scholarly journals A scoping review of studies on the health impact of electronic nicotine delivery systems

2021 ◽  
Author(s):  
Cother Hajat ◽  
Emma Stein ◽  
Saran Shantikumar ◽  
Raymond Niaura ◽  
Pietro Ferrara ◽  
...  
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Controlled Trial ◽  
Health Impact ◽  
Delivery Systems ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery

AbstractWe conducted a scoping review of studies on health outcomes from electronic nicotine delivery systems (ENDS). The objective was to identify, narratively synthesize, assess the strength and quality of evidence and critically appraise studies that have reported disease end points associated with the use of ENDS. We included published literature on the health impact of ENDS from 01/01/2015 until 01/02/2020 following the PRISMA guidelines using PubMed, Embase, Scopus and Google Scholar. The database search identified 755 studies, and other sources 265; 37 studies met final eligibility criteria. Levels of evidence included 24(65%) cross-sectional, one (2.7%) case–control and six (16%) case studies, four (11%) cohort studies, one (2.7%) randomized controlled trial (RCT) and one (2.7%) meta-analysis; 27(73%) studies reported only on harms, eight (22%) reported on benefits, two (2%) on benefits and harms. Quality ratings were poor in 20 (54%), fair in 9(24%) and good in 8(22%) of studies. In our review, ENDS was not shown to be causative for harmful cardiovascular disease (CVD) outcomes and shown to be beneficial for hypertensive patients. Switching from cigarettes to e-cigarettes resulted in reduced exacerbations of chronic obstructive pulmonary disease (COPD), with no evidence of long-term deterioration in lung function. Mental Health, cancer and mortality were not adequately studied to form any consensus. Our review has not demonstrated ENDS to be causative of harmful CVD outcomes; furthermore switching from cigarettes to e-cigarettes was associated with improved hypertensive control and reduced exacerbations of COPD, with no evidence of increased asthma risk or long-term respiratory harm. Mental health, cancer and mortality outcomes have not been adequately studied to form a conclusion. Overall, the findings of our review did not provide evidence to counter the consensus held by many that ENDS use is safer than the risks posed from smoking cigarettes.

scholarly journals In vitro and in vivo cardiac toxicity of flavored electronic nicotine delivery systems

2021 ◽  
Vol 320 (1) ◽  
pp. H133-H143
Author(s):  
Obada Abouassali ◽  
Mengmeng Chang ◽  
Bojjibabu Chidipi ◽  
Jose Luis Martinez ◽  
Michelle Reiser ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Cardiac Electrophysiology ◽  
Cardiac Toxicity ◽  
Delivery Systems ◽  
Cardiac Safety ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery

The use of electronic nicotine delivery systems (ENDS) is not harm free. It is not known whether ENDS negatively affect cardiac electrophysiological function. Our study in cell lines and in mice shows that ENDS can compromise cardiac electrophysiology, leading to action potential instability and inducible ventricular arrhythmias. Further investigations are necessary to assess the long-term cardiac safety profile of ENDS products in humans and to better understand how individual components of ENDS affect cardiac toxicity.

scholarly journals Longitudinal transitions of exclusive and polytobacco electronic nicotine delivery systems (ENDS) use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)

2020 ◽  
Vol 29 (Suppl 3) ◽  
pp. s147-s154 ◽  
Author(s):  
Cassandra A Stanton ◽  
Eva Sharma ◽  
Kathryn C Edwards ◽  
Michael J Halenar ◽  
Kristie A Taylor ◽  
...  
Keyword(s):  
Young Adults ◽  
Delivery Systems ◽  
Health Study ◽  
Cross Sectional ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
The Us ◽  
The Usa ◽  
Nationally Representative ◽  
Reasons For Use

ObjectiveElectronic nicotine delivery systems (ENDS; including e-cigarettes) are rapidly evolving in the US marketplace. This study reports cross-sectional prevalence and longitudinal pathways of ENDS use across 3 years, among US youth (12–17 years), young adults (18–24 years) and adults 25+ (25 years and older).DesignData were from the first three waves (2013–2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth and adults. Respondents with data at all three waves (youth, n=11 046; young adults, n=6478; adults 25+, n=17 188) were included in longitudinal analyses.ResultsWeighted cross-sectional ever use of ENDS increased at each wave. Across all three waves, young adults had the highest percentages of past 12-month, past 30-day (P30D) and daily P30D ENDS use compared with youth and adults 25+. Only about a quarter of users had persistent P30D ENDS use at each wave. Most ENDS users were polytobacco users. Exclusive Wave 1 ENDS users had a higher proportion of subsequent discontinued any tobacco use compared with polytobacco ENDS users who also used cigarettes.ConclusionsENDS use is most common among young adults compared with youth and adults 25+. However, continued use of ENDS over 2 years is not common for any age group. Health education efforts to reduce the appeal and availability of ENDS products might focus on reducing ENDS experimentation, and on reaching the smaller subgroups of daily ENDS users to better understand their reasons for use.

Government intervention in the market for electronic nicotine delivery systems (ENDS). The known, the unknown and challenges

2020 ◽  
Vol 20 (3) ◽  
pp. 283-294
Author(s):  
Ayda A. Yurekli ◽  
Patricia Kovacevic ◽  
Emil Sunley ◽  
Karthik Ranganathan
Keyword(s):  
Simulation Analysis ◽  
Health Impact ◽  
Delivery Systems ◽  
Economic Research ◽  
Electronic Nicotine Delivery Systems ◽  
Content Type ◽  
The Public ◽  
Premature Deaths ◽  
Nicotine Delivery ◽  
The Impact

Purpose This paper aims to describe the various government measures that regulate the market for novel tobacco harm reduction products (THRPs), with an emphasis on e-cigarettes [electronic nicotine delivery systems (“ENDS”)], and evaluates the public health impact of excise taxes levied on these products. Design/methodology/approach The paper reviews the economic research on the impact ENDS. Using cited evidence, the paper compares the tax treatment of ENDS and cigarettes and provides a simulation of potential lives that can be saved under alternative tax treatment of ENDS. Findings ENDS are considerably less harmful than cigarettes. Imposing the same tax burden on them (per unit of “harm”) as on cigarettes leads to poorer health outcomes. Differential tax treatment of ENDS will encourage more cigarette smokers to switch to ENDS and could save millions of lives worldwide. Research limitations/implications Country experiences with regulatory measures on ENDS are limited to those with high THRP penetration. The paper’s simulation analysis used evidence from a limited number of studies. Rigorous economic analysis is needed to understand how ENDS could save lives and could prevent expected one billion premature deaths by the end of this century. Originality/value The paper uses research evidence in its analysis of the impact that the differential taxation of cigarettes and ENDS would have. It also provides a rough estimate of the number of lives that could be saved if more smokers who are trying to quit can make the switch to ENDS.

scholarly journals Motives and perceptions regarding electronic nicotine delivery systems (ENDS) use among adults with mental health conditions

2018 ◽  
Vol 80 ◽  
pp. 102-109 ◽  
Author(s):  
Claire Adams Spears ◽  
Dina M. Jones ◽  
Scott R. Weaver ◽  
Terry F. Pechacek ◽  
Michael P. Eriksen
Keyword(s):  
Mental Health ◽  
Delivery Systems ◽  
Health Conditions ◽  
Electronic Nicotine Delivery Systems ◽  
Mental Health Conditions ◽  
Nicotine Delivery

scholarly journals Electronic Nicotine Delivery Systems (ENDS) and Their Relevance in Oral Health

Toxics ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 61 ◽  
Author(s):  
Gozde Isik Andrikopoulos ◽  
Konstantinos Farsalinos ◽  
Konstantinos Poulas
Keyword(s):  
Oral Health ◽  
Periodontal Diseases ◽  
Delivery Systems ◽  
Long Term Effects ◽  
Periodontal Health ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
Gingival Cells ◽  
Oral Cells

The number and popularity of electronic nicotine delivery systems (ENDS) and especially e-cigarettes (e-cigs) have been increasing in the last decade. Although ENDS owe their popularity to excluding the harmful chemicals that are present in tobacco smoke, there is a debate whether they are safe, regulated, and as harmless as they are assumed to be and have potential unknown long-term effects. Involvement of cigarette smoking to the progression of periodontal diseases, other adverse oral health outcomes, and its detrimental effects to oral health are well-described. ENDS producer companies claim that these products can improve oral health by providing alternatives to smoking. However, the effect of e-cigs on oral health is not fully understood and is still debated among many scientists and clinicians. The number of studies addressing the potential toxic effect of ENDS or e-cig aerosol on oral cells is limited along with the clinical studies which are still preliminary, and their sample size is limited. The long-term effects of inhaled aerosols and the potential synergistic effect of the e-cigs components are not known. It is essential and of utmost importance to determine whether exposure to ENDS aerosol contributes to the progression of periodontal diseases and how it affects periodontal ligament and gingival cells which are believed to be its first targets. This review briefly summarizes the available evidence about the effects of e-cigs on periodontal health including several pathophysiological events, such as oxidative stress, DNA damage, inflammation, cellular senescence, dysregulated repair, and periodontal diseases.

scholarly journals Beliefs and Self-reported Practices of Health Care Professionals Regarding Electronic Nicotine Delivery Systems: A Mixed-Methods Systematic Review and Synthesis

2019 ◽  
Vol 22 (5) ◽  
pp. 619-629 ◽  
Author(s):  
Daniel A Erku ◽  
Coral E Gartner ◽  
Kylie Morphett ◽  
Kathryn J Steadman
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Professionals ◽  
Delivery Systems ◽  
Potential Health ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
Patient Health ◽  
Training And Support

Abstract Aims This review explores the (1) beliefs and attitudes of health care professionals (HCPs) toward electronic nicotine delivery systems (ENDS) including use as a smoking cessation aid and/or harm reduction, safety and regulation, and (2) the extent and content of patient–HCP communication about ENDS. Methods PubMed, Embase, CINAHL, and PsycINFO were searched to identify articles published since 2003. The Mixed Methods Appraisal Tool and Strengthening the Reporting of Observational Studies in Epidemiology checklists were used to assess the quality of studies. Thematic synthesis was used to analyze qualitative data. Results A total of 45 articles (32 quantitative, 12 qualitative, and 1 mixed) were included. There was wide variation regarding beliefs about the efficacy of ENDS as a cessation aid. Although the majority of HCPs believes that ENDS are safer than combustible cigarettes, they also have concern about the short and long-term safety of ENDS, uptake by adolescents, and the potential for ENDS to act as a “gateway” to smoking cigarettes. Beliefs about ENDS are influenced by media stories and experiences provided by patients. Although most HCPs do not proactively recommend ENDS, they are more likely to support ENDS use among patients with smoking related comorbidities, heavy smokers with previous unsuccessful quit attempts, or patients who express interest in trying them. Conclusions Overall, HCPs hold diverse views about the efficacy of ENDS and expressed wariness over their potential health effects. HCP endorsement of ENDS use seems to depend largely on patient health status, the presence of other competing risk factors and patient preferences. Implication Although evidence on safety and efficacy of ENDS is emerging, HCPs should be honest with their clients, stating that the long-term safety is not yet established but what is known is that they appear to be a lower risk alternative to cigarettes. Our review highlights a need for further training and support for HCPs regarding ENDS use, which would enable them to guide their clients in making evidence-based decisions.

scholarly journals Effect of Electronic Nicotine Delivery Systems on Cigarette Abstinence in Smokers with no Plans to Quit: Exploratory Analysis of a Randomized Placebo-Controlled Trial

2021 ◽  
Author(s):  
Jonathan Foulds ◽  
Caroline O Cobb ◽  
Miao-Shan Yen ◽  
Susan Veldheer ◽  
Phoebe Brosnan ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Delivery Systems ◽  
Exploratory Analysis ◽  
Smoking Reduction ◽  
Double Blind ◽  
Electronic Nicotine Delivery Systems ◽  
Quit Smoking ◽  
Nicotine Delivery ◽  
Penn State ◽  
Virginia Commonwealth University

Introduction: The extent to which use of electronic nicotine delivery systems (ENDS) for smoking reduction leads to cigarette abstinence in smokers with no plans to quit smoking is unclear. This exploratory analysis examined the effects of ENDS delivering different amounts of nicotine on cigarette abstinence up to 24-week follow-up, in comparison to placebo or a behavioral substitute. Methods: This four-arm parallel-group, randomized placebo-controlled trial took place at two academic medical centers in USA (Penn State Hershey and Virginia Commonwealth University). Participants were current adult smokers (N=520) interested in reducing but not planning to quit. They received brief advice and were randomized to one of four 24-week conditions, receiving either an eGo-style ENDS paired with 0, 8 or 36 mg/ml nicotine liquid (double-blind) or a cigarette-shaped tube, as a cigarette substitute (CS). Self-reported daily cigarette consumption and exhaled carbon monoxide (CO) were measured at all study visits. Outcomes included intent-to-treat, self-reported 7-day cigarette abstinence, biochemically confirmed by exhaled CO at 24 weeks after randomization. Results: At 24 weeks, significantly more participants in the 36 mg/ml condition (14/130, 10.8%) than in the 0 mg/ml condition (1/130, 0.8%) and the CS condition (4/130, 3.1%) were abstinent (relative risk = 14 [95% CI=1.9-104.9] and 3.5 [95% CI=1.2-10.4], respectively). The abstinence rate in the 8 mg/ml condition was 4.6% (6/130). Conclusions: When smokers seeking to reduce smoking tried ENDS, few quit smoking in the short term. However, if smokers continued to use an ENDS with cigarette-like nicotine delivery, a greater proportion completely switched to ENDS, as compared with placebo or a cigarette substitute.

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