highlighted among the public, particularly the young generation in Lebanon.

Electronic cigarettes: an update on products, regulation, public health approaches and oral health.

Electronic cigarettes remain a divisive topic amongst public health experts and researchers. The division hinges on the the role of e-cigarettes in public health, i.e., whether e-cigarettes represent a potential to compromise decades of public health efforts by driving smoking rates up, or an effective tool to drive smoking rates down. Dental settings are a strategic place for stop smoking interventions, with large proportions of the population attending regularly and harms of smoking often presenting early in the mouth. Dental professionals should be equipped with the necessary information to provide evidence-based advice and recommendations to their patients. To update dental professionals and researchers on the current regulations, public health approaches, and oral health effects of prevailing novel nicotine products, with a focus on e-cigarettes. Narrative literature review. Regulatory approaches vary considerably around the world but in the UK and Europe, e-cigarettes are regulated as consumer or medicinal product, and their use is permitted. In the UK, e-cigarettes have increasingly been supported by public health institutions for smoking cessation as part of a Tobacco Harm Reduction strategy. The potential harms (including to oral health) from e-cigarette use are likely to be much less than from tobacco cigarettes.

Tobacco Cessation - The Underused Potential in Clinical Routine

Tobacco control, psychosocial and medical assistance regarding tobacco cessation is still a hidden potential within the German health care system. So far doctors rarely talk to their patients about their smoking status and physical and psychological benefits of quitting.This paper focusses on recommended current diagnostic and treatment standards, as well as evidence-based methods to address the topic on how to stop smoking and its association with certain diseases such as COPD, lung cancer and COVID-19 infection. The role of e-cigarettes as a cessation tool and its health related risks are critically examined. Consequences and advice how to implement smoking cessation procedures into daily practice are presented.

Role of e-cigarettes and pharmacotherapy during attempts to quit cigarette smoking: The PATH Study 2013-16.

BackgroundMore smokers report using e-cigarettes to help them quit than FDA-approved pharmacotherapy.ObjectiveTo assess the association of e-cigarettes with future abstinence from cigarette and tobacco use.DesignCohort study of US sample, with annual follow-up.ParticipantsUS adult (ages 18+) daily cigarette smokers identified at Wave 1 (W1; 2013–14) of the PATH Study, who reported a quit attempt before W2 and completed W3 (n = 2443).ExposuresUse of e-cigarettes, pharmacotherapy (including nicotine replacement therapy), or no product for last quit attempt (LQA), and current daily e-cigarette use at W2.AnalysisPropensity score matching (PSM) of groups using different methods to quit.Outcome measures12+ months abstinence at W3 from cigarettes and from all tobacco (including e-cigarettes). 30+ days abstinence at W3 was a secondary outcome.ResultsAmong daily smokers with an LQA, 23.5% used e-cigarettes, 19.3% used pharmacotherapy only (including NRT) and 57.2% used no product. Cigarette abstinence for 12+ months at W3 was ~10% in each group. Half of the cigarette abstainers in the e-cigarette group were using e-cigarettes at W3. Different methods to help quitting had statistically comparable 12+ month cigarette abstinence at W3 (e-cigarettes vs no product: Risk Difference (RD) = 0.01, 95% CI: -0.04 to 0.06; e-cigarettes vs pharmacotherapy: RD = 0.02, 95% CI:-0.04 to 0.09). Likewise, daily e-cigarette users at W2 did not show a cessation benefit over comparable no-e-cigarette users and this finding was robust to sensitivity analyses. Abstinence for 30+ days at W3 was also similar across products.LimitationsThe frequency of e-cigarette use during the LQA was not assessed, nor was it possible to assess continuous abstinence from the LQA.ConclusionAmong US daily smokers who quit cigarettes in 2014–15, use of e-cigarettes in that attempt compared to approved cessation aids or no products showed similar abstinence rates 1–2 years later.

The E-cigarette ban in India-A step in the right direction?

Electronic cigarettes (e-cigarettes) are a popular method to help quit tobacco smoking. However, there is a paucity of data in the literature on their safety and efficacy. Recently, the Indian Government has called for a ban on all e-cigarettes and taken steps to restrict access to vaping products from the market. This major decision was an attempt to safeguard the younger population from using e-cigarette and their possible longer-term addiction together with its promotions by domestic industries. In this article, we evaluate the role of e-cigarettes to help stop smoking tobacco cessation and consider the factors that have facilitated the ban on e-cigarettes in India.

Immunological and pathological effects of electronic cigarettes.

Electronic cigarettes (E-cigarettes) are considered a preferable alternative to conventional cigarettes due to the lack of combustion and the absence of tobacco-specific toxicants. E-cigarettes have rapidly gained in popularity in recent years amongst both existing smokers and previous non-smokers. However, a growing literature demonstrates that E-cigarettes are not as safe as generally believed. Here, we discuss the immunological, and other, deleterious effects of E-cigarettes on a variety of cell types and host defence mechanisms in humans and in murine models. We review not only the effects of complete E-cigarette liquids, but also each of the main components-nicotine, humectants and flavourings. This MiniReview thus highlights the possible role of E-cigarettes in the pathogenesis of disease and raises awareness of the potential harm that E-cigarettes may cause.

Use of electronic cigarettes in the perioperative period: A mixed-method study exploring perceptions of cardiothoracic patients in Australia.

INTRODUCTIONElectronic cigarettes (e-cigarettes) may reduce tobacco use and achieve tobacco abstinence in the perioperative period of cardiothoracic surgery for patients who smoke. However, research on patients’ views on the role of e-cigarettes as a smoking cessation tool is lacking. This mixed-methods study explored perceptions on the use of e-cigarettes among current smokers and ex-smokers awaiting cardiothoracic surgery in AustraliaMETHODSA cross-sectional study and semi-structured interviews were conducted with 62 patients who were diagnosed with coronary artery disease or lung cancer and were scheduled for elective cardiothoracic surgery at six metropolitan hospitals in Sydney. Data were collected on demographic characteristics, smoking history, surgical risk index, self-efficacy, interest in, perceived benefits of, and barriers to using e-cigarettes in the perioperative periodRESULTSCurrent smokers reported significantly higher interest in the use of e-cigarettes (p=0.008), and perceived fewer barriers (p=0.048) and more health benefits (p=0.079), compared to ex-smokers. Current smokers considered e-cigarettes to be either a safer alternative to tobacco or a novel method for quitting. Recent ex-smokers, defined as those who quit 2–8 weeks, were a distinct group with high nicotine dependency, a long history of smoking, and multiple failed quit attempts. Compared to longer-term ex-smokers (8–52 weeks quit), recent ex-smokers were more interested in e-cigarettes (p=0.029) and considered e-cigarettes a useful aid to prevent relapse in the lead up to surgery and to manage their nicotine cravings.CONCLUSIONSE-cigarettes may be considered a short-term novel aid and a bridge to evidence-based methods to reduce harm from continued tobacco use for some patients awaiting cardiothoracic surgery for coronary artery disease or lung cancer. This study presents reasons why patients awaiting cardiothoracic surgery may enquire about or use e-cigarettes, which will help clinicians identify those who need more consistent, sustained cessation support.

Uptake and Perceptions of E-cigarette use in Vascular Patients

Introduction: Smoking is one of the most important risk factors for cardiovascular disease (CVD). Electronic cigarettes (e-cigarettes) are becoming increasingly popular. However, little is known regarding their patterns of use in patients with established CVD.Aims: We aimed to assess the perceptions and patterns of use of e-cigarettes in patients presenting to a vascular clinic.Methods: We performed a qualitative study to identify perceptions and beliefs about e-cigarettes. Semi-structured interviews of consecutive patients consenting to participate were performed over five-months. Individuals were recruited from a vascular surgery outpatient clinic. Initial interviews were based on a questionnaire. Further structured interviews were conducted with patients currently using e-cigarettes, which were transcribed and analysed to assess perceptions and patterns of use.Results/Findings: Four overarching themes emerged: attraction to e-cigarettes as a harm reduction/smoking cessation strategy; uncertainty regarding the risks of e-cigarettes; use of various types of smoking cessation strategies; dual use and often complete relapse to tobacco products.Conclusions: Patients with established CVD view e-cigarettes as a means of smoking cessation; however, many relapse to tobacco products or use both simultaneously. Further research is necessary regarding the role of e-cigarettes in smoking cessation in this high-risk group.

National Academies Report Details Health Impact of E-Cigarettes

Back to table of contents Previous article Next article Professional NewsFull AccessNational Academies Report Details Health Impact of E-CigarettesNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:13 Mar 2018https://doi.org/10.1176/appi.pn.2018.3a12AbstractAmong the 47 conclusions reached by the expert committee are items related to smoking cessation and the harm reduction potential of e-cigarettes.A comprehensive new report from the National Academies of Sciences, Engineering, and Medicine (NASEM) provides some mixed signals in relation to a central question about the public health impact of electronic cigarettes: do they have a value in helping people quit smoking?The report cited strong evidence to suggest that electronic cigarettes, or e-cigarettes, contain fewer harmful compounds than traditional cigarettes and that smokers who completely switch to e-cigarettes can reduce their health risks in the short term. However, there is no substantive evidence that e-cigarettes can actually aid in smoking cessation. The role of e-cigarettes in smoking cessation has been a topic of much debate since these devices first came on the market. Some health professionals, for example, believe they can be a form of nicotine replacement therapy just like patches, while others worry that their resemblance to regular cigarettes reinforces negative smoking behaviors that make it harder to quit. As noted in the NASEM report—which included the results of over 800 peer-reviewed studies—there are some data from observational studies that suggest e-cigarettes can promote smoking cessation, but evidence from more controlled studies is lacking. The report identified just a handful of randomized clinical studies, and most of these showed only that e-cigarettes that contain nicotine are more effective at promoting smoking cessation than e-cigarettes without nicotine. There are insufficient data to know how these devices compare with current FDA-approved cessation products such as varenicline or nicotine patches.People who completely transition from traditional cigarettes to e-cigarettes appear to have improved health outcomes in the short term (one year or less), the report concluded. Douglas Ziedonis, M.D., M.P.H., a professor of psychiatry at the University of California, San Diego, was cautiously optimistic about this finding: “The short-term benefits are encouraging, but remember that addiction is a long-term issue,” he told Psychiatric News.Ziedonis said that while the concept of reducing harm in patients by encouraging switching to e-cigarettes is laudable, there are not enough data on the long-term behaviors of smokers who made the switch. “Many smokers, for example, will just flip-flop between tobacco products, and that is not helpful for their health,” he said. Until more evidence about cessation efficacy and long-term health outcomes becomes available, Ziedonis recommends that psychiatrists continue to focus on cessation strategies with their patients, though the use of e-cigarettes as part of the process can and should be a topic of conversation. Ziedonis said he believes the objective NASEM report will be a great resource for mental health professionals, even those who do not specialize in addiction psychiatry. “Smoking is associated with psychiatric disorders, and questions about e-cigarettes are only going to get more common in psychiatry offices,” he said. ■“Public Health Consequences of E-Cigarettes” can be accessed here. ISSUES NewArchived

Role of E-Cigarettes in smoking cessation: A systematic review

Introduction: E-cigarettes (EC) are devices that heat liquid into an aerosol that user inhales. Youth are using EC at increasing and alarming rates. The tobacco industry aggressively markets EC to youth, glamorizing EC use in advertisements, and offering EC in candy flavors such as bubble gum and gummy bears. The liquid usually in EC has nicotine and other additives which is addictive. Aim: The purpose of this study was to systematically review the role of e-cigarettes in smoking cessation. Materials and Methods: A literature review was performed; PubMed, PubMed Central and Cochrane Library, Embase, and Google Scholar were searched from 1970 to December 2017 to identify appropriate studies. Results: Out of the total 817 titles appeared, 17 articles fulfilled the criteria and were selected for the review. Two articles which were hand searched and one article which was through E-mail was also included in this review. EC have a direct impact on smokers and efficiency in quitting smoking was assessed very low. Majority of the study found that EC could increase the risk of smokers developing nicotine dependence and thus evidence on smoking reduction was found very low. Conclusions: There are relatively a few studies evaluating the role of EC in smoking cessation. EC products are marketed in a wide variety of channels that have broad reach among youth and young adults, including magazines, television, radio, and the Internet. More randomized controlled trials and longitudinal studies are needed to further clarify the role of EC in smoking cessation.

The E-cigarette – a New Tool to Aid Smoking Cessation

This editorial shows that, despite controversies in the public health community and among professionals regarding the role of e-cigarettes as an aid to stopping smoking, and although the potential health risks of long-term use of nicotine are unknown, modern devices should be regarded more as a solution than a problem. Clinicians, owing to the high morbidity and mortality of smoking should include e-cigarettes as efficient tools to help smokers to quit smoking or at least as a substitute for cigarettes. Effort is needed to improve knowledge about this tool.

Article Commentary: The role of e-cigarettes in the tobacco endgame

Article Commentary: The role of e-cigarettes in the tobacco endgame

E-cigarettes: effective cessation tools or public health threat?

In a short time, electronic cigarettes have become a multi-billion dollar industry. Since their introduction to the market, prevalence of ever-use among smokers in the USA appears to have increased from ∼2% in 2010 to >30% in 2012, and the rate of increase appears to be similar in the United Kingdom, Ireland and other Western countries according to a special Eurobarometer survey in 2014.1 The e-cigarette market is estimated to be worth over $3 billion. However, there is no consensus on the role of e-cigarettes and their contribution to the provision of smoking cessation (SC) services, nor to global tobacco control. At the Conference of the Parties to the WHO Framework Convention on Tobacco Control in September 2014, the secretariat presented a report outlining the current facts concerning e-cigarettes, put forth an opinion on these devices, and offered considerations on options for regulation.2 This was on the tail of two contrasting letters to Margaret Chan, Director General of the WHO, submitted by scientists from many disciplines including tobacco control, public health, epidemiology, pharmacology and the clinical sciences (Letters to Dr Chan; June 2014). One letter stated that e-cigarettes offer huge prospective gains by reducing the prevalence of cigarette smoking and subsequently, the harm done by smoking. Those in favour of this position therefore requested support for the introduction and widespread availability of e-cigarettes. The other letter cautioned restraint, citing the possible damage that e-cigarettes could have on tobacco control. For those favouring the widespread proliferation of e-cigarettes, the main considerations appear to be the efficacy and safety of e-cigarettes with regards to SC and potential for harm reduction. For those cautioning restraint the main consideration seems to be the possible effects these products may have on broad tobacco control measures such as smoking …

Beliefs and behavior regarding e-cigarettes in a large cross-sectional survey.

1570 Background: The use of e-cigarettes has developed dramatically in recent years. However, the role of e-cigarettes in helping cigarette cessation or in lowering social stigma of tobacco use rem...