scholarly journals A pre-post pilot study of electronic cigarettes to reduce smoking in people with severe mental illness

2018 ◽  
Vol 49 (6) ◽  
pp. 1033-1040 ◽  
Author(s):  
Lauren M. Hickling ◽  
Rocio Perez-Iglesias ◽  
Ann McNeill ◽  
Lynne Dawkins ◽  
John Moxham ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Pilot Study ◽  
Harm Reduction ◽  
Psychotic Disorder ◽  
Electronic Cigarettes ◽  
Mental Illnesses ◽  
Cigarette Use ◽  
Smoking Cigarette ◽  
Harm Reduction Intervention ◽  
Serious Mental Illnesses

AbstractBackgroundSmoking is the largest single contributor to poor physical health and increased mortality in people with serious mental illnesses. The aim of the study was to investigate the utility of electronic cigarettes (e-cigarettes) as a harm reduction intervention in this population.MethodFifty tobacco smokers with a psychotic disorder were enrolled onto a 24-week pilot study (ClinicalTrials.gov: NCT02212041) investigating the efficacy of a 6-week free e-cigarette intervention to reduce smoking. Cigarette and e-cigarette use was self-reported at weekly visits, and verified using carbon monoxide tests. Psychopathology, e-cigarette acceptability and adverse effects were assessed using standardised scales.ResultsThere was a significant (⩾50%) reduction in cigarettes consumed per day between baseline and week 6 [F(2.596,116.800) = 25.878, p < 0.001], and e-cigarette use was stable during this period [F(2.932,46.504) = 2.023, p = 0.115]. These changes were verified by significant carbon monoxide reductions between these time points [F(3.335,126.633) = 5.063, p = 0.002].ConclusionsThe provision of e-cigarettes is a potentially useful harm reduction intervention in smokers with a psychotic disorder.

Should psychiatrists support the availability of nicotine e-cigarettes in Australia?

2019 ◽  
Vol 27 (4) ◽  
pp. 392-395 ◽  
Author(s):  
James G Scott ◽  
Sarah Jhetam ◽  
Renee Chen ◽  
Mark Daglish
Keyword(s):  
Harm Reduction ◽  
Electronic Cigarettes ◽  
Position Statement ◽  
Cigarette Use ◽  
Physical And Mental Health ◽  
Limited Evidence ◽  
Tobacco Harm Reduction ◽  
People With Mental Illness ◽  
Potential Risks ◽  
Zealand College

Objective: To examine the position statement of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) regarding the availability of electronic cigarettes in Australia. Conclusion: There is limited evidence supporting the efficacy of nicotine e-cigarettes as an effective tobacco harm-reduction or cessation strategy for people with mental illness. The recommendations to increase their availability under regulation must be balanced with the physical and mental health risks of vapour inhalation and nicotine use, particularly for youth. Future recommendations by the RANZCP in relation to e-cigarettes must consider both the available evidence for harm reduction and the potential risks associated with youth e-cigarette use.

scholarly journals Reducing the Smoking-Related Health Burden in the US through Diversion to Electronic Cigarettes: A System Dynamics Simulation Study

2020 ◽  
Author(s):  
Arielle Selya
Keyword(s):  
Harm Reduction ◽  
Time Delays ◽  
Electronic Cigarettes ◽  
Dynamics Simulation ◽  
Political Resistance ◽  
Cigarette Use ◽  
Ideal Case ◽  
Implementation Challenges ◽  
The Us ◽  
The Ideal

Abstract Background: Electronic cigarettes (“e-cigarettes”) have altered tobacco use trends, and their impacts are controversial. Given their lower risk relative to conventional cigarettes, e-cigarettes have potential for harm reduction. This study presents a simulation-based analysis of an e-cigarette harm reduction policy set in the US. Methods: A system dynamics simulation model was constructed, with separate aging chains representing different stages of use for both cigarette smokers and e-cigarette users. These structures interact with a policy module to close the gap between actual (simulated) and goal numbers of cigarette smokers, chosen to reduce the tobacco-attributable death rate to that due to all accidents in the general population. The policy is two-fold, removing existing flavor bans and providing an informational campaign promoting e-cigarettes as a lower-risk alternative. Realistic practical implementation challenges are modeled in the policy sector, including time delays, political resistance, and budgetary limitations. Effects of e-cigarettes on conventional smoking occurs through three mechanisms: 1) diversion from ever initiating conventional smoking; 2) reducing progression to established smoking; and 3) increasing smoking cessation. An important unintended effect was included, which increases the tobacco-related mortality accordingly with an increase in nicotine users due to e-cigarettes. Results: The base-case model replicated the historical exponential decline in smoking and the exponential increase in e-cigarette use since 2010. The ideal-case policy was able to reduce conventional smoking to the goal level approximately 40 years after implementation. Implementation obstacles (time delays, political resistance, and budgetary constraints) delayed and weakened the effect of the policy by up to 95% in the worst case, relative to the ideal-case scenario; however, these discrepancies substantially decreased over time in dampened oscillations as negative feedback loops stabilize the system after the one-time “shock” introduced by policy changes. Conclusions: Current findings demonstrate that the promotion of e-cigarettes as a harm-reduction policy is a viable strategy, given current knowledge of e-cigarettes’ effects on conventional smoking. Given the strong effects of implementation challenges on policy effectiveness in the short term, accurately modeling such obstacles is essential in policy design. Ongoing research is needed with forthcoming data on e-cigarette use prevalence and possible effects on cigarette smoking.

scholarly journals E-Cigarette Use and Future Cigarette Initiation Among Never Smokers and Relapse Among Former Smokers in the PATH Study

2019 ◽  
Vol 134 (5) ◽  
pp. 528-536 ◽  
Author(s):  
Robert McMillen ◽  
Jonathan D. Klein ◽  
Karen Wilson ◽  
Jonathan P. Winickoff ◽  
Susanne Tanski
Keyword(s):  
Cigarette Smoking ◽  
Harm Reduction ◽  
Electronic Cigarettes ◽  
Computer Assisted ◽  
Cigarette Use ◽  
Cigarette Smokers ◽  
Potential Harm ◽  
Increased Risk ◽  
Never Smokers

Objectives: Any potential harm-reduction benefit of electronic cigarettes (e-cigarettes) could be offset by nonsmokers who initiate e-cigarette use and then smoke combustible cigarettes. We examined correlates of e-cigarette use at baseline with combustible cigarette smoking at 1-year follow-up among adult distant former combustible cigarette smokers (ie, quit smoking ≥5 years ago) and never smokers. Methods: The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal study, surveyed 26 446 US adults during 2 waves: 2013-2014 (baseline) and 2014-2015 (1-year follow-up). Participants completed an audio computer-assisted interview in English or Spanish. We compared combustible cigarette smoking at 1-year follow-up by e-cigarette use at baseline among distant former combustible cigarette smokers and never smokers. Results: Distant former combustible cigarette smokers who reported e-cigarette past 30-day use (9.3%) and ever use (6.7%) were significantly more likely than those who had never used e-cigarettes (1.3%) to have relapsed to current combustible cigarette smoking at follow-up ( P < .001). Never smokers who reported e-cigarette past 30-day use (25.6%) and ever use (13.9%) were significantly more likely than those who had never used e-cigarettes (2.1%) to have initiated combustible cigarette smoking ( P < .001). Adults who reported past 30-day e-cigarette use (7.0%) and ever e-cigarette use (1.7%) were more likely than those who had never used e-cigarettes (0.3%) to have transitioned from never smokers to current combustible cigarette smokers ( P < .001). E-cigarette use predicted combustible cigarette smoking in multivariable analyses controlling for covariates. Conclusions: Policies and counseling should consider the increased risk for nonsmokers of future combustible cigarette smoking use as a result of using e-cigarettes and any potential harm-reduction benefits e-cigarettes might bring to current combustible cigarette smokers.

scholarly journals Reducing the smoking-related health burden in the USA through diversion to electronic cigarettes: a system dynamics simulation study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Arielle S. Selya
Keyword(s):  
Harm Reduction ◽  
Tobacco Smoking ◽  
Lower Risk ◽  
Time Delays ◽  
Electronic Cigarettes ◽  
Dynamics Simulation ◽  
Political Resistance ◽  
Cigarette Use ◽  
Implementation Challenges ◽  
The Usa

Abstract Background Electronic cigarettes (“e-cigarettes”) have altered tobacco smoking trends, and their impacts are controversial. Given their lower risk relative to combustible tobacco, e-cigarettes have potential for harm reduction. This study presents a simulation-based analysis of an e-cigarette harm reduction policy set in the USA. Methods A system dynamics simulation model was constructed, with separate aging chains representing people in different stages of use (both of combustible cigarettes and e-cigarettes). These structures interact with a policy module to close the gap between actual (simulated) and goal numbers of individuals who smoke, chosen to reduce the tobacco-attributable death rate (i.e., mostly combustible cigarette-attributable, but conservatively allowing e-cigarette-attributable deaths) to that due to all accidents in the general population. The policy is two-fold, removing existing e-liquid flavor bans and providing an informational campaign promoting e-cigarettes as a lower-risk alternative. Realistic practical implementation challenges are modeled in the policy sector, including time delays, political resistance, and budgetary limitations. Effects of e-cigarettes on tobacco smoking occur through three mechanisms: (1) diversion from ever initiating smoking; (2) reducing progression to established smoking; and (3) increasing smoking cessation. An important unintended effect of possible death from e-cigarettes was conservatively included. Results The base-case model replicated the historical exponential decline in smoking and the exponential increase in e-cigarette use since 2010. Simulations suggest tobacco smoking could be reduced to the goal level approximately 40 years after implementation. Implementation obstacles (time delays, political resistance, and budgetary constraints) could delay and weaken the effect of the policy by up to 62% in the worst case, relative to the ideal-case scenario; however, these discrepancies substantially decreased over time in dampened oscillations as negative feedback loops stabilize the system after the one-time “shock” introduced by policy changes. Conclusions The simulation suggests that the promotion of e-cigarettes as a harm-reduction policy is a viable strategy, given current evidence that e-cigarettes offset or divert from smoking. Given the strong effects of implementation challenges on policy effectiveness in the short term, accurately modeling such obstacles can usefully inform policy design. Ongoing research is needed, given continuing changes in e-cigarette use prevalence, new policies being enacted for e-cigarettes, and emerging evidence for substitution effects between combustible cigarettes and e-cigarettes.

scholarly journals “It is the One Thing that has Worked”: facilitators and barriers to switching to nicotine salt pod system e-cigarettes among African American and Latinx people who smoke: a content analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Kim Pulvers ◽  
Myra Rice ◽  
Jasjit S. Ahluwalia ◽  
Michael J. Arnold ◽  
Crystal Marez ◽  
...  
Keyword(s):  
African American ◽  
Health Disparities ◽  
Harm Reduction ◽  
Ethnic Minority ◽  
Kansas City ◽  
Electronic Cigarettes ◽  
Cigarette Use ◽  
Smoking Reduction ◽  
Facilitators And Barriers ◽  
Racial Ethnic

Abstract Background Electronic cigarettes are a harm reduction strategy for individuals who smoke cigarettes who cannot or do not want to quit using FDA-approved cessation methods. Identifying perceived facilitators and barriers to switching among people who smoke cigarettes is critical to optimizing health impact. This is particularly important for the most dominant e-cigarette device, nicotine salt pod electronic cigarettes. We investigate the experience using pod electronic cigarettes among African American and Latinx individuals who smoke, the two largest racial/ethnic minority groups who experience significant health disparities. Methods From July 2018 to May 2019, adults who smoked cigarettes, age 21 + (N = 114; M age = 44.6, 59.6% male, 52.6% African American from Kansas City, 47.4% Latinx from San Diego) received JUUL-brand electronic cigarettes (referred to hereafter as JUUL) for 6 weeks and answered interview questions at week six. We inquired what they liked and disliked about using JUUL, what helped with switching and made switching difficult, future intentions for continued JUUL use, and how JUUL compared to past smoking reduction methods. Responses were coded into themes by independent raters. Theme frequencies were analyzed separately by race/ethnicity and week 6 use trajectory (exclusive JUUL use, dual JUUL and cigarette use, exclusive cigarette use). Results Clean/smell was the aspect of using JUUL most commonly liked (23%), followed by convenience (19%). Coughing/harshness was a more common barrier to switching for African American (44%) than Latinx (9%), and for continuing cigarette use (56%) than for those who exclusively switched or dually used JUUL and combustible cigarettes (15–21%). Most (78% African American; 90% Latinx) reported that the benefits of using JUUL outweighed barriers, and this varied by JUUL use trajectory: 94% exclusive switch, 86% dual use, and 42% continued cigarette use. The majority said they would continue using JUUL to replace cigarettes (83% African American; 94% Latinx) and that JUUL worked better than other methods to reduce cigarettes (72%). Conclusion African American and Latinx individuals who smoked experience using pod electronic cigarettes was generally positive. Understanding facilitators and impediments to switching to electronic cigarettes among racial/ethnic minority people who smoke can inform harm reduction interventions and reduce tobacco-related health disparities. Trial Registration ClinicalTrials.gov Identifier: NCT03511001 posted April 27, 2018.

scholarly journals Point of Sale Advertising and Promotion of Cigarettes, Electronic Cigarettes, and Heated Tobacco Products in Warsaw, Poland—A Pilot Study

2021 ◽  
Vol 18 (24) ◽  
pp. 13002
Author(s):  
Paweł Koczkodaj ◽  
Paloma Cuchi ◽  
Agata Ciuba ◽  
Elwira Gliwska ◽  
Armando Peruga
Keyword(s):  
Pilot Study ◽  
Secondary Schools ◽  
Electronic Cigarettes ◽  
Consumer Products ◽  
Cigarette Use ◽  
Tobacco Products ◽  
Point Of Sale ◽  
European Cities ◽  
Polish Law ◽  
Advertising And Promotion

Prevalence of smoking and e-cigarette use among teenagers in Poland is high. Polish law bans most advertising and promotion for cigarettes, e-cigarettes, and heated tobacco products (HTPs). This study investigates marketing for these products at points of sale (POS) near secondary schools in Warsaw, Poland, noting if the advertising and promotion were allowed under current Polish laws. All POS within 250 m radii of five selected secondary schools in each of three Warsaw districts were assessed for tobacco and e-cigarette direct advertising, inside and outside; offers of gifts or promotional discounts; tobacco merchandising, and tobacco displays. Of the 112 POS surveyed, 83% exposed customers to some form of advertising or promotion of cigarettes, e-cigarettes, or HTPs; in 76%, advertising or promotion that violated Polish law was present. More than 80% of POS surveyed displayed tobacco products; in 19%, these products were displayed near products of interest to minors. POS density observed here was 30.3 per km2, higher than in other European cities. In Poland, a high proportion of POS near schools violates the law banning the advertisement and promotion of tobacco and nicotine consumer products through a dense tobacco retailer network.

scholarly journals Carbonyls and Carbon Monoxide Emissions from Electronic Cigarettes Affected by Device Type and Use Patterns

2020 ◽  
Vol 17 (8) ◽  
pp. 2767 ◽  
Author(s):  
Yeongkwon Son ◽  
Chiranjivi Bhattarai ◽  
Vera Samburova ◽  
Andrey Khlystov
Keyword(s):  
Carbon Monoxide ◽  
Standardized Testing ◽  
Electronic Cigarettes ◽  
Rapid Development ◽  
Liquid Composition ◽  
Cigarette Use ◽  
Exposure Limits ◽  
Use Patterns ◽  
Type Device ◽  
Cigarette Design

Dangerous levels of harmful chemicals in electronic cigarette (e-cigarette) aerosols were reported by several studies, but variability in e-cigarette design and use patterns, and a rapid development of new devices, such as JUUL, hamper efforts to develop standardized testing protocols and understand health risks associated with e-cigarette use. In this study, we investigated the relative importance of e-cigarette design, power output, liquid composition, puff topography on e-cigarette emissions of carbonyl compounds, carbon monoxide (CO), and nicotine. Four popular e-cigarette devices representing the most common e-cigarette types (e.g., cig-a-like, top-coil, ‘mod’, and ‘pod’) were tested. Under the tested vaping conditions, a top-coil device generated the highest amounts of formaldehyde and CO. A ‘pod’ type device (i.e., JUUL) emitted the highest amounts of nicotine, while generating the lowest levels of carbonyl and CO as compared to other tested e-cigarettes. Emissions increased nearly linearly with puff duration, while puff flow had a relatively small effect. Flavored e-liquids generated more carbonyls and CO than unflavored liquids. Carbonyl concentrations and CO in e-cigarette aerosols were found to be well correlated. While e-cigarettes emitted generally less CO and carbonyls than conventional cigarettes, daily carbonyl exposures from e-cigarette use could still exceed acute exposure limits, with the top-coil device potentially posing more harm than conventional cigarettes.

scholarly journals Maxillofacial injury related to an exploding e-cigarette

2021 ◽  
Vol 14 (1) ◽  
pp. e239677
Author(s):  
Angelo La Valle ◽  
Rory O'Connor ◽  
A Brooks ◽  
Ramzi Freij
Keyword(s):  
Harm Reduction ◽  
Tobacco Smoking ◽  
Electronic Cigarettes ◽  
Cigarette Use ◽  
Maxillofacial Injury ◽  
Dramatic Effect ◽  
The Public ◽  
The Media ◽  
Psychological Impairment ◽  
The Uk

Electronic cigarettes (also known as e-cigarettes or electronic nicotine delivery systems) were invented in China in 2003 then introduced to the British market in 2007. They remain popular among the public and are deemed to be effective in reducing tobacco smoking (the UK being one of the first countries to embrace them in a harm reduction policy). However, reports in the media of e-cigarettes exploding are of concern, considering the potential functional and psychological impairment that lifelong disfigurement will cause, especially given their uptake among people of any age. We present a case of this rare, but dramatic, effect of e-cigarette use as a warning to the public.

scholarly journals Expired Air Carbon Monoxide Testing Is Effective for Preoperative Screening of Cigarette Use in Orthopaedic Patients: A Prospective Pilot Study of 70 Veterans

2021 ◽  
pp. 24
Author(s):  
◽  
Keyword(s):  
Carbon Monoxide ◽  
Pilot Study ◽  
Predictive Value ◽  
Screening Tool ◽  
Cigarette Use ◽  
Active Smoking ◽  
Retest Reliability ◽  
Prospective Pilot Study ◽  
Orthopaedic Patients ◽  
Test Retest Reliability

Introduction: Screening for cigarette use is standard in the orthopedic pre-operative clinic, however traditional biochemical testing methods, including serum and urine cotinine assays, do not differentiate active smoking from nicotine replacement therapy (NRT). In this prospective pilot study, we hypothesize that exhaled carbon monoxide (eCO) testing will be non-inferior to the gold standard serum cotinine (SC) test in screening for pre-operative cigarette use, will differentiate active smoking from NRT, and will allow for substantial cost savings in a clinic setting. Methods: Adult orthopaedic veterans indicated for elective surgery at our institution were offered inclusion. Self-reported smoking status (SRS), eCO and SC levels were obtained preoperatively. An eCO level of >6 parts per million and a SC level >3 ng/ml were considered positive for recent cigarette use. Agreement between SRS, eCO levels and SC levels, and eCO level test-retest reliability were evaluated. Results: Of the 55 patients enrolled into the study, 4 were self-reported Current Smokers and 51 were self-reported Ex-Smokers or Non-Smokers. Combining SRS with eCO levels as a screening tool for recent cigarette use yielded a sensitivity of 100%, a specificity of 98%, a positive predictive value of 95% and a negative predictive value of 100%. eCO testing differentiated NRT from cigarette use in all non-smoking patients. Test-retest reliability for eCO levels showed perfect agreement for 16 patients that had two or more eCO levels pre-operatively. Conclusion: Exhaled CO testing is as effective as SC testing but can differentiate active smoking from NRT, while maintaining a high level of accuracy and reliability when combined with SRS as a screening tool.

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