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 Explosions, Burn Injuries and Adverse Health Effects of Electronic Nicotine Delivery Systems: A Review of Current Regulations and Future Perspectives

2021 ◽  
Vol 24 ◽  
pp. 462-474
Author(s):  
Ayesha Rahman Ahmed ◽  
Beverly Etchey ◽  
Mahiba Ahmed
Keyword(s):  
Health Effects ◽  
Significant Risk ◽  
The United States ◽  
Delivery Systems ◽  
Long Term Effects ◽  
Safe Alternative ◽  
Electronic Nicotine Delivery Systems ◽  
Adverse Health Effects ◽  
Adverse Health ◽  
Nicotine Delivery

Purpose: While there is a declining trend in the use of traditional methods of smoking tobacco, electronic nicotine delivery systems (ENDS) have gained popularity worldwide. ENDS are marketed as safe for the primary reason that they do not contain the well-established toxic ingredients found in traditional cigarettes. However, growing concerns over incidences of fire and explosion with specific types of ENDS, as well as their short and long-term effects, remain unaddressed. This review examines the under studied role of customized components such as batteries, e-liquid compositions, and methods of nicotine delivery that result in physical injuries and adverse health effects of ENDS. Methods: Using online reference databases (Web of Science, PubMed, Medline other, Google scholar, FDA website, FDA register), we analyzed the mechanisms through which ENDS may pose significant risk to human health. Results: An increase in the use and popularity of ENDS has been observed among youth and adults in the United States since 2007. The ENDS devices available to the public allow for custom alterations which can introduce incompatible components, resulting in overheating and explosion related injuries. Heavy metals have been found to leach from some devices into the e-liquid, and the heating of e-liquid ingredients can produce toxic byproducts. Conclusions: Overall, the current literature demonstrates that ENDS are not a safe alternative to traditional cigarettes due to explosion risks and negative health effects including addiction, adverse respiratory and cardiovascular effects, heavy metal leaching, and toxic byproducts exposure. These risks warrant regulation of ENDS devices and formulations, with urgency underscored by their increasing popularity among youth and adults.

scholarly journals New Challenges: Developing Gendered and Equitable Responses to Involuntary Exposures to Electronic Nicotine Delivery Systems (ENDS) and Cannabis Vaping

2018 ◽  
Vol 15 (10) ◽  
pp. 2097
Author(s):  
Natalie Hemsing ◽  
Lorraine Greaves
Keyword(s):  
Health Effects ◽  
Secondhand Smoke ◽  
New Products ◽  
Delivery Systems ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
New Challenges ◽  
Gendered Patterns ◽  
Specific Health ◽  
Research And Policy

Recreational cannabis use is in the process of being legalized in Canada, and new products and devices for both nicotine and cannabis vaping are being introduced. Yet, research on the harms of involuntary exposure to electronic nicotine delivery systems (ENDSs) and cannabis vaping is in its infancy, and there is a lack of investigation on sex-specific health effects and gendered patterns of exposure and use. We argue that responses to ENDS and cannabis vaping exposures should align with policy and progress on restricting exposure to tobacco secondhand smoke (SHS). Furthermore, we argue that sex, gender, and equity considerations should be integrated in both research and policy to benefit all Canadians.

New Zealand tobacco retailers’ understandings of and attitudes towards selling Electronic Nicotine Delivery Systems: a qualitative exploration

2019 ◽  
pp. tobaccocontrol-2019-055173 ◽  
Author(s):  
Jerram Bateman ◽  
Lindsay Robertson ◽  
Louise Marsh ◽  
Louise Thornley ◽  
Janet Hoek
Keyword(s):  
New Zealand ◽  
Cost Savings ◽  
Delivery Systems ◽  
Electronic Nicotine Delivery Systems ◽  
Risks And Benefits ◽  
Quit Smoking ◽  
Nicotine Delivery ◽  
Qualitative Exploration ◽  
Depth Interviews ◽  
Incorrect Information

IntroductionIn 2017, the New Zealand Government signalled its intent to legalise the widespread sale of Electronic Nicotine Delivery Systems (ENDS), which many New Zealand retailers have actually sold for several years. Although ENDS uptake may reduce the harm smokers face, it requires them to adopt an entirely new practice; we therefore explored how effectively existing non-specialist tobacco retailers could advise and support potential quitters.MethodsUsing in-depth interviews with 18 tobacco retailers (prior to legislative change), we explored knowledge of ENDS, attitudes towards selling ENDS and supporting customers’ cessation attempts, perceptions of ENDS’ risks and benefits, and views on the proposed legislation.ResultsParticipants generally had poor knowledge of ENDS products and provided either no advice or gave incorrect information to customers. They believed that the main benefit consumers would realise from using ENDS rather than tobacco would be cost savings; relatively, few saw ENDS as smoking cessation devices. Those who stocked ENDS did so despite reporting very low customer demand, and saw tobacco as more important to their business than ENDS, citing higher repeat business, ancillary sales and rebates. Participants typically supported liberalising ENDS availability, though several expressed concerns about potential youth uptake.ConclusionsTobacco retailers’ limited understanding of ENDS, and the higher value they placed on tobacco, suggests they may have little capacity or inclination to support ENDS users to quit smoking. Licensing schemes for both ENDS and smoked tobacco could simultaneously reduce supply of smoked tobacco while requiring ENDS retailers to meet minimum knowledge standards.

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.

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 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 Electronic nicotine delivery system-induced alterations in oral health via saliva assessment

2020 ◽  
Vol 245 (15) ◽  
pp. 1319-1325
Author(s):  
Saeed Alqahtani ◽  
Bruce Cooper ◽  
Claire A Spears ◽  
Christa Wright ◽  
Jonathan Shannahan
Keyword(s):  
Risk Factor ◽  
Oral Health ◽  
Pilot Study ◽  
Periodontal Disease ◽  
Health Effects ◽  
Inflammatory Cytokines ◽  
Delivery Systems ◽  
Disease Development ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery

Use of electronic nicotine delivery systems (ENDS) is becoming increasingly prevalent. ENDS aerosols contain a variety of toxic components that may adversely impact health. Although exposure to traditional cigarette smoke is a risk factor for periodontal disease, the effects of ENDS on oral health have not been adequately examined. To evaluate potential oral health effects associated with ENDS use, a pilot study was performed with 14 current ENDS users and 16 never tobacco users. Participants completed questionnaires about their ENDS use and overall health. Saliva samples were assessed for differential biomarkers of inflammation, toxicity, and disease development. This included evaluation of specific inflammatory cytokines and the global assessment of alterations in metabolites. ENDS users were determined to have elevated saliva levels of interleukin-1β and tumor necrosis factor-α indicative of inflammation. Metabolite profiling determined 368 metabolites were differentially expressed in the saliva of ENDS users versus never tobacco users. Cotinine, the primary metabolite of nicotine, was the most significantly altered metabolite between the groups. Increased levels of prostaglandins and leukotrienes indicated that ENDS users exhibited increased arachidonic acid metabolism compared to never tobacco users. Additionally, a variety of other metabolites known to be involved in immune signaling such as gangliosides, ceramides, angiotensin, and others were also different between groups. Overall, our pilot study demonstrates differential saliva component profiles in current ENDS users, which may contribute to periodontal disease development. These alterations suggest specific pathways of oral disease induced by ENDS use and could be utilized as potential future biomarkers. Impact statement The use of traditional tobacco products is a known risk factor for the development of diseases including periodontal disease. To date, the potential oral health effects related to electronic nicotine delivery systems (ENDS) use is unknown. This study collected saliva from ENDS users and never tobacco users to examine differences in the oral cavity of inflammatory cytokines and metabolites. The identification and measurement of these ENDS-related changes provide insight into disease pathways potentially associated with ENDS use. The utilization of saliva samples collected from human participates enhances the application of the findings compared to the majority of studies using cell culture and animal models. In addition, these foundational findings can inform future studies to examining specific pathways identified, interventional approaches, and application of translatable biomarkers of ENDS use.

scholarly journals Pharmacological Interventions for Vaping Cessation

2021 ◽  
Vol 1 (4) ◽  
Author(s):  
Sara D. Khangura ◽  
Sarah C. McGill
Keyword(s):  
Smoking Cessation ◽  
Health Effects ◽  
Delivery Systems ◽  
Evidence Based ◽  
Pharmacological Interventions ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
Evidence Based Guidelines

The use of electronic nicotine delivery systems and other vaping products is on the rise, and the health effects from these products remain uncertain. No evidence-based guidelines regarding the use of pharmacological vaping cessation interventions were identified. Some guidelines suggest that it may be reasonable to apply smoking cessation interventions and/or protocols for vaping cessation, but no guidance specific to the use of pharmacotherapy was identified.

Updated Health and Cost Impacts of Electronic Nicotine Delivery Systems, Using Recent Estimates of Relative Harm for Vaping Compared to Smoking

2021 ◽  
Author(s):  
Jennifer A Summers ◽  
Driss Ait Ouakrim ◽  
Nick Wilson ◽  
Tony Blakely
Keyword(s):  
New Zealand ◽  
Cost Saving ◽  
Health System ◽  
Population Health ◽  
Delivery Systems ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
Life Years ◽  
Per Capita ◽  
The Impact

Abstract Background Measuring population health and costs effects of liberalizing access to electronic nicotine delivery systems (ENDS) is an evolving field with high persisting uncertainty. A critical area of uncertainty for policy-makers are estimates of net harms from ENDS relative to cigarettes, therefore, we model these harms using updated estimates incorporating disease specificity. Methods We use updated estimates of relative harm of vaping vs smoking, based upon relevant biomarker studies to model the impact of liberalizing access to ENDS in New Zealand (NZ), relative to a ban (where ENDS are not legally available), in an existing proportional multi-state life-table model of 16 tobacco-related diseases. Results This modeling suggests that ENDS liberalization results in an expected gain of 195 000 quality-adjusted life-years (QALYs) over the remainder of the NZ population’s lifespan. There was wide uncertainty in QALYs gained (95% uncertainty interval [UI] = −8000 to 406 000) with a 3.2% probability of net health loss (based upon the number of simulation runs returning positive QALY gains). The average per capita health gain was 0.044 QALYs (equivalent to an extra 16 days of healthy life). Health system cost-savings were expected to be NZ$2.8 billion (US$2.1 billion in 2020 US$; 95%UI: −0.3 to 6.2 billion [2011 NZ$]), with an estimated 3% chance of a net increase in per capita cost. Conclusions This updated modeling around liberalizing ENDs in NZ, still suggests likely net health and cost-saving benefits—but of lesser magnitude than previous work and with a small possibility of net harm to population health. Implications This study found evidence using updated biomarker studies that ENDS liberalization could result in QALY gains across the New Zealand population lifespan that are also cost-saving to the health system. Governments should include the information from these types of modeling studies in their decision-making around potentially improving access to ENDS for existing smokers, while at the same further reducing access to tobacco.

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