Total Number Of Puffs Research Articles

Consumption of JUUL vs. Other E-Cigarette Brands among U.S. E-Cigarette Users: Evidence from Wave 5 of the PATH Study.

This study examines the use of JUUL vs. other e-cigarette brands among U.S. youth (12–17 years), young adult (18–24 years), and adult (25 years and above) e-cigarette users. Data were from the Population Assessment of Tobacco and Health (PATH) study Wave 5 survey (2019). The study population was past 30-day e-cigarette users who knew the brand of e-cigarettes they usually/last used (N = 2569). JUUL use was reported by 65.2% of youth, 60.7% of young adult, and 25.6% of adult e-cigarette users in our study sample. The share of JUUL consumed in the past 30 days, measured by the total number of puffs, was 15.4% by youth, 55.5% by young adults, and 29.1% by adults. By contrast, the share of other e-cigarettes consumed was 4.2% by youth, 28.9% by young adults, and 66.9% by adults. Youth JUUL users were more likely to use e-cigarettes within 30 min after waking (aOR = 2.30, 95% CI: 1.12–4.75) than youth users of other brands of e-cigarettes. Additionally, youth e-cigarette users who currently smoked cigarettes were less likely to use JUUL (aOR = 0.55, 95% CI: 0.30–0.99). This study concludes that JUUL consumption was disproportionally higher among youth and young adults in the U.S. in 2019.

Puffing topography and physiological responses in men and women with low versus high waterpipe dependence during smoking: The WiHi Irbid project

BackgroundWaterpipe smoking is spreading worldwide, and it is associated with many adverse effects. The aim of this study was to investigate the interaction of waterpipe smoking puffing topography, and related physiological measures, with both gender and level of dependence on waterpipe. MethodExclusive waterpipe smokers were asked to smoke a single waterpipe session in a specialized laboratory while their smoking topography, and in-breath CO level were recorded pre- and post- smoking. Waterpipe dependence was measured using the LWDS-11 scale. ResultsIn the high dependence group, the total number of puffs, was greater in men than women. In addition, the average flow rate was greater in men with high compared to low dependence. For inter-puffing intervals, greater values were recorded in men and women with low versus high dependence. No other differences were found between the subgroups in total session time, average puff duration, average puff volume, and maximum flow rate. Pre-smoking CO content and CO boost were greater in men versus women in both dependence groups. Post-smoking CO content was greater in women with high versus low dependence, whereas it was lower in women versus men with low dependence. ConclusionsThe current results indicate several effects for waterpipe smoking dependence on smoking topography. Many of these differences were gender dependent with men having higher exposure than women in most aspects.

Effects of Nicotine Metabolic Rate on Cigarette Reinforcement.

The rate of nicotine metabolism, estimated by the nicotine metabolite ratio (NMR), is an important determinant of tobacco dependence. This study investigated the effect of NMR on smoking behavior due to nicotine reinforcement during ad libitum smoking. As part of a larger study, participants were stratified based on saliva NMR as fast and slow metabolizers. After smoking a cigarette and measuring nicotine blood concentrations, participants smoked as desired over a 90-minute period. Analysis included time to first cigarette, total number of cigarettes, total number of puffs, and weight of tobacco consumed. Sixty-one (48%) participants were fast metabolizers and 66 (52%) slow metabolizers by NMR. No significant differences were found regarding the smoking topography variables by NMR. Normal metabolizers by genotype (n = 79) had a shorter time to first cigarette than reduced metabolizers (n = 39; p = .032). Blacks smoked fewer cigarettes (p = .008) and took fewer total puffs (p = .002) compared with Whites. Among Whites, fast metabolizers by NMR had a shorter time to first cigarette compared with slow metabolizers (p = .014). Among fast metabolizers, Whites had, compared with Blacks, shorter latency to first cigarette (p = .003) and higher number of total puffs (p = .014) and cigarettes smoked (p = .014). Baseline cigarettes per day and nicotine elimination half-life significantly predicted topography outcomes. Saliva NMR did not predict cigarette reinforcement during a relatively brief period of ad libitum smoking. Differences were seen by race, with White fast metabolizers by NMR having shorter time to first cigarettes compared with slow metabolizers. After a 90-minute period of nicotine abstinence, NMR was not significantly associated with smoking reinforcement. Slow and fast metabolizers had similar time to first cigarette, number of cigarettes smoked, total number of puffs, and tobacco consumed; however, within-race differences show that within Whites, fast metabolizers had a faster time to first cigarette than slow metabolizers.

Combined Smoking Cues Enhance Reactivity and Predict Immediate Subsequent Smoking.

Cue reactivity (CR) research has reliably demonstrated robust cue-induced responding among smokers exposed to common proximal smoking cues (eg, cigarettes, lighter). More recent work demonstrates that distal stimuli, most notably the actual environments in which smoking previously occurred, can also gain associative control over craving. In the real world, proximal cues always occur within an environment; thus, a more informative test of how cues affect smokers might be to present these two cue types simultaneously. Using a combined-cue counterbalanced CR paradigm, the present study tested the impact of proximal (smoking and neutral) + personal environment (smoking and nonsmoking places) pictorial cues, on smokers' subjective and behavioral CR; as well as the extent to which cue-induced craving predicts immediate subsequent smoking in a within-subjects design. As anticipated, the dual smoking cue combination (ProxS + EnvS) led to the greatest cue-induced craving relative to the other three cue combinations (ProxS + EnvN, ProxN + EnvS, and ProxN ± EnvN), ps < .004. Dual smoking cues also led to significantly shorter post-trial latencies to smoke, ps < .01. Overall CR difference score (post-trial craving minus baseline craving) was predictive of subsequent immediate smoking indexed by: post-trial latency to smoke [B = -2.69, SE = 9.02; t(143) = -2.98, p = .003]; total puff volume [B = 2.99, SE = 1.13; t(143) = 2.65, p = .009]; and total number of puffs [B = .053, SE = .027; t(143) = 1.95, p = .05]. The implications of these findings for better understanding the impact of cues on smoking behavior and cessation are discussed. This novel cue reactivity study examined smokers' reactivity to combined proximal and distal smoking cues. Exposure to a combination of two smoking cues (proximal and environment) led to the greatest increases in cue-induced craving and smoking behavior compared to all other cue combinations. Further, the overall magnitude of cue-induced craving was found to significantly predict immediate subsequent smoking. This work provides new insight on how exposure to various cues and cue combinations directly affect smokers' craving and actual smoking behavior, as well as the relationship between those two indices of reactivity.

Week Long Topography Study of Young Adults Using Electronic Cigarettes in Their Natural Environment.

Results of an observational, descriptive study quantifying topography characteristics of twenty first generation electronic nicotine delivery system users in their natural environment for a one week observation period are presented. The study quantifies inter-participant variation in puffing topography between users and the intra-participant variation for each user observed during one week of use in their natural environment. Puff topography characteristics presented for each user include mean puff duration, flow rate and volume for each participant, along with descriptive statistics of each quantity. Exposure characteristics including the number of vaping sessions, total number of puffs and cumulative volume of aerosol generated from ENDS use (e-liquid aerosol) are reported for each participant for a one week exposure period and an effective daily average exposure. Significant inter-participant and intra-participant variation in puff topography was observed. The observed range of natural use environment characteristics is used to propose a set of topography protocols for use as command inputs to drive machine-puffed electronic nicotine delivery systems in a controlled laboratory environment.

Methylphenidate increases cigarette smoking in participants with ADHD

Methylphenidate (Ritalin®) is commonly prescribed for behavioral problems associated with attention deficit/hyperactivity disorder (ADHD). The results of previous studies suggest that methylphenidate increases cigarette smoking in participants without psychiatric diagnoses. Whether methylphenidate increases cigarette smoking in participants diagnosed with ADHD is unknown. In this within-subjects, repeated measures experiment, the acute effects of a range of doses of methylphenidate (10, 20, and 40 mg) and placebo were assessed in nine cigarette smokers who were not attempting to quit and met diagnostic criteria for ADHD but no other Axis I psychiatric disorders other than nicotine dependence. Each dose of methylphenidate was tested once while placebo was tested twice. One hour after ingesting drug, participants were allowed to smoke ad libitum for 4 h. Measures of smoking included total cigarettes smoked, total puffs, and carbon monoxide levels. Snacks and decaffeinated drinks were available ad libitum; caloric intake during the 4-h smoking session was calculated. Methylphenidate increased the total number of cigarettes smoked, total number of puffs, and carbon monoxide levels. Methylphenidate decreased the number of food items consumed and caloric intake. The results of this experiment suggest that acutely administered methylphenidate increases cigarette smoking in participants with ADHD, which is concordant with findings from previous studies that tested healthy young adults. These data indicate that clinicians may need to consider non-stimulant options or counsel their patients before starting methylphenidate when managing ADHD-diagnosed individuals who smoke.

Abstract 4701: DNA-adducts levels and chromosomal aberrations in relation to smoking history and topography in smokers

Abstract Introduction: Tobacco smoking is the major cause of morbidity and mortality in developed countries. Important determinants of tobacco carcinogen exposure include the smoking history and smoking topography. Tobacco carcinogens-induced DNA adducts and chromosomal aberrations have been associated with cancer development. It is unknown if the choice of cigarettes and smoking topography lead to differences in carcinogen-DNA adduct levels and chromosomal aberrations. Methods: We studied 207 population-based smokers (97 Caucasians and 110 African Americans). The subjects smoked two cigarettes, one hour apart, and the smoking topography was measured. We assessed three parameters of smoke exposure (serum cotinine, nicotine boost and carbon monoxide boost) in order to collect corroborative evidence that reflect different types of exposure. Carcinogen-DNA adducts and chromosomal aberrations in lymphocytes were determined by using the 32P-postlabeling analysis and standard cytogenetic method, respectively. Results: The chance of having high level of DNA-adducts was significantly higher in males than females (OR: 1.9; 95%CI: 1.09-3.31). Weakly associations of the DNA-adducts were observed with age and race (higher in older people and African-Americans smokers) (OR: 1.7; 95%CI: 0.97-2.90; OR: 1.5; 95%CI: 0.87-2.60). DNA-adducts were significantly associated with the baseline and post cigarette CO level for the first (p-value=0.001; 0.007 respectively) and second cigarette (p-value=&amp;lt;0.001; 0.001 respectively), with the total number of puffs for the second cigarette (p-value=0.04) and with the cumulative topography (p-value=0.03). Marginal associations were observed for the changes in CO2 pre and post cigarettes (p-value=0.08), the average inter-puff interval and the total puff volume for the second cigarette (p-value=0.06; 0.07 respectively). The changes in CO2 pre and post first and second cigarette were significantly associated with the mean number of chromosomal aberrations per cell (p-value=0.05; 0.01 respectively). Conclusion: In this study we observed potentially important associations of smoking topography with both DNA adduct levels and chromosomal aberrations. Larger study sets will be necessary to clarify the magnitude of these associations and to account for baseline differences related to gender, age, and race. Such an approach could provide useful information for understanding differential susceptibility to lung cancer among smokers. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4701.

Choice of add-on therapy in asthma - another inhaler or a tablet/syrup? A survey of 1415 UK asthmatics.

To determine preferences for asthma treatment given as inhaled therapy or as a tablet / syrup, to identify factors that influence this choice, and to assess how many patients would sacrifice greater efficacy of therapy in order to use the delivery route of their choice. Postal Questionnaire to patients with an active diagnosis of asthma aged less than 60 years under the care of general practitioners, paediatricians or adult respiratory physicians. Patient preference for inhaled therapy or tablet/syrup. 715 replies were analysed (93% Caucasian). 58% (417) preferred tablets (p<0.01) based on an equal chance of symptom improvement. There was no sex difference, but more children aged 6-10 and parents of under 6 year olds preferred tablets or syrup than adults (65% vs. 54%, p=0.03). Preference for tablets increased with number of current inhalers (p<0.05) but there was no correlation with total number of puffs per day or numbers of existing tablets taken. 238 (36%) opted for their preferred route of delivery in preference to greater efficacy. More asthmatics would choose a tablet or syrup than another inhaler as add-on therapy for their asthma. This preference was more marked in children and in patients already taking several inhalers. 36% of patients are prepared to sacrifice greater efficacy in favour of their choice of route of delivery.

“Smoke pH”: A Review

Abstract The analytical methods developed since the 1950s to determine the “smoke pH” of cigarette mainstream smoke (MSS) are reviewed. Most of the methods involve averaging the values obtained with all the puffs from a cigarette or averaging values from the total number of puffs from several cigarettes plus solution of the MSS in various quantities of water prior to pH determination. “Smoke pH” values thus obtained have little relevance to the situation involving a smoker who smokes a cigarette one puff at a time. In the human biological situation, the smoke components must traverse a layer of buffered fluid separating the smoke-filled respiratory tract cavity and the underlying tissue. Seldom is the effect of either the volume or the pH of the buffered fluid taken into account in determining the “smoke pH” of cigarette MSS taken one puff at a time. While numerous recent discussions have dealt with the effect of pH on the nature (degree of protonation) of nicotine in cigarette MSS and its rate of absorption by the smoker, seldom is the volume and/or pH of oral cavity saliva or of the fluid coating the lung surface considered in the assessment of either the nature or absorption of nicotine by the smoker. If the degree of protonation of nicotine be pH dependent, then the degree of protonation of nicotine as it traverses the film of fluid separating the respiratory tract cavity and the underlying tissue must be dependent on the pH of the buffered fluid and not on the “smoke pH” per se. Statements that adjustment of the “smoke pH” by ammoniation of one or more tobacco blend components increases both the level of MSS nicotine and its rate of absorption, thus resulting in greater consumer acceptance and continuation of smoking, fail to take into account the other changes that occur in the MSS composition to enhance its consumer acceptability. Inclusion of modest percentages of ammoniated tobacco in the blend increases the “smoke pH” of the MSS but does not necessarily increase MSS nicotine level. Not only are the MSS levels of several low molecular acids, aldehydes, and ketones known to be respiratory tract irritants substantially reduced but also the MSS levels of several highly flavorful pyrazines are substantially increased. These MSS composition changes yield an MSS classified as milder and more flavorful and whose consumer acceptability is considerably enhanced. Until the pH of MSS is determined on a per puff basis in a system simulating that in the oral cavity or the lung of the smoker, the nature of specific smoke components at the time of contact and their reactivity with respiratory tract tissue remain highly speculative. “Smoke pH” value for MSS, like the “tar” value for MSS, provides little, if any, useful information about the chemical composition of the source of the MSS or about its chemical and biological properties.