Cigarette Tobacco Use Research Articles

Comparative Risks of Electronic Versus Tobacco Cigarette Use During Pregnancy: Findings From a Low-Risk Sample [ID: 1374893

INTRODUCTION: Harms of tobacco use in pregnancy are well studied and include low birth weight, decreased newborn well-being, and need for medical interventions after birth. Less understood is the effect of noncombustible alternatives, including electronic cigarettes (ECs). We examined whether EC use during pregnancy also increases risk of adverse birth outcomes. METHODS: Data were from the Michigan Obstetrics Initiative (OBI), a quality improvement effort involving 75 maternity hospitals, focused on safely reducing cesarean delivery rates. Our participants were nulliparous, singleton pregnancy, term delivery, and vertex fetal positioning. Data were from medical records, entered locally, and compiled centrally by OBI. RESULTS: Participants delivered since January 1, 2021, with no known pregnancy alcohol and opioid use: controls (no EC/tobacco use [n=26,394], EC only [n=493], and tobacco only [n=2,126]). After control for confounding and comparison to controls, the EC group had significantly lower birth weight; the tobacco group had reduced birth weight, and greater rates of arterial cord pH less than 7.1, 5-minute Apgar scores less than 8, and neonatal intensive care unit admission. CONCLUSION: While EC use in pregnancy reduced birth weight, most newborn risks linked to tobacco exposure were not predicted by EC use. Additional study is needed, as nonsignificant trends toward poorer outcomes for EC users were evident, and potentially significant with larger samples or when amount/timing of EC exposure is considered. Further, given this sample was low risk, cases for whom EC use led to adverse outcomes were potentially eliminated. Growing evidence suggests pregnant patients should be counseled to avoid EC use.

Electronic cigarettes exposures modulate Heart Rate and Heart Rate Variability

Background: Despite a lack of empirical data, an unprecedented rise in electronic cigarettes (ECs) has been widely perceived as safe. Multiple studies support a causal link between tobacco cigarette (TC) use and cardiovascular (CV) diseases; however, there is a lack of data with EC use. We have previously shown that chronic and acute EC use decreases heart rate variability (HRV) in humans, likely via increased sympathetic nervous system activation. Objective: We aimed to evaluate HRV effects induced by brief EC exposures utilizing an in-vivo model for freely moving C57BL/6 mice. Methods and Results: Telemetry devices were implanted in the abdomen of six 10-week-old C57BL/6 male mice to monitor electrocardiographic activity continuously. Mice underwent an exposure protocol designed to reflect human vaping topography with two EC exposures, each lasting 15-minutes (4-sec puff/ 26-sec Air) followed by 45-min post-exposure periods. Air (primary control) and PBS (secondary control) were also included, each with their own post-exposure events. During EC exposures, we observed bradycardic effects in heart rate (HR) with the standard deviation of NN intervals (SDNN), root mean square of successive differences (RMSSD), and the proportion of adjacent normalized RR intervals that differed by more than 6 ms (pNN 6 ) significantly (p< 0.05) altered as compared to Air exposures. After EC exposures, SDNN, RMSSD and pNN 6 parameters significantly decreased compared to Air. No significant differences between Air and PBS were observed in these parameters. Frequency domain parameters also indicated significant changes in HRV; the low frequency (LF) and high frequency (HF) bands showed marked increases during and after the EC exposures, while the log (LF/HF) ratio remained relatively unchanged, suggesting a possible coactivation of both parasympathetic and sympathetic branches of the autonomic nervous system. Conclusion: Short-term EC exposures lower heart rate and altered HRV in mice in an acute manner, suggesting that ECs may not be safe as previously assumed. This work was funded by the Tobacco-Related Disease Research Program (TRDRP) which included the High Impact Pilot Research Award [28IP-0036], the Cornelius Hopper Diversity Award Supplement and the Student Research Award Supplement, the UCLA Center for Occupational and Environmental Health (COEH) Student Project Award, and in part by the National Institute of Environmental Health Sciences (NIEHS) via the Student-to-Scientist Bridge program at California State University, Northridge [5R25ES025507]. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Tobacco Cigarette Use and Control in Saudi Arabia from 1980 to 2020: Insights from Peri-FCTC MPOWER Implementations

Tobacco Cigarette Use and Control in Saudi Arabia from 1980 to 2020: Insights from Peri-FCTC MPOWER Implementations

Sociodemographic inequalities in cigarette, smokeless tobacco, waterpipe tobacco, and electronic cigarette use among adolescents in 114 countries: a cross-sectional analysis

Sociodemographic inequalities in cigarette, smokeless tobacco, waterpipe tobacco, and electronic cigarette use among adolescents in 114 countries: a cross-sectional analysis

Study protocol of the Our Futures Vaping Trial: a cluster randomised controlled trial of a school-based eHealth intervention to prevent e-cigarette use among adolescents

BackgroundEffective and scalable prevention approaches are urgently needed to address the rapidly increasing rates of e-cigarette use among adolescents. School-based eHealth interventions can be an efficient, effective, and economical approach, yet there are none targeting e-cigarettes within Australia. This paper describes the protocol of the OurFutures Vaping Trial which aims to evaluate the efficacy and cost-effectiveness of the first school-based eHealth intervention targeting e-cigarettes in Australia.MethodsA two-arm cluster randomised controlled trial will be conducted among Year 7 and 8 students (aged 12–14 years) in 42 secondary schools across New South Wales, Western Australia and Queensland, Australia. Using stratified block randomisation, schools will be assigned to either the OurFutures Vaping Program intervention group or an active control group (health education as usual). The intervention consists of four web-based cartoon lessons and accompanying activities delivered during health education over a four-week period. Whilst primarily focused on e-cigarette use, the program simultaneously addresses tobacco cigarette use. Students will complete online self-report surveys at baseline, post-intervention, 6-, 12-, 24-, and 36-months after baseline. The primary outcome is the uptake of e-cigarette use at 12-month follow-up. Secondary outcomes include the uptake of tobacco smoking, frequency/quantity of e-cigarettes use and tobacco smoking, intentions to use e-cigarettes/tobacco cigarettes, knowledge about e-cigarettes/tobacco cigarettes, motives and attitudes relating to e-cigarettes, self-efficacy to resist peer pressure and refuse e-cigarettes, mental health, quality of life, and resource utilisation. Generalized mixed effects regression will investigate whether receiving the intervention reduces the likelihood of primary and secondary outcomes. Cost-effectiveness and the effect on primary and secondary outcomes will also be examined over the longer-term.DiscussionIf effective, the intervention will be readily accessible to schools via the OurFutures platform and has the potential to make substantial health and economic impact. Without such intervention, young Australians will be the first generation to use nicotine at higher rates than previous generations, thereby undoing decades of effective tobacco control.Trial registrationThe trial has been prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12623000022662; date registered: 10/01/2023).

Associations of dual use of tobacco cigarettes and e-cigarettes, sleep duration, physical activity and depressive symptoms among middle-aged and older Korean adults.

There is limited evidence of the association between dual tobacco-e-cigarette use and health-related variables in Korea. Thus, this study aimed to investigate the associations between types of cigarette smoking, sleep duration, physical activity and depressive symptoms among Korean adults. A cross-sectional study design using the 2019 Korean Community Health Survey. The study subjects consisted of 179,004 adults older than 40 years from a total of 229,099 individuals. Self-reported general characteristics, smoking history, sleep duration, physical activity and depressive symptoms were analysed. In multinomial logistic regression, dual users of tobacco cigarettes and e-cigarettes were more likely to have sleep duration of less than 7h per day and to report both mild and moderate-to-severe depressive symptoms than non-smokers. Single use of either cigarettes or e-cigarettes increased the risk of short sleep duration and moderate-to-severe depressive symptoms.

Addictive Potential of e-Cigarettes as Reported in e-Cigarette Online Forums: Netnographic Analysis of Subjective Experiences

While e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are addictive, users will experience typical symptoms of addiction. The aim of our study was to investigate whether and how e-cigarette users report signs of addiction. We identified 3 large German-language e-cigarette online forums via a systematic Google search. Based on a netnographic approach, we used deductive content analysis to investigate relevant posts in these forums. Netnography has the advantage of limiting the social desirability bias that prevails in face-to-face research, such as focus groups. The data were coded according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for tobacco use disorder, adapted for e-cigarettes. The DSM-5 criteria were used to portray a broad spectrum of possible experiences of addiction. Overall, 5337 threads in 3 forums were screened, and 451 threads containing relevant information were included in the analysis. Users reported experiences consistent with the DSM-5 criteria, such as craving e-cigarettes, excessive time spent vaping, and health issues related to e-cigarette use. However, our analysis also showed that users reported the absence of typical tobacco use disorder criteria, such as successful attempts to reduce the nicotine dosage. For most themes, reports of their absence were more frequent than of their presence. The absence of perceived addiction was mostly reported in contrast to prior tobacco smoking. This is the first study to use a netnographic approach to explore unfiltered self-reports of experiences of e-cigarette addiction by users in online forums. As hypothesized, some but not all users reported subjective experiences that corresponded to the criteria of tobacco use disorder as defined by the DSM-5. Nevertheless, subjective reports also indicated that many e-cigarette users felt in control of their behavior, especially in contrast to their prior use of tobacco cigarettes. The finding that some e-cigarette users subjectively experience addiction highlights the need for effective cessation programs to support users who experience their e-cigarette use as burdensome. This research can guide the refinement of instruments to assess e-cigarette addiction and guide cessation programs. RR2-10.1186/s40359-021-00682-8.

Socio-temporal contextual and community factors associated with daily exclusive ENDS use and dual use with tobacco cigarettes among adolescent vapers: an ecological momentary assessment study

BackgroundAdolescents who dual use ENDS with tobacco cigarettes are more likely to have an increased risk of developing dependence. Yet, little is understood about the factors driving dual use among adolescents. The current study sought to reveal the day-to-day socio-temporal contextual and community factors associated with adolescents’ use of electronic nicotine delivery systems (ENDS), and how these factors predict dual use with tobacco cigarettes.MethodsWe collected ecological momentary assessments (EMA) from a sample of 50 adolescent past two-week vapers (ages 14–17 years old) over 14 days. Daily EMA data were collected on ENDS and tobacco cigarette use, as well as a range of contextual (i.e., motivations to vape, location of vaping, who with when vaping) and community factors (i.e., exposure to peers vaping, to adults vaping, to ENDS advertising, to ENDS warning messages). Our primary analyses were multilevel regressions, accounting for daily observations nested within individuals (N = 700 observations).ResultsParticipants used ENDS exclusively on 44% of days and dual used ENDS and tobacco cigarettes on 8% of the days. Dual use days (versus exclusive ENDS use days) were associated with “vaping because tobacco use was prohibited” (OR = 34.65, p < .05). Also, dual use days (versus no use days) were associated with greater exposure to adults vaping (OR = 5.59, p < .05), peers vaping (OR = 7.48, p < .05), and (c) ENDS advertisements or promotions (OR = 2.12, p < .01), whereas exclusive use days (versus no use days) were only associated with greater exposure to peers vaping (OR = 2.58, p < .01).ConclusionsResults showed that exposure to peers and adults vaping and exposure to ENDS marketing were associated with same day dual use behaviors. And, that adolescents who dual used were motivated to use ENDS because they were easy to conceal. Findings support stricter regulation of ENDS marketing and for smoke-free air laws that include ENDS. In addition, these findings support prioritizing family- and school-based prevention programming that effectively communicates risk associated with ENDS use, including heightened risk of dual use and dependence. Such efforts can reduce the number of adolescents who use ENDS as well as the number who transition to tobacco cigarette use.

Smoking Behaviors and Prognosis in Patients With Non–Muscle-Invasive Bladder Cancer in the Be-Well Study

Tobacco smoking is an established risk factor associated with bladder cancer, yet its impact on bladder cancer prognosis is unclear. To examine associations of use of tobacco (cigarettes, pipes, and cigars), e-cigarettes, and marijuana with risk of recurrence and progression of non-muscle-invasive bladder cancer (NMIBC) and to explore use of smoking cessation interventions. The Be-Well Study is a prospective cohort study of patients with NMIBC diagnosed from 2015 to 2019 and followed-up for 26.4 months in the Kaiser Permanente Northern and Southern California integrated health care system. Eligibility criteria were age at least 21 years, first NMIBC diagnosis (stages Ta, Tis, or T1), alive, and not in hospice care. Exclusion criteria were previous diagnosis of bladder cancer or other cancer diagnoses within 1 year prior to or concurrent with NMIBC diagnosis. Data were analyzed from April 1 to October 4, 2022. Use of cigarettes, pipes, cigars, e-cigarettes, and marijuana was reported in the baseline interview. Use of smoking cessation interventions (counseling and medications) was derived from electronic health records. Hazard ratios (HRs) and 95% CIs of recurrence and progression of bladder cancer were estimated by multivariable Cox proportional hazards regression. A total of 1472 patients (mean [SD] age at diagnosis, 70.2 [10.8%] years; 1129 [76.7%] male patients) with NMIBC were enrolled at a mean (SD) of 2.3 (1.3) months after diagnosis, including 874 patients (59.4%) who were former smokers and 111 patients (7.5%) who were current cigarette smokers; 67 patients (13.7%) smoked pipes and/or cigars only, 65 patients (4.4%) used e-cigarettes, 363 patients (24.7%) used marijuana. Longer cigarette smoking duration and more pack-years were associated with higher risk of recurrence in a dose-dependent manner, with the highest risks for patients who had smoked for 40 or more years (HR, 2.36; 95% CI, 1.43-3.91) or 40 or more pack-years (HR, 1.97; 95% CI, 1.32-2.95). There was no association of having ever smoked, being a former or current cigarette smoker, and years since quit smoking with recurrence risk. No associations with pipes, cigars, e-cigarettes, or marijuana were found. Of 102 patients offered a smoking cessation intervention, 57 (53.8%) received an interventions after diagnosis, with female patients more likely than male patients to engage in such interventions (23 of 30 female patients [76.7%] vs 34 of 76 male patients [44.7%]; P = .003). These findings suggest that longer duration and more pack-years of cigarette smoking were associated with higher risk of NMIBC recurrence. Cigarette smoking remains a critical exposure before and after diagnosis in survivors of NMIBC.

Attitude and Practice Toward Use of Cigarettes and Electronic Cigarettes Among Pregnant Women: A Questionnaire-Based Survey.

This study aimed to evaluate attitude and practice toward use of regular tobacco cigarettes and electronic cigarettes among pregnant women. A total of 1123 pregnant women participated on a voluntary basis in this questionnaire survey. Maternal characteristics, cigarette consumption parameters, and personal opinions regarding the adverse effects of smoking during pregnancy were evaluated. Active smokers composed 12.4% (9.4%: regular tobacco cigarettes, 3.0%: electronic cigarettes) of the study population. Smoking during the current pregnancy, particularly via regular tobacco cigarettes, was more likely for women with smoking during previous pregnancies (56.0% vs. 7.8%, P < .001), previous history of low birth weight infant delivery (16.1% vs. 8.6%, P = .013), premature delivery (16.7% vs. 7.0%, P < .001), and stillbirth (22.8% vs. 11.7%, P = .002). The presence versus absence of smoking during pregnancy was associated with a lower likelihood of being a housewife (70.5% vs. 80.5%, P = .010) and a higher likelihood of having an actively smoking mother (25.9% vs. 11.2%, P < .001) or partner (65.7% vs. 46.9%, P < .001). Regular tobacco cigarette users considered electronic cigarettes to have a higher risk of adverse impacts (11.1% vs. 2.9%, P = .012), while electronic cigarette users considered regular cigarettes to have a higher risk of nicotine exposure (55.9% vs. 13.0%, P < .001). Our findings indicate being employed, having an actively smoking mother or partner, as well as smoking in previous pregnancies, to be the risk factors for increased likelihood of smoking during pregnancy.

Associations of tobacco cigarette use and dependence with substance use disorder treatment completion by sex/gender and race/ethnicity

IntroductionIndividuals with substance use disorders (SUD) are approximately five times more likely to smoke cigarettes than the general population. Individuals who smoke cigarettes have greater odds of SUD relapse compared to individuals who do not smoke cigarettes, but we know little about how cigarette use is related to SUD treatment completion overall by sex/gender or race/ethnicity. MethodsThis study examined 2855 adults (71.98 % male; >70 % racial/ethnic minority) in outpatient and residential SUD treatment at a New York–based treatment agency over a six-month period in 2018. ResultsOverall, approximately three-fourths of SUD treatment-seeking participants smoked cigarettes, with high rates across sex/gender and racial/ethnic groups. Nicotine dependence did not differ by sex/gender, and White Non-Hispanic adults had the highest levels of nicotine dependence across racial/ethnic groups. Those who smoked cigarettes were significantly less likely to complete treatment compared to those who did not smoke cigarettes (OR = 0.69; 95 % CI: 0.58, 0.82). The study found no overall differences in SUD treatment completion and length of stay by sex/gender or race/ethnicity. ConclusionsGiven the high prevalence of cigarette smoking and lower odds of completing SUD treatment, the current system of care for SUD treatment may be enhanced by addressing cigarette smoking from onset of treatment.

Differences in Hemodynamic Status in Users of Tobacco Cigarettes and E-Cigarettes

Background/Aim: The use of cigarettes is increasing every year, thus placing Indonesia in the first rank in ASEAN in the number of smokers. Cigarettes have many types, such as tobacco cigarettes and e-cigarettes. E-cigarettes are considered to be more 'healthy' than conventional cigarettes. Meanwhile, both tobacco cigarettes and e-cigarettes have the same content and mechanism that can have an effect on hemodynamic status. This study was performed to increase knowledge for further research regarding differences in hemodynamic status in users of tobacco cigarettes and users of electric cigarettes (e-cigarettes). Methods: Based on the topic/subject, a literature search was conducted in the form of journals, textbooks through the Google Scholar, PubMed, and Cochrane databases. Which is determined from 2016 to 2021 and is indexed by Scopus, ISSN, national journals, and international journals. Results: From the discussion of journals regarding research and theories about the effect of using tobacco cigarettes and e-cigarettes on hemodynamic status. There is no difference in hemodynamic status in the use of the two types of cigarettes because the content and mechanisms that affect the cardiovascular system are the same. Conclusion: Based on the literature review, it can be concluded that there is no difference in hemodynamic status in the use of tobacco cigarettes and e-cigarettes. Keywords: hemodynamic status, tobacco cigarettes, e-cigarettes.

Electronic cigarette use in adolescence is associated with later cannabis use

BackgroundResearch is needed to determine whether e-cigarette use during adolescence is associated with higher odds of subsequent cannabis use, net of tobacco cigarette use and childhood confounders. MethodsMultivariable logistic regressions predicting using cannabis by age 17 based upon prospective, intergenerational data from 10,251 youth in a nationally representative UK birth cohort followed from infancy who had not used cannabis by age 14. The focal predictor is e-cigarette use by age 14 in the context of the potential confounder tobacco cigarette use. Regressions include sociodemographic background and risk factors assessed at age 11 (e.g., alcohol initiation, problem behaviors, parental and peer smoking) and during early childhood (e.g., maternal smoking during pregnancy, parental substance use). ResultsYouth use of e-cigarettes by age 14 was associated with 2.8 times higher odds of subsequent cannabis use by age 17 [OR 2.75; 95% CI 1.82,4.15], net of tobacco cigarette smoking and childhood confounders. Similarly, use of e-cigarettes by age 14 was associated with 2.5 times higher odds [OR 2.46; 95% CI 1.48,4.08] of frequent cannabis use at age 17 (>10 times in prior year). If youth used both e-cigarettes and tobacco cigarettes by age 14, the probabilities of cannabis initiation were 75% and of frequent use was 25% by age 17, compared to probabilities of 23% and 6%, respectively, among youth who had used neither product. ConclusionsFindings add to accumulating evidence that adolescent e-cigarette use is associated with higher odds of later cannabis initiation and frequent use, independent of tobacco cigarette use.

The Mood Boost from Tobacco Cigarettes is More Erratic with the Additions of Cannabis and Alcohol.

A large body of literature indicates that nicotine results in an acute mood "boost," including increased positive affect and decreased negative affect. Young adults frequently engage in polysubstance use of cigarettes with cannabis and alcohol-a trend that is likely to accelerate with the expanding legalization of cannabis. However, little is known about whether polysubstance use, defined here as combustible tobacco cigarette use within the same hour as cannabis and alcohol, is associated with changes in the nicotine mood boost. The present study aimed to address this gap. Young adults (N = 202, 52% female, mean age = 21 years at time 1) provided ecological moments assessment (EMA) reports of cigarette use over two 7-day bursts spaced 1 year apart. In each report, participants rated mood levels before and after smoking, and indicated cannabis and alcohol use. Mixed-effects location-scale modeling simultaneously tested changes in mood levels and variability related to smoking events with cannabis and/or alcohol compared with smoking-only events. From before to after smoking, positive affect increased and negative affect decreased, on average. Overall, the additions of cannabis and/or alcohol had nonsignificant associations with these mean changes. However, polysubstance use, as well as cigarette-cannabis co-use, were each associated with significantly greater within-person variability in the positive and negative affect changes related to smoking. The mood benefits associated with smoking were more erratic in the contexts of polysubstance use and cigarette-cannabis co-use. Potential implications for young adults' long-term nicotine use trajectories are discussed. Among young adults who smoke cigarettes, the mood "boost" from smoking may be more erratic-which is to say, more likely to be either amplified or attenuated-with the additions of cannabis and alcohol together, or cannabis alone. On occasions when young adults seek out cannabis and alcohol to enhance their smoking mood boost, but instead experience a dampening effect, they might consume more nicotine, contributing over time to greater dependence. Future investigation is warranted, with particular attention to nicotine-cannabis co-use.

Addiction-Related Outcomes of Nicotine and Alcohol Co-use: New Insights Following the Rise in Vaping.

Nicotine and alcohol-containing products are some of the most commonly used substances of abuse and are both leading causes of preventable death. These substances also have significant interactions that have additive and, in some cases, multiplicative effects on the health consequences of their use. Thus, to reduce these negative consequences, it is important to understand the abuse liability of nicotine and alcohol in combination, especially in the most relevant use cases among those who are most vulnerable. Specifically, as tobacco cigarette use is continually decreasing, vaping is quickly replacing cigarettes as the primary mode of nicotine use. This pattern is especially true in adolescent populations in which vaping has grown considerably. Particularly concerning is that adolescents are more vulnerable than adults to the negative consequences of substance use. It is therefore imperative to revisit the literature as it relates to the rising state of co-use of vaping products with alcohol. Here, we review the clinical outcomes of nicotine and alcohol co-use as they relate to the abuse liability of each individually. Special attention is paid to adolescent findings, where available, as well as investigations that use nontobacco nicotine products as these may more accurately reflect the more recent trends of co-use. Though nicotine alone has previously been considered a proxy for tobacco and tobacco cigarette use, combustible routes of administration have been decreasing. They are, instead, being replaced by e-cigarettes that do not involve other tobacco constituents and contain additional nonnicotine constituents of their own. Unfortunately, the literature remains limited with regard to e-cigarettes and their interactions with other substances, especially their prevalent co-use with alcohol. This review attempts to discuss the current literature on nicotine and alcohol co-use in the context of the vaping epidemic, predominantly focusing on addiction-related outcomes and why e-cigarette use may be unique.

Tobacco Smoke and Electronic Cigarette Vapor Alter Enhancer RNA Expression That Can Regulate the Pathogenesis of Lung Squamous Cell Carcinoma.

Simple SummaryIt is well established that tobacco smoke is the key player in lung squamous cell carcinoma (LUSC) pathogenesis, and there is growing evidence that electronic cigarette (e-cigarette) vapor may also cause LUSC. Recently, several studies have associated tobacco smoke with differential enhancer RNA (eRNA) expression. However, the effects of tobacco smoke and e-cigarette vapor on eRNA expression in correlation to LUSC outcomes have not been fully elucidated. This study demonstrates that tobacco smoke and e-cigarette vapor may decrease DNA methylation and increase chromosomal alterations at key sites, which ultimately upregulate the expression of oncogenic eRNAs and downregulate the expression of tumor-suppressing eRNAs. Subsequently, we demonstrate that these eRNAs may have altered interactions with immune cells to promote LUSC pathogenesis and reduced patient survival. We hope our results can be validated in future studies, and the key eRNAs we identified may be used as effective targets for more specialized treatments for smoking-mediated LUSC. Tobacco is the primary etiologic agent in worsened lung squamous cell carcinoma (LUSC) outcomes. Meanwhile, it has been shown that etiologic agents alter enhancer RNAs (eRNAs) expression. Therefore, we aimed to identify the effects of tobacco and electronic cigarette (e-cigarette) use on eRNA expression in relation to LUSC outcomes. We extracted eRNA counts from RNA-sequencing data of tumor/adjacent normal tissue and before/after e-cigarette tissue from The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO), respectively. Tobacco-mediated LUSC eRNAs were correlated to patient survival, clinical variables, and immune-associated elements. eRNA expression was also correlated to mutation rates through the Repeated Evaluation of Variables Conditional Entropy and Redundance (REVEALER) algorithm and methylated sites through methylationArrayAnalysis. Differential expression analysis was then completed for the e-cigarette data to compare with key tobacco-mediated eRNAs. We identified 684 downregulated eRNAs and 819 upregulated eRNAs associated with tobacco-mediated LUSC, specifically, with the cancer pathological stage. We also observed a decrease in immune cell abundance in tobacco-mediated LUSC. Yet, we found an increased association of eRNA expression with immune cell abundance in tobacco-mediated LUSC. We identified 16 key eRNAs with significant correlations to 8 clinical variables, implicating these eRNAs in LUSC malignancy. Furthermore, we observed that these 16 eRNAs were highly associated with chromosomal alterations and reduced CpG site methylation. Finally, we observed large eRNA expression upregulation with e-cigarette use, which corresponded to the upregulation of the 16 key eRNAs. Our findings provide a novel mechanism by which tobacco and e-cigarette smoke influences eRNA interactions to promote LUSC pathogenesis and provide insight regarding disease progression at a molecular level.

Adolescent electronic cigarette use and tobacco smoking in the Millennium Cohort Study

AbstractAimsTo evaluate the catalyst, diversion and common liability hypotheses by examining associations between e‐cigarette use and tobacco cigarette smoking at modal ages 14 and 17 years, controlling for adolescent and infancy risk factors.DesignIntergenerational, prospective cohort data from the Millennium Cohort Study (MCS). Nationally representative sample of infants born September 2000 to January, 2002.SettingUnited Kingdom.ParticipantsParent and child data from 10 625 youth assessed in infancy and modal ages 11, 14 and 17 years.MeasurementsAge 14 and 17 e‐cigarette and combustible cigarette use (recency, frequency). Potential confounders were age 11 risk factors (e.g. alcohol use, externalizing behaviors, parental tobacco use, permissiveness), infancy risk factors (e.g. maternal smoking during pregnancy, smoke exposure in infancy) and demographic characteristics.FindingsAmong youth who had not smoked tobacco by age 14 (n = 9046), logistic regressions estimated that teenagers who used e‐cigarettes by age 14 compared with non‐e‐cigarette users, had more than five times higher odds of initiating tobacco smoking by age 17 [odds ratio (OR) = 5.25, 95% confidence interval (CI) = 3.28–8.38] and nearly triple the odds of being a frequent tobacco smoker at age 17 (OR = 2.91, 95% CI = 1.56–5.41), net of risk factors and demographics. Among youth who had not used e‐cigarettes by age 14 (n = 9078), teenagers who had smoked tobacco cigarettes by age 14 had three times higher odds of initiating e‐cigarettes by age 17 (OR = 2.98, 95% CI = 1.74–5.09) compared with non‐tobacco smokers and nearly three times higher odds of frequently using e‐cigarettes at age 17 (OR = 2.90, 95% CI = 1.21–6.95), net of confounders. Similar links between e‐cigarette and tobacco cigarette use were observed in regressions following coarsened exact matching.ConclusionsE‐cigarette use by age 14 is associated with increased odds of tobacco cigarette initiation and frequent smoking at age 17 among British youth. Similarly, tobacco smoking at age 14 is associated with increased odds of both e‐cigarette initiation and frequent use at age 17.

Association of 1 Vaping Session With Cellular Oxidative Stress in Otherwise Healthy Young People With No History of Smoking or Vaping

This randomized clinical crossover trial evaluates the association of a single session of electronic cigarette vaping with cellular oxidative stress in healthy young people who do not smoke compared with individuals with long-term tobacco cigarette or electronic cigarette use.

California’s tobacco 21 minimum sales age law and adolescents’ tobacco and nicotine use: differential associations among racial and ethnic groups

ObjectiveA California, USA, law raised the minimum tobacco sales age to 21 (T21) on 9 June 2016. We investigated whether T21 was associated with reductions adolescents’ use of tobacco cigarettes,...

Association between electronic cigarette use and tobacco cigarette smoking initiation in adolescents: a systematic review and meta-analysis

BackgroundThis systematic review of prospective longitudinal primary studies sought to determine whether electronic cigarette (e-cigarette) use by teenagers who had never smoked conventional tobacco cigarettes (tobacco cigarettes) at baseline was associated with subsequently commencing tobacco cigarette smoking.MethodsThe review followed the principles of a systematic review and meta-analysis. A key word search identified peer-reviewed articles published between 1 January 2005 and 2 October 2019 from seven bibliographic databases and one search engine. Using pre-prepared inclusion/exclusion criteria two researchers independently screened abstracts, and subsequently, full text papers. Selected articles were quality assessed in duplicate. Data on study participants characteristics, exposure and outcome measures were recorded in an adapted Cochrane Data Extraction Form. Feasibility assessment was done to detect clinical heterogeneity and choose an approach to meta-analysis. Analysis comprised pairwise random effects meta-analyses, and sensitivity and subgroup analyses.ResultsFrom the 6619 studies identified, 14 one-off primary studies in 21 articles were suitable for inclusion. The participants ages ranged from 13 to 19 years and comprised teenagers based in Europe and North America. Nine of the 14 one-off studies, with follow-up periods between 4 and 24 months, met the criteria for inclusion in a meta-analysis of the association between ever use of e-cigarettes and subsequent initiation of tobacco cigarette use. Based on primary study adjusted odds ratios, our meta-analysis calculated a 4.06 (95% confidence interval (CI): 3.00–5.48, I2 68%, 9 primary studies) times higher odds of commencing tobacco cigarette smoking for teenagers who had ever used e-cigarettes at baseline, though the odds ratio were marginally lower (to 3.71 times odds, 95%CI: 2.83–4. 86, I2 35%, 4 primary studies) when only the four high-quality studies were analysed.ConclusionThe systematic review found that e-cigarette use was associated with commencement of tobacco cigarette smoking among teenagers in Europe and North America, identifying an important health-related harm. Given the availability and usage of e-cigarettes, this study provides added support for urgent response by policymakers to stop their use by teenagers to decrease direct harms in this susceptible population group, as well as to conserve achievements in diminishing tobacco cigarette initiation.