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 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 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 Validation and Acceptability of a Cuffless Wrist-Worn Wearable Blood Pressure Monitoring Device Among Users and Health Care Professionals: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Susie Cartledge ◽  
Chandan Karmakar ◽  
Jonathan Charles Rawstorn ◽  
Steve F Fraser ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Mixed Methods Study ◽  
Care Providers ◽  
Long Term Monitoring ◽  
Term Monitoring

BACKGROUND Blood pressure (BP) is an important modifiable cardiovascular risk factor, yet its long-term monitoring remains problematic. Wearable cuffless devices enable the capture of multiple BP measures during everyday activities and could improve BP monitoring, but little is known about their validity or acceptability. OBJECTIVE This study aimed to validate a wrist-worn cuffless wearable BP device and assess its acceptability among users and health care professionals. METHODS A mixed methods study was conducted to examine the validity and comparability of a wearable cuffless BP device against ambulatory and home devices. BP was measured simultaneously over 24 hours using wearable and ambulatory devices and over 7 days using wearable and home devices. Pearson correlation coefficients compared the degree of association between the measures, and limits of agreement (LOA; Bland-Altman plots) were generated to assess measurement bias. Semistructured interviews were conducted with users and 10 health care professionals to assess acceptability, facilitators, and barriers to using the wearable device. Interviews were audio recorded, transcribed, and analyzed. RESULTS A total of 9090 BP measurements were collected from 20 healthy volunteers (mean 20.3 years, SD 5.4; N=10 females). Mean (SD) systolic BP (SBP)/diastolic BP (DBP) measured using the ambulatory (24 hours), home (7 days), and wearable (7 days) devices were 126 (SD 10)/75 (SD 6) mm Hg, 112 (SD 10)/71 (SD 9) mm Hg and 125 (SD 4)/77 (SD 3) mm Hg, respectively. Mean (LOA) biases and precision between the wearable and ambulatory devices over 24 hours were 0.5 (−10.1 to 11.1) mm Hg for SBP and 2.24 (−17.6 to 13.1) mm Hg for DBP. The mean biases (LOA) and precision between the wearable and home device over 7 days were −12.7 (−28.7 to 3.4) mm Hg for SBP and −5.6 (−20.5 to 9.2) mm Hg for DBP. The wearable BP device was well accepted by participants who found the device easy to wear and use. Both participants and health care providers agreed that the wearable cuffless devices were easy to use and that they could be used to improve BP monitoring. CONCLUSIONS Wearable BP measures compared well against a gold-standard ambulatory device, indicating potential for this user-friendly method to augment BP management, particularly by enabling long-term monitoring that could improve treatment titration and increase understanding of users’ BP response during daily activity and stressors.

Cigarette Smoke Preparations, Not Electronic Nicotine Delivery Systems (ENDS) Preparations, Induce Features of Lung Disease in a 3D Lung Repeat-Dose Model

2020 ◽  
Author(s):  
Rachael E Rayner ◽  
Patrudu Makena ◽  
Gaddamanugu L Prasad ◽  
Estelle Cormet-Boyaka
Keyword(s):  
Lung Cancer ◽  
Lung Disease ◽  
Cellular Transformation ◽  
Delivery Systems ◽  
Conditioned Media ◽  
Repeat Dose ◽  
Potential Health ◽  
Exposure System ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery

Cigarette smoking is a risk factor for several lung diseases, including chronic obstructive pulmonary disease, cardiovascular disease and lung cancer. The potential health effects of chronic use of electronic nicotine delivery systems (ENDS) is unclear. This study utilized fully differentiated primary normal human bronchial epithelial (NHBE) cultures in a repeat-dose exposure to evaluate and compare the effect of combustible cigarette and ENDS preparations. We show that 1-hour daily exposure of NHBE cultures over a 10-day period to combustible cigarette whole smoke-conditioned media (WS-CM) increased expression of oxidative stress markers, cell proliferation, airway remodeling, cellular transformation markers, and decreased mucociliary function including ion channel function and airway surface liquid. Conversely, aerosol conditioned media (ACM) from ENDS with similar nicotine concentration (equivalent-nicotine units) as WS-CM and nicotine alone had no effect on those parameters. In conclusion, primary NHBE cultures in a repeat-dose exposure system represent a good model to assess the features of lung disease. This study also reveals that cigarette and ENDS preparations differentially elicit several key endpoints, some of which are potential biomarkers for lung cancer or COPD.

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 A qualitative exploration of information-seeking by electronic nicotine delivery systems (ENDS) users in New Zealand

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e023375 ◽  
Author(s):  
Lindsay Robertson ◽  
Janet Hoek ◽  
Mei-Ling Blank ◽  
Rosalina Richards ◽  
Pamela Ling ◽  
...  
Keyword(s):  
New Zealand ◽  
Health Effects ◽  
Information Seeking ◽  
Information Needs ◽  
Delivery Systems ◽  
Scientific Data ◽  
Product Knowledge ◽  
Potential Health ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery

ObjectivesGiven recent increases in awareness and uptake of electronic nicotine delivery systems (ENDS), we aimed to explore ENDS users’ information needs and search behaviours and whether information gaps exist.DesignQualitative study using semistructured interviews that probed participants’ smoking behaviours and ENDS use; data in this study examine ENDS information-seeking behaviours. We used qualitative description to analyse interview transcripts.Participants and settingWe recruited 39 current ENDS users (20 dual users and 19 exclusive ENDS users who reported having previously smoked cigarettes regularly) aged 18 and over, from three urban centres in New Zealand.ResultsSeveral participants used Google to search for information on ENDS’ health effects, but described the material they retrieved as vague or contradictory. Some interpreted the absence of information on long-term health effects as evidence ENDS did not pose potential health risks, and several perceived e-liquids as benign. Many relied on information sourced from other ENDS users, gleaned from online forums, YouTube or from discussions with friends and acquaintances; these sources typically presented ENDS positively. Several participants found specialist ENDS retailers provided valuable advice; non-specialist store staff generally lacked detailed product knowledge and sometimes offered inaccurate information.ConclusionPeople seeking information on ENDS’ health effects are more likely to retrieve recommendations, product reviews and endorsements from online sources or through exchanges with other users, than they are to find scientific data. Health authorities could help meet potential users’ information needs by, first, creating and frequently updating objective lay summaries of the latest scientific evidence; second, by mandating licensing for retailers with guidelines to disclose uncertainty over ENDS’ efficacy for cessation and longer-term health effects, and the need for complete substitution of ENDS for combustible cigarettes among those who use these products.

scholarly journals Fluctuation between cigarette smoking and use of electronic nicotine delivery systems: Impact on clozapine concentrations and clinical effect

2021 ◽  
Vol 11 (6) ◽  
pp. 365-368
Author(s):  
Daniel J. Montville ◽  
Jaclyn M. Lindsey ◽  
Jonathan G. Leung
Keyword(s):  
Delivery System ◽  
Health Care Professionals ◽  
Psychiatric Symptoms ◽  
Delivery Systems ◽  
Serum Concentrations ◽  
Hydrocarbon Production ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
Polycyclic Aromatic ◽  
The Impact

Abstract Unlike with smoking cigarettes, electronic nicotine delivery systems do not cause CYP450 1A2 induction as there is a lack of combustion and polycyclic aromatic hydrocarbon production. Changing to the use of an electronic nicotine delivery system from cigarettes can result in the deinduction of CYP450 1A2 and the increase of certain medication serum concentrations, including clozapine. A case is reported in which the switch from smoking to an electronic nicotine delivery system resulted in increased clozapine serum concentration and constipation, necessitating pharmacologic management. The patient ultimately transitioned back to cigarettes, which resulted in the emergence of psychiatric symptoms. An evaluation of longitudinal serum concentrations and clinical correlation is provided. It is important that patients and health care professionals have knowledge not only about the impact of smoking cigarettes on clozapine metabolism, but also the effects of switching to or from an electronic nicotine delivery system.

Electronic Nicotine Delivery Systems (ENDS): What Nurses Need to Know

2017 ◽  
Vol 24 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Carol Essenmacher ◽  
Madeline Naegle ◽  
Carolyn Baird ◽  
Bridgette Vest ◽  
Rene Spielmann ◽  
...  
Keyword(s):  
Health Risks ◽  
Current Knowledge ◽  
Delivery Systems ◽  
Research Literature ◽  
Subject Matter Experts ◽  
Potential Health ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
Key Stakeholders ◽  
Policy Proposals

BACKGROUND: Efforts to decrease adverse effects of tobacco use are affected by emergence of new nicotine delivery products. Advertising, product promotion, and social media promote use of these products, yet a lack of evidence regarding safety leaves nurses unprepared to counsel patients. OBJECTIVES: To critically evaluate current research, reviews of literature, expert opinion, and stakeholder policy proposals on use and safety of electronic nicotine delivery systems (ENDS). DESIGN: A targeted examination of literature generated by key stakeholders and subject matter experts was conducted using key words, modified by risk factors, and limited to the past 8 years. RESULTS: Current knowledge gaps in research literature and practice implications of the literature are discussed. CONCLUSIONS: The safety of ENDS is questionable and unclear. There are clear health risks of nicotine exposure to developing brains. Potential health risks of ENDS secondhand emissions exposure exist. Using ENDS to facilitate total tobacco cessation is not proven.

scholarly journals World Vaping Day: Contextualizing Vaping Culture in Online Social Media Using a Mixed Methods Approach

2017 ◽  
Vol 13 (2) ◽  
pp. 196-215 ◽  
Author(s):  
Jason B. Colditz ◽  
Joel Welling ◽  
Noah A. Smith ◽  
A. Everette James ◽  
Brian A. Primack
Keyword(s):  
Social Media ◽  
Mixed Methods ◽  
Mixed Methods Research ◽  
Delivery Systems ◽  
Primary Data ◽  
Electronic Nicotine Delivery Systems ◽  
Mixed Methods Approach ◽  
Online Social Media ◽  
Nicotine Delivery ◽  
Prevalence Estimates

Few studies have demonstrated the use of mixed methods research to contextualize health topics using primary data from social media. To address this gap in the methodological literature, we present research about electronic nicotine delivery systems, using Twitter data from “World Vaping Day.” To engage with the quantitative breadth and qualitative depth of 5,149 collected tweets, we utilized a convergent parallel mixed methods framework, integrating thematic prevalence estimates with phenomenological contextualization. Sentiment was more positive than negative across all categories except policy related. A total of 23% of tweets were promotional and relatively few tweets related to tobacco use (4.9%) or health concerns (4.2%). Salient themes included modifying or upgrading electronic nicotine delivery systems devices, and general mistrust of public health advocates and tobacco companies.

scholarly journals Pharmacy Students’ Perceptions of Electronic Nicotine Delivery Systems as Compared to Those of Other Health Care Students

2020 ◽  
Vol 84 (7) ◽  
pp. ajpe7690
Author(s):  
Michelle Sahr ◽  
Shelby Kelsh ◽  
Anne Ottney ◽  
Mark Young ◽  
Rodney Larson ◽  
...  
Keyword(s):  
Health Care ◽  
Delivery Systems ◽  
Pharmacy Students ◽  
Electronic Nicotine Delivery Systems ◽  
Health Care Students ◽  
Nicotine Delivery
Sign in / Sign up

Export Citation Format

Share Document