scholarly journals A Longitudinal Study of Exposure to Tobacco-Related Toxicants and Subsequent Respiratory Symptoms Among U.S. Adults with Varying E-cigarette Use Status

2020 ◽  
Vol 22 (Supplement_1) ◽  
pp. S61-S69
Author(s):  
Hongying Dai ◽  
Ali S Khan

Abstract Background The link between e-cigarette use and subsequent development of respiratory diseases remains an open question. Aims and Methods A subset of a probability sample of U.S. adults from the Population Assessment of Tobacco and Health Study Waves 1 and 2 were selected for biospecimen analysis (n = 4614). Subjects were divided into three mutually exclusive groups at baseline: nonusers (n = 2849), exclusive e-cigarette users (n = 222), and poly e-cigarette/tobacco users (n = 1,543). Geometric mean concentrations of baseline biomarkers from five classes of harmful and potentially harmful constituents were reported. Multivariable linear regressions were conducted to examine the relationship between baseline biomarkers and subsequent respiratory symptoms among user groups. Results Baseline exclusive e-cigarette users (33.6%[confidence interval, CI: 26.7% to 41.4%]) and poly e-cigarette/tobacco users (50.8%[CI: 47.4% to 54.2%]) had higher prevalence of subsequent respiratory symptoms than nonusers (21.7%[19.2% to 24.4%]). As compared with nonusers, poly e-cigarette/tobacco users had higher concentrations in clinically relevant biomarkers at baseline than exclusive e-cigarette users. Among poly e-cigarette/tobacco users, baseline nicotine metabolites (TNE2, cotinine), tobacco-specific nitrosamine (NNAL), PAH (1-NAP, 3-FLU), and volatile organic compound (N-Acetyl-S-(2-carboxyethyl)-l-cysteine, N-acetyl-S-(2-cyanoethyl)-l-cysteine) were significantly higher among those reporting subsequent respiratory symptoms than those who did not. Among exclusive e-cigarette users, baseline NNAL was significantly higher among those reporting subsequent respiratory symptoms than those who did not. Within subjects with subsequent respiratory symptoms, NNAL was 2.5 times higher in exclusive e-cigarette users (10.7[6.5 to 17.5]) and 63.4 times higher in poly e-cigarette/tobacco users (199.6[176.7 to 225.4]) than nonusers (3.1[2.4 to 3.9]). Conclusions E-cigarette use is associated with higher concentrations of known tobacco-related toxicants and risks of subsequent respiratory symptoms than nonusers. Poly e-cigarette/tobacco users exhibit higher risk than exclusive e-cigarette users. Implications This longitudinal study identified positive associations between baseline urinary biomarkers of exposure to tobacco-related toxicants and increased risks of subsequent respiratory symptoms across varying e-cigarette use groups. E-cigarette use is associated with increased exposure to known tobacco-related toxicants, and certain toxicant exposure increases the risk of respiratory symptoms.

2019 ◽  
Vol 22 (5) ◽  
pp. 798-805 ◽  
Author(s):  
Erna J Z Krüsemann ◽  
Franziska M Wenng ◽  
Jeroen L A Pennings ◽  
Kees de Graaf ◽  
Reinskje Talhout ◽  
...  

Abstract Introduction Sensory research on e-liquid flavors can be performed by means of smelling and vaping. However, data comparing smelling versus vaping e-liquid flavors are lacking. This study aims to investigate if smelling could be an alternative to vaping experiments by determining the correlation for hedonic flavor assessment between orthonasal smelling and vaping of e-liquids, for smokers and nonsmokers. Methods Twenty-four young adult smokers (mean age 24.8 ± 9.3) and 24 nonsmokers (mean age 24.9 ± 7.7) smelled and vaped 25 e-liquids in various flavors. Participants rated liking, intensity, familiarity, and irritation on a 100-mm Visual Analog Scale. Pearson correlations within and between smelling and vaping were calculated. Differences between user groups were calculated using t tests. Results Correlation coefficients between smelling and vaping based on mean group ratings were 0.84 for liking, 0.82 for intensity, 0.84 for familiarity, and 0.73 for irritation. Means of the within-subjects correlation coefficients were, respectively, 0.51, 0.37, 0.47, and 0.25. Correlations between smelling and vaping varied across individuals (ranging from −0.27 to 0.87) and flavors (−0.33 to 0.81). Correlations and mean liking ratings did not differ between smokers and nonsmokers. Conclusions The strong group-level correlations between orthonasal smelling and vaping e-liquid flavors justify the use of smelling instead of vaping in future research. For example, smelling could be used to investigate differences in e-liquid flavor liking between (potential) user groups such as nicotine-naïve adolescents. The more modest within-subject correlations and variation across individuals and flavors merit caution in using smelling instead of vaping in other types of experiments. Implications This study supports the use of orthonasal smelling (instead of vaping) e-liquids to measure hedonic flavor perception in some studies where vaping would be inappropriate or not feasible. Examples of research situations where smelling e-liquids may be sufficient are (1) investigating nicotine-naïve individuals (ie, nonusers), (2) investigating individuals under legal age for e-cigarette use (ie, youth and adolescents), (3) investigating brain responses to exposure of e-liquid flavors using functional magnetic resonance imaging or electroencephalogram, and (4) comparing hedonic flavor assessment between adolescent nonusers and current smokers to provide support for future regulations on e-liquid flavors.


2019 ◽  
pp. tobaccocontrol-2018-054694 ◽  
Author(s):  
Dongmei Li ◽  
Isaac K Sundar ◽  
Scott McIntosh ◽  
Deborah J Ossip ◽  
Maciej Lukasz Goniewicz ◽  
...  

BackgroundWheezing is a symptom of potential respiratory disease and known to be associated with smoking. Electronic cigarette use (‘vaping’) has increased exponentially in recent years. This study examined the cross-sectional association of vaping with wheezing and related respiratory symptoms and compare this association with smokers and dual users.MethodsThe Population Assessment of Tobacco and Health study wave 2 data collected from October 2014 to October 2015 with 28 171 adults were used. The cross-sectional association of vaping with self-reported wheezing and related respiratory symptoms relative to smokers and dual users of tobacco and electronic cigarettes were studied using multivariable logistic and cumulative logistic regression models with consideration of complex sampling design.ResultsAmong the 28 171 adult participants, 641 (1.2%) were current vapers who used e-cigarettes exclusively, 8525 (16.6%) were current exclusive smokers, 1106 (2.0%) were dual users and 17 899 (80.2%) were non-users. Compared with non-users, risks of wheezing and related respiratory symptoms were significantly increased in current vapers (adjusted OR (aOR)=1.67, 95% CI: 1.23 to 2.15). Current vapers had significantly lower risk in wheezing and related respiratory symptoms compared with current smokers (aOR=0.68, 95% CI: 0.53 to 0.87). No significant differences were found between dual users and current smokers in risk of wheezing and related respiratory symptoms (aOR=1.06, 95% CI: 0.91 to 1.24).ConclusionsVaping was associated with increased risk of wheezing and related respiratory symptoms. Current vapers had lower risk in wheezing and related respiratory symptoms than current smokers or dual users but higher than non-users. Both dual use and smoking significantly increased the risk of wheezing and related respiratory symptoms.


2020 ◽  
Vol 22 (Supplement_1) ◽  
pp. S70-S75
Author(s):  
Zidian Xie ◽  
Dongmei Li

Abstract Introduction The use of electronic cigarettes (vaping), especially with marijuana, has become increasingly popular among adults. Aims and Methods The Population Assessment of Tobacco and Health study Wave 4 data on 33 606 adult participants who indicated ever using electronic cigarettes were included in the study. By controlling for confounding variables (such as age and smoking history), multivariable weighted logistic regression models were used to examine the cross-sectional association between lifetime e-cigarette use with or without marijuana and self-reported past 12-month respiratory symptoms as well as lifetime respiratory diseases. Results Compared to adults who never vaped, adults who had ever vaped with marijuana had a significantly higher association with self-reported past 12-month respiratory symptoms but not lifetime respiratory diseases. Compared to adults who had ever vaped without marijuana, adults who had ever vaped at least sometimes with marijuana had a significantly greater risk of having wheezing/whistling in the chest (adjusted odds ratio [aOR] = 1.21, 95% confidence interval [CI]: 1.01, 1.44), chest sounded wheezy during or after exercise (aOR = 1.59, 95% CI: 1.31, 1.93), and had a dry cough at night (aOR = 1.35, 95% CI: 1.16, 1.57), while adults who had ever vaped rarely with marijuana had a significantly greater risk of having wheezing/whistling in the chest (aOR = 1.31, 95% CI: 1.06, 1.61), chest sounded wheezy during or after exercise (aOR = 1.24, 95% CI: 1.01, 1.52), and had a dry cough at night (aOR = 1.24, 95% CI: 1.04, 1.47). Conclusions Lifetime e-cigarette use with marijuana is associated with self-reported past 12-month respiratory symptoms in adults. Implications The use of e-cigarettes with marijuana has become prevalent in recent years. Our cross-sectional study suggests that there may be respiratory health symptoms associated with ever vaping with marijuana that is independent of nicotine vaping, which should raise public awareness of potential health risks associated with the use of e-cigarettes with marijuana. Further longitudinal studies on the respiratory health effects of e-cigarette use with marijuana are warranted.


Author(s):  
Fulwah Alqahtani ◽  
Marzouqah Alanazi ◽  
Wajdan Alassaf ◽  
Fadilah Sfouq Aleanizy ◽  
Muna Aljahany ◽  
...  

Abstract Objectives This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh. Methods We conducted a retrospective, descriptive longitudinal study from March to July 2020 by analyzing data of all confirmed cases of COVID-19 among ED visitors and healthcare workers in King Abdullah bin Abdulaziz University Hospital. Results During the study period, a total of 1,182 swab samples were collected for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), of which 285 (24.1%) tested positive. Of the 285 cases of confirmed SARS-CoV-2 infection, 18 were healthcare workers and 267 were patients. As a result of using the respiratory pathway for COVID-19 patients, the hospital managed to limit transmission of SARS-CoV-2 not only between patients but also between patients and healthcare workers, while also containing the pandemic. There were no cases of nosocomial SARS-CoV-2 infection recorded among the patients who visited the ED or the flu clinic. All confirmed cases were community acquired and patients were cared for under constrained measures. Conclusions Implementing infection control measures and restricting those with respiratory symptoms to the ED pathway prevented nosocomial spread of SARS-CoV-2 infection in the ED.


Toxics ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 52
Author(s):  
Connor R. Miller ◽  
Hangchuan Shi ◽  
Dongmei Li ◽  
Maciej L. Goniewicz

Following their introduction a decade ago, electronic cigarettes (e-cigarettes) have grown in popularity. Given their novelty, knowledge of the health consequences of e-cigarette use remains limited. Epidemiologic studies have not comprehensively explored associations between e-cigarette use and hypertension, a highly prevalent health condition and major contributor to cardiovascular disease burden. In this study, cross-sectional associations of cigarette smoking and e-cigarette use (vaping) with self-reported diagnosed hypertension were evaluated among 19,147 18–55 year old respondents in Wave 3 (2015–2016) of the Population Assessment of Tobacco and Health Study. Multivariable analyses first modeled smoking and vaping as separate 2-category variables, then as a 6-category composite variable accounting for former smoking. After adjusting for potential confounders, current vaping (aOR = 1.31; 95%CI: 1.05–1.63) and current smoking (aOR = 1.27; 95%CI: 1.10–1.47) were both associated with higher odds of hypertension. In analyses modeling smoking and vaping compositely, respondents who were concurrently smoking and vaping had the highest odds of hypertension (aOR = 1.77; 95%CI: 1.32–2.39 [referent: never smokers]). These results differ somewhat from prior epidemiologic studies of vaping and respiratory outcomes, which consistently report smaller point estimates for current vaping than for current smoking. Our findings reinforce the uncertainty surrounding long-term health consequences of vaping, as well as highlight important distinctions between respiratory and cardiovascular outcomes when considering the harm reduction potential of e-cigarettes.


2005 ◽  
Vol 12 (8) ◽  
pp. 426-432 ◽  
Author(s):  
Benoît Levesque ◽  
Jean-François Duchesne ◽  
Suzanne Gingras ◽  
Pierre Allard ◽  
Edgar Delvin ◽  
...  

BACKGROUND: Respiratory disease is a major cause of morbidity in young people. It is now recognized that atopy plays an important role in the development of chronic respiratory symptoms in children.OBJECTIVE: To examine the determinants and consequences of serum total and specific immunoglobulin E (IgE) in a general population sample of Québec children and adolescents.METHODS: In 1999, 2349 children and adolescents (nine, 13 or 16 years of age) who had participated in a respiratory symptom and disease questionnaire had their total IgE measured. Of these participants, a subsample of 451 children and adolescents was analyzed to detect antibodies to eight specific allergens (ie, allergens of dust mites [Dermatophagoides farinae and Dermatophagoides pteronyssinus], cat, dog, ragweed, Timothy grass, mould [alternaria] and cockroach).RESULTS: The geometric mean of the total IgE was 44.4 U/mL among all participants. Concentrations were higher in boys and increased with age. More than 41% of the participants were sensitized to at least one specific allergen. Such sensitization was strongly associated with the occurrence of respiratory conditions and symptoms, namely asthma, wheezing and rhinitis. Family history, school location and ethnic origin had an impact on the prevalence of atopy and total IgE levels.CONCLUSIONS: Allergic sensitization is a major determinant in the development of asthma, wheezing and rhinitis in children and adolescents in the province of Québec.


2016 ◽  
Vol 25 (Suppl 1) ◽  
pp. i90-i95 ◽  
Author(s):  
Yue-Lin Zhuang ◽  
Sharon E Cummins ◽  
Jessica Y Sun ◽  
Shu-Hong Zhu

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