Types Of Devices Research Articles

Harm perceptions across vaping product features: An on-line cross-sectional survey of adults who smoke and/or vape in the United Kingdom.

Vaping products are diverse with a wide variety of features, and popular products change rapidly. This study examined the features and types of vaping products that people who smoke and/or vape perceive contribute to the health harms of vaping. This was a cross-sectional survey co-designed with adults who smoked/vaped and pre-registered. An on-line survey (November 2022) was used of a convenience sample of adults in the United Kingdom who smoked and/or vaped (n = 494). As primary outcomes, respondents were asked to select any of 15 vaping product features they perceived might have any effect on the health harms of vaping (for each: selected, not selected). Independent variables were smoking/vaping status (smoke and vape; vape, formerly smoked; vape, never regularly smoked; smoke, do not currently vape); relative vaping harm perceptions [less harmful than smoking (accurate), equally/more harmful than smoking or do not know/refused (other)]. Binary logistic regressions were used to compare outcomes by current vaping/smoking status and relative harm perceptions, adjusting for age and sex. Most people (54.7%) selected between one and three features. The most frequently selected were nicotine concentration (62.2%) and amount of e-liquid consumed (59.1%), followed by nicotine type (e.g. salt or freebase; 33.0%), source/purchase location (25.3%), flavours (24.7%), temperature to heat e-liquid (21.1%), heat produced by device (20.9%), e-liquid brand (20.9%), amount of emissions (18.6%), device type (e.g. disposable, pod, tank; 17.2%), material of tank (17.0%), power/wattage (13.0%), device brand (8.1%), device size (4.1%) and device weight (2.4%). Higher nicotine concentrations, more e-liquid and salt (versus freebase) nicotine were perceived to confer greater harms. Disposables were perceived as slightly more harmful than reusable devices. There were few differences by current vaping/smoking status and between those with accurate (versus other) harm perceptions of vaping relative to smoking (P > 0.05 for most contrasts, adjusting for age and sex). Certain features and types of vaping products [higher nicotine concentrations, more e-liquid consumed and salt (versus freebase) nicotine]were perceived to confer greater health harms among a sample of UK adults who smoked and/or vaped. Findings are consistent with pervasive misperceptions that nicotine is a major cause of harm, although e-liquid volume is likely to contribute to harms.

Effectiveness of laser pulsed irradiation for antimicrobial photodynamic therapy

The aim of this study was to compare two types of light irradiation devices for antimicrobial photodynamic therapy (aPDT). A 660-nm light-emitting diode (LED) and a 665-nm laser diode (LD) were used for light irradiation, and 0.1 mg/L TONS 504, a cationic chlorin derivative, was used as the photosensitizer. We evaluated the light attenuation along the vertical and horizontal directions, temperature rise following light irradiation, and aPDT efficacy against Staphylococcus aureus under different conditions: TONS 504 only, light irradiation only, and TONS 504 with either LED (30 J/cm2) or LD light irradiation (continuous: 30 J/cm2; pulsed: 20 J/cm2 at 2/3 duty cycle, 10 J/cm2 at 1/3 duty cycle). Both LED and LD light intensities were inversely proportional to the square of the vertical distance from the irradiated area. Along the horizontal distance from the nadir of the light source, the LED light intensity attenuated according to the cosine quadrature law, while the LD light intensity did not attenuate within the measurable range. Following light irradiation, the temperature rise increased as the TONS 504 concentration increased in the order of pulsed LD < continuous LD < LED irradiation. aPDT with light irradiation only or TONS 504 only had no antimicrobial effect, while aPDT with TONS 504 under continuous or pulsed LD light irradiation provided approximately 3 log reduction at 30 J/cm2 and 20 J/cm2 and approximately 2 log reduction at 10 J/cm2. TONS 504-aPDT under pulsed LD light irradiation provided anti-microbial effect without significant temperature rise.

Insertion site and risk of peripheral intravenous catheter colonization and/or local infection: a post hoc analysis of the CLEAN 3 study including more than 800 catheters

AimAlthough uncommon, infections associated with peripheral intravenous catheters (PIVCs) may be responsible for severe life-threatening complications and increase healthcare costs. Few data are available on the relationship between PIVC insertion site and risk of infectious complications.MethodsWe performed a post hoc analysis of the CLEAN 3 database, a randomized 2 × 2 factorial study comparing two skin disinfection procedures (2% chlorhexidine-alcohol or 5% povidone iodine-alcohol) and two types of medical devices (innovative or standard) in 989 adults patients requiring PIVC insertion before admission to a medical ward. Insertion sites were grouped into five areas: hand, wrist, forearm, cubital fossa and upper arm. We evaluated the risk of risk of PIVC colonization (i.e., tip culture eluate in broth showing at least one microorganism in a concentration of at least 1000 Colony Forming Units per mL) and/or local infection (i.e., organisms growing from purulent discharge at PIVC insertion site with no evidence of associated bloodstream infection), and the risk of positive PIVC tip culture (i.e., PIVC-tip culture eluate in broth showing at least one microorganism regardless of its amount) using multivariate Cox models.ResultsEight hundred twenty three PIVCs with known insertion site and sent to the laboratory for quantitative culture were included. After adjustment for confounding factors, PIVC insertion at the cubital fossa or wrist was associated with increased risk of PIVC colonization and/or local infection (HR [95% CI], 1.64 [0.92—2.93] and 2.11 [1.08—4.13]) and of positive PIVC tip culture (HR [95% CI], 1.49 [1.02—2.18] and 1.59 [0.98—2.59]).ConclusionPIVC insertion at the wrist or cubital fossa should be avoided whenever possible to reduce the risk of catheter colonization and/or local infection and of positive PIVC tip culture.

Home energy management strategy to schedule multiple types of loads and energy storage device with consideration of user comfort: a deep reinforcement learning based approach

With the increase in the integration of renewable sources, the home energy management system (HEMS) has become a promising approach to improve grid energy efficiency and relieve network stress. In this context, this paper proposes an optimization dispatching strategy for HEMS to reduce total cost with full consideration of uncertainties, while ensuring the users’ comfort. Firstly, a HEMS dispatching model is constructed to reasonably schedule the start/stop time of the dispatchable appliances and energy storage system to minimize the total cost for home users. Besides, this dispatching strategy also controls the switching time of temperature-controlled load such as air conditioning to reduce the energy consumption while maintaining the indoor temperature in a comfortable level. Then, the optimal dispatching problem of HEMS is modeled as a Markov decision process (MDP) and solved by a deep reinforcement learning algorithm called deep deterministic policy gradient. The example results verify the effectiveness and superiority of the proposed method. The energy cost can be effectively reduced by 21.9% at least compared with other benchmarks and the indoor temperature can be well maintained.

Impact of different fibrin glue application methods on inguinal hernia mesh fixation capability

The use of fibrin glue for inguinal hernia mesh fixation has been suggested to be effective in preventing hematomas and reducing postoperative pain compared to tacks and sutures.. The effect of fibrin glue can vary significantly based on the device used. This study assessed the efficacy of fibrin glue based on the type of devices used in an ex vivo system. The rabbit’s abdominal wall was trimmed to a size of 3.0 × 6.0 cm and was secured at the edges with metal fixtures. To measure the maximum tensile strength at the point of adhesion failure, the hernia mesh was fixed to the rabbit’s abdominal wall using fibrin glue in a 2 cm square area, left for 3 min, and then pulled at a speed of 50 cm/min. The test was conducted 10 times for each group. The median (minimum–maximum) tensile strength values using the spraying, two-liquid mixing, and sequential layering methods were 3.58 (1.99–4.95), 0.51 (0.27–1.89), and 1.32 (0.63–1.66) N, respectively. The spraying method had predominantly higher tensile strength values than the two-liquid mixing and sequential layering methods (P < 0.01). In conclusion, in hernia mesh fixation, the spraying method can be adopted to achieve appropriate adhesive effects.

Does e-cigarette use predict short-term smoking cessation behaviors among adults who smoke in Mexico? A longitudinal study

IntroductionThis study assessed quit attempts among adults who use cigarettes either exclusively or with e-cigarettes in Mexico, where non-daily smoking predominates. MethodsAn open cohort of Mexican adults who smoke was surveyed every four months from November 2018 to March 2021. Participants followed to the next survey were analyzed (n = 2220 individuals, 4560 observations). Multinomial logistic models regressed smoking quit attempts reported at the followup survey (ref = no attempt; tried to quit; sustained attempt of ≥30 days) on e-cigarette use frequency (none = ref; 1–2 days/week; ≥3 days/week), adjusting for sociodemographics and smoking-related variables. Additional models subdivided e-cigarette users by intentions to quit smoking in the next six months (i.e., yes/no), use of nicotine (i.e., yes/no), and vaping device used (i.e., open/closed). ResultsAt 4-month follow-up, 32.7 % had tried to quit, and 2.9 % had quit for 30 days or more. Compared to those who smoke exclusively, occasional, and frequent e-cigarette users were more likely to try to quit (Adjusted Relative Risk Ratio or ARRR = 1.26 and 1.66, respectively) but no more likely to sustain their quit attempt. Among those who intended to quit smoking, e-cigarette users were no more likely to either try or sustain quit attempts. Furthermore, use of e-cigarettes with nicotine (59.6 %) was unassociated with cessation except that those who frequently used e-cigarettes with nicotine were more likely to try to quit than those who smoke exclusively (ARRR = 1.88). Device type used was not differentially associated with outcomes. ConclusionsMexicans who smoke and use e-cigarettes appear more likely than those who smoke exclusively to try to quit but not to sustain abstinence.

Comparative Cryogenic Investigation of FD-SOI Devices with Doped Epitaxial and Metallic Source/Drain

Defects induced by the source/drain process have a significant impact on the scattering mechanism of PMOS at cryogenic temperatures. Here, the cryogenic characteristics of FD-SOI devices with heavily doped epitaxial source/drain (Epi FD-SOI devices) and metallic Schottky barrier source/drain (SB FD-SOI devices) were investigated from 300 K down to 6 K. The doping profile along the channel was analyzed by TCAD simulation analysis. Experimental comparison of transistor performance at cryogenic temperatures was carried out for these devices with gate lengths (L G ) of 100 nm and 40 nm. The I-V characteristics of the FD-SOI devices were measured with a liquid helium cooling environment. The cryogenic effect of the two types of devices on Key parameters including transconductance (G m ), field effect mobility (μ FE ), threshold voltage (V th ) and subthreshold slope (SS) were systematically analyzed. The doping distribution of the heavily doped epitaxial SiGe source/drain structure were subjected to more Coulomb scattering at cryogenic temperatures, whereas the doping distribution of the Schottky-barrier source/drain structure dictates that the device is mainly subjected to phonon scattering at cryogenic temperatures.

Defect Engineering in Composition and Valence Band Center of Y2(YxRu1-x)2O7-δ Pyrochlore Electrocatalysts for Oxygen Evolution Reaction.

Oxygen evolution reaction (OER) takes place in various types of electrochemical devices that are pivotal for the conversion and storage of renewable energy. This paper describes a strategy in the design of solid-state structures of OER electrocatalysts through controlling the cation substitution on the active metal site and consequently valence band center position of site-mixed Y2(YxRu1-x)2O7-δ pyrochlore to achieve high catalytic activity. We found that partially replacing the B-site Ru4+ cation with A-site Y3+ in pyrochlore-structured Y2Ru2O7-δ modifies the oxidation state of B-site Ru from 4+ to 5+, as observed by electron paramagnetic resonance (EPR) spectroscopy but does not continuously increase the oxygen vacancy concentration in these oxygen substoichiometric compositions, as quantified by thermogravimetric analysis (TGA) decomposition studies. We found the increased Ru oxidation state leads to a downshift in valence band center. X-ray photoelectron spectroscopy (XPS) analysis was performed to quantitatively determine the optimal band center to be ∼1.27 eV below the Fermi energy level based on the analysis of the valence band edge of these Ru-based Y2(YxRu1-x)2O7-δ OER electrocatalysts. This work highlights that defect engineering can be a practical, effective approach to the optimization of oxidation state and electronic band center for high OER catalytic performance in a quantitative manner.

Equilibrium in the Computing Continuum through Active Inference

Computing Continuum (CC) systems are challenged to ensure the intricate requirements of each computational tier. Given the system’s scale, the Service Level Objectives (SLOs), which are expressed as these requirements, must be disaggregated into smaller parts that can be decentralized. We present our framework for collaborative edge intelligence, enabling individual edge devices to (1) develop a causal understanding of how to enforce their SLOs and (2) transfer knowledge to speed up the onboarding of heterogeneous devices. Through collaboration, they (3) increase the scope of SLO fulfillment. We implemented the framework and evaluated a use case in which a CC system is responsible for ensuring Quality of Service (QoS) and Quality of Experience (QoE) during video streaming. Our results showed that edge devices required only ten training rounds to ensure four SLOs; furthermore, the underlying causal structures were also rationally explainable. The addition of new types of devices can be done a posteriori; the framework allowed them to reuse existing models, even though the device type had been unknown. Finally, rebalancing the load within a device cluster allowed individual edge devices to recover their SLO compliance after a network failure from 22% to 89%.

Associations between vaping and self-reported respiratory symptoms in young people in Canada, England and the US

BackgroundPrevalence of youth nicotine vaping has increased, heightening concerns around negative health effects. This study aimed to compare self-reported respiratory symptoms among youth by vaping behaviours.MethodsParticipants (n = 39,214) aged 16–19 from the 2020 and 2021 International Tobacco Control Policy Evaluation Project (ITC) Youth Tobacco and Vaping Surveys (Canada, England, US). Weighted multivariable logistic regression assessed associations between reporting any of five respiratory symptoms in the past week (shortness of breath, wheezing, chest pain, phlegm, cough) and: past 30-day smoking and/or vaping; lifetime/current vaping. Among past-30-day vapers (n = 4644), we assessed associations between symptoms and vaping frequency, use of nicotine salts, usual flavour and device type(s).ResultsOverall, 27.8% reported experiencing any of the five respiratory symptoms. Compared with youth who had only vaped, those who had only smoked had similar odds of symptoms [adjusted odds ratio, OR (95% confidence interval, CI): 0.97 (0.85–1.10)], those who both smoked and vaped had higher odds [1.26 (1.12–1.42)], and those who had done neither, lower odds [0.67 (0.61–0.72)]. Compared with those who had never vaped, past use, experimentation and current regular or occasional use were all associated with higher odds. Reporting usually using nicotine salts was associated with higher odds of symptoms [1.43 (1.22–1.68)] than non-salt but was often uncertain. Compared with tobacco flavour (including with menthol), menthol/mint and sweets flavours were associated with similar odds; fruit [1.44 (1.07–1.93)], multiple [1.76 (1.30–2.39)] and ‘other’ [2.14 (1.45–3.16)] flavours with higher odds. All device types were associated with similar odds.ConclusionsAmong youth, vaping was associated with increased reporting of past-week respiratory symptoms. Among those who vaped, some flavour types and potentially nicotine salts were associated with respiratory symptoms.

Shake table tests on a rigid block isolated with high-damping unbonded fiber-reinforced elastomeric isolators

Fiber-reinforced elastomeric isolators (FREIs) represent a relatively recent type of elastomeric device. In contrast to traditional steel-reinforced elastomeric isolators (SREIs), FREIs are constructed with multiple layers of rubber pads and fiber layers instead of steel laminas. This choice is aimed at cost reduction during the manufacturing and installation process. To enhance cost-efficiency, FREIs can also be used in unbonded applications (UFREIs), where the device is placed between the foundation and the superstructure without bonding or fastening. This approach helps to further minimize installation expenses. Furthermore, the lateral rollover deformation, a characteristic feature of this configuration, improves energy dissipation. This study investigates the seismic isolation capabilities of high-damping unbonded FREIs for low-rise masonry buildings. Specifically, unidirectional cyclic and shake table tests of a rigid block isolated with two UFREIs are discussed. The primary goals of this experimental study include evaluating the effectiveness of UFREIs in reducing seismic demands, analyzing the response of UFREIs under unidirectional ground-motion excitation, confirming the ability of UFREIs to withstand major unidirectional excitation without sustaining damage, and exploring the limitations of this isolation system under a range of seismic inputs and low axial loads.

Experimental and analytical study on performance of anti-collision device using titanium steel and tires under impact load

Anti-collision devices can reduce the damage of bridge columns under ship collision, and a new type of device is proposed in the paper using a combination of titanium steel and recycled tires. The use of titanium steel is to improve the corrosion resistance, and the use of recycled tires is to improve self-floating capacity as well as save the cost. Three test specimens were designed and tested to investigate the behavior of the device under impact load and reveal the failure mechanism; finite element models were conducted to analyze and compare with the experimental results. Also, parametric study was conducted to reveal the effect of parameters on the ultimate capacity of the device. The performances of different types of the anti-collision device are compared, and the failure mechanism is studied. The results show that the proposed device effectively improves the performance of buffering energy dissipation and durability under impact load.

A Qualitative Study on Digital Citizenship Education in Primary Schools

In recent years, the number of studies related to digital citizenship has increased amidst the intense use of digital media. The literature, rich in theoretical and empirical examples related to this topic, provides a clear picture of contemporary society. There is little empirical research on digital citizenship education in the early school years. Thus, through this investigation, we aimed to collect qualitative data on the development of specific digital competencies and digital citizenship in primary school students. Therefore, the authors considered it appropriate to use the observation method in its participatory version. Over a year, a group of 29 pupils, aged between 6 and 7, formed the sample to identify how they would develop digital competencies and digital citizenship in the context of formal and non-formal learning experiences. To collect the necessary information, we used the observation protocol, conducted in the form of open-ended questions described by Gay, Mills &amp; Airasian (2006). The results of the study showed that parental educational attainment, family structure, time spent online, and the type of device have an important impact on the development of digital competencies and digital citizenship in young learners.

Macintosh-style videolaryngoscope use for tracheal intubation in elective surgical patients revisited: a sub-analysis of the 2022 Cochrane review data

The Cochrane systematic review and meta-analysis published in 2022 that compared videolaryngoscopy (VL) with direct laryngoscopy (DL) for facilitating tracheal intubation in adults found that all three types of VL device (Macintosh-style, hyper-angulated and channeled) reduced the risk of failed intubation and increased the likelihood of first-pass success. We report the findings of a subgroup re-analysis of the 2022 Cochrane meta-analysis data focusing on the Macintosh-style VL group. This was undertaken to establish whether sufficient evidence exists to guide airway managers in making purchasing decisions for their local institutions based upon individual device-specific performance. This re-analysis confirmed the superiority of Macintosh-style VL over Macintosh DL in elective surgical patients, with similar efficacy demonstrated between the Macintosh-style VL devices examined. Thus, when selecting which VL device(s) to purchase for their hospital, airway managers decisions are likely to remain focused upon issues such as financial costs, portability, cleaning schedules and previous device experience.

Benchmarking Android Malware Analysis Tools

Today, malware is arguably one of the biggest challenges organisations face from a cybersecurity standpoint, regardless of the types of devices used in the organisation. One of the most malware-attacked mobile operating systems today is Android. In response to this threat, this paper presents research on the functionalities and performance of different malicious Android application package analysis tools, including one that uses machine learning techniques. In addition, it investigates how these tools streamline the detection, classification, and analysis of malicious Android Application Packages (APKs) for Android operating system devices. As a result of the research included in this article, it can be highlighted that the AndroPytool, a tool that uses machine learning (ML) techniques, obtained the best results with an accuracy of 0.986, so it can be affirmed that the tools that use artificial intelligence techniques used in this study are more efficient in terms of detection capacity. On the other hand, of the online tools analysed, Virustotal and Pithus obtained the best results. Based on the above, new approaches can be suggested in the specification, design, and development of new tools that help to analyse, from a cybersecurity point of view, the code of applications developed for this environment.

Computed Simulation of Transcatheter Edge-to-Edge Mitral Valve Repair - A Proof of Concept Study.

As transcatheter mitral valve (MV) interventions are expanding and more device types and sizes become available, a tool supporting operators in preprocedural planning and the clinical decision-making process is highly desirable. We sought to develop a finite element (FE) computational simulation model to predict results of transcatheter edge-to-edge (TEER) interventions. We prospectively enrolled patients with secondary mitral regurgitation (MR) referred for a clinically indicated TEER. Three-dimensional (3D) transesophageal echocardiograms performed at the beginning of the procedure were used to perform the simulation. On the 3D dynamic model of the MV that was first obtained, we simulated the clip implantation using the same clip(s) type, size, number, and implantation location that was used during the intervention. The 3D model of the MV obtained after simulation of the clip implantation was compared to the clinical results obtained at the end of the intervention. We analyzed the degree and location of residual MR and the shape and area of the diastolic mitral valve area. We performed computational simulation on 5 patients. Overall, the simulated models predicted well the degree and location of the residual regurgitant orifice(s) but tended to underestimate the diastolic mitral orifice area. In this proof-of-concept study, we present preliminary results on our algorithm simulating clip implantation in 5 patients with functional MR. We show promising results regarding the feasibility and accuracy in terms of predicting residual MR and the need to improve the estimation of the diastolic mitral valve area.

Enhanced contact performance of high-brightness micro-LEDs via ITO/Al anode stack and annealing process

Micro-light-emitting diodes (Micro-LEDs) are a new type of display device based on the third-generation semiconductor gallium nitride (GaN) material which stands out for its high luminous efficiency, elevated brightness, short response times, and high reliability. The contact between anode layers and P-GaN is one of the keys to improving the performance of the devices. This study investigates the impact of electrode structure design and optimized annealing conditions on the anode contact performance of devices. The Micro-LED device with the size of 9.1 μm whose electrode structure is ITO/Ti/Al/Ni/Cr/Pt/Au (100/50/350/100/500/500/5000 Å) exhibits a significant improvement in contact performance after annealing under the Ar gas atmosphere at 500 °C for 5 min. The optimized device exhibited a current of 10.9 mA and a brightness of 298,628 cd/m2 under 5 V. The EQE peak value of Device A is 10.06% at 400 mA.

Stroke outcomes following durable left ventricular assist device implant in patients bridged with micro-axial flow pump: Insights from a large registry.

Stroke after durable left ventricular assist device (d-LVAD) implantation portends high mortality. The incidence of ischemic and hemorrhagic stroke and the impact on stroke outcomes of temporary mechanical circulatory support (tMCS) management among patients requiring bridge to d-LVAD with micro-axial flow-pump (mAFP, Abiomed) is unsettled. Consecutive patients, who underwent d-LVAD implantation after being bridged with mAFP at 19 institutions, were retrospectively included. The incidence of early ischemic and hemorrhagic stroke after d-LVAD implantation (<60 days) and association of pre-d-LVAD characteristics and peri-procedural management with a specific focus on tMCS strategies were studied. Among 341 patients, who underwent d-LVAD implantation after mAFP implantation (male gender 83.6%, age 58 [48-65] years, mAFP 5.0/5.5 72.4%), the early ischemic stroke incidence was 10.8% and early hemorrhagic stroke 2.9%. The tMCS characteristics (type of mAFP device and access, support duration, upgrade from intra-aortic balloon pump, ECMELLA, ECMELLA at d-LVAD implantation, hemolysis, and bleeding) were not associated with ischemic stroke after d-LVAD implant. Conversely, the device model (mAFP 2.5/CP vs. mAFP 5.0/5.5: HR 5.6, 95%CI 1.4-22.7, p = 0.015), hemolysis on mAFP support (HR 10.5, 95% CI 1.3-85.3, p = 0.028) and ECMELLA at d-LVAD implantation (HR 5.0, 95% CI 1.4-18.7, p = 0.016) were associated with increased risk of hemorrhagic stroke after d-LVAD implantation. Both early ischemic (HR 2.7, 95% CI 1.9-4.5, p < 0.001) and hemorrhagic (HR 3.43, 95% CI 1.49-7.88, p = 0.004) stroke were associated with increased 1-year mortality. Among patients undergoing d-LVAD implantation following mAFP support, tMCS characteristics do not impact ischemic stroke occurrence, while several factors are associated with hemorrhagic stroke suggesting a proactive treatment target to reduce this complication.

Representation of aided AAC in contemporary young adult fiction

The current study explored both the extent to which representation of augmentative and alternative communication (AAC) exists in young adult literature, as well as qualitative characteristics of that representation. A systematic search of multiple databases was conducted using standardized keywords and inclusion criteria. Descriptive statistics and literary content analysis were employed in order to analyze quantitative and qualitative information about each of the 32 novels that fit inclusion criteria. Results indicated that, while representation of AAC in young adult fiction largely aligned with existing statistics regarding types of AAC devices used, stories often differed from current information about the most common etiologies of AAC users. Analyses of character development revealed most featured AAC-using characters were multidimensional and expressed positive attitudes regarding their devices, although some characters also expressed frustration. These results indicated that representation of AAC in young adult literature was sparse. However, the representation that did exist at least partially reflected reality and may represent a positive portrayal of AAC use and users.

Nicotine Dependency Levels Among Adult Electronic Cigarette Smokers in Jeddah, Saudi Arabia: An Analytical Cross-Sectional Study.

Electronic cigarettes (ECs) are a recent method to deliver nicotine with less harmful effects than traditional cigarettes. Studying nicotine dependence in adult EC users is a crucial area, but few measures are available to evaluate nicotine dependence induced by EC. Our study aims to estimate the levels of nicotine dependency among adult EC smokers using a modified Fagerström Test of Nicotine Dependence (e-FTND) in Jeddah, Saudi Arabia, and to identify EC-associated sociodemographic and smoking-related factors affecting nicotine dependency. An analytical cross-sectional study was conducted on adults 18 years of age and older in Jeddah, Saudi Arabia, from December 2023 to March 2024. Data were collected from the participants using a pre-tested structured self-administered questionnaire, and nicotine dependence was assessed using the modified e-FTND. Descriptive statistics such as frequency, mean, and standard deviation were applied. Chi-square was used to assess the association between categorical variables. Ordinal regression was used to predict the nicotine dependency levels with different variables. A total of 344 participants were included in the study. The mean e-FTND score for EC users was 4.14 ± 2.45. Females had a lower likelihood of experiencing higher dependence compared to males (OR = 0.52, 95% CI: 0.32, 0.85). Using ECs for more than three years was associated with higher odds of increased dependence (OR = 3.18, 95% CI: 1.28, 7.98; p < 0.001). The use of Pod system devices lowered the odds of developing high nicotine dependence (OR = 0.32, 95% CI: 0.13, 0.75; p = 0.01) compared to Iqos device users, while mechanical Mod device users exhibited a trend towards higher dependence, although it was not statistically significant. Nicotine concentration in ECs had a significant impact on the degree of nicotine dependence. Higher concentrations were associated with increased odds of higher dependence (12-18 mg: OR = 3.26, 95% CI: 1.55, 6.91; >18 mg: OR = 4.53, 95% CI: 2.37, 8.75; p < 0.001). Most exclusive EC users in the study developed a moderate nicotine dependence level. The EC device type and nicotine concentration were significant drivers of nicotine dependence. Additionally, the personal characteristics of the users, such as male gender and duration of use, were associated with a higher risk of dependence. An in-depth understanding of the magnitude of nicotine dependence among EC users will enhance the opportunity for tailored health-enhancing interventions and policies.