scholarly journals Heat-not-burn tobacco products: an emerging threat to cardiovascular health

2020 ◽  
Vol 319 (6) ◽  
pp. H1234-H1239
Author(s):  
Nicholas D. Fried ◽  
Jason D. Gardner
Keyword(s):  
United States ◽  
Cigarette Smoking ◽  
Cardiovascular Health ◽  
Electronic Cigarettes ◽  
Cardiovascular Effects ◽  
The United States ◽  
Tobacco Products ◽  
Aerosol Exposure ◽  
Philip Morris ◽  
Tobacco Specific Nitrosamines

Cigarette smoking is at all-time lows globally, but the use of electronic cigarettes has increased profoundly. Recent reports of electronic cigarette or vaping use-associated lung injury may lead individuals to explore novel methods of nicotine consumption, such as heat-not-burn devices. IQOS from Philip Morris, a heat-not-burn device, became available for purchase in the United States in October 2019. Philip Morris claims that 8.8 million people have abandoned traditional cigarettes in favor of IQOS; however, evidence suggests that it may act as a gateway or complement to cigarette smoking, rather than a replacement. Surveys indicate that 96% of Korean IQOS users also smoke cigarettes, and 45% of Italian users of IQOS had never smoked cigarettes. In the United States, Canada, and England, susceptibility of youth to trying IQOS was slightly lower than electronic cigarettes, but higher than cigarette smoking. Heat-not-burn products produce mainstream and second-hand emissions of harmful chemicals, including nicotine, particulate matter, benzene, acrolein, and tobacco-specific nitrosamines. The levels of these emissions, despite being less than those of traditional cigarettes, are potentially harmful to cardiovascular health. A study of current smokers showed similar acute effects of heat-not-burn tobacco products and traditional cigarettes on heart rate, blood pressure, and arterial stiffness. Rats exposed to IQOS had similar vascular endothelial function impairment to those exposed to cigarettes. Heat-not-burn aerosol exposure of cultured macrophages elicited increased oxidative stress, although less than that induced by cigarette smoke. Further studies are needed to better understand the cardiovascular effects of heat-not-burn tobacco products.

Pediatric Collections: Vaping: Effects and Solutions

2020 ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Health Care Providers ◽  
Electronic Cigarettes ◽  
The United States ◽  
Care Providers ◽  
Tobacco Products ◽  
Pediatric Health ◽  
Pediatric Health Care

Electronic cigarettes are the tobacco products most commonly used by youths in the United States. The use of e-cigarettes, also known as vaping or JUULing, is a public health epidemic. This collection offers reviews and research to assist pediatric health care providers in identifying and treating adolescent use and exposure to e-cigarettes. https://shop.aap.org/pediatric-collections-vaping-effects-and-solutions-paperback/

scholarly journals Not Quite the Rule, But No Longer the Exception: Multiple Tobacco Product Use and Implications for Treatment, Research, and Regulation

2019 ◽  
Vol 22 (11) ◽  
pp. 2114-2117
Author(s):  
Lauren R Pacek ◽  
Andrea C Villanti ◽  
F Joseph Mcclernon
Keyword(s):  
United States ◽  
Cigarette Smoking ◽  
Tobacco Dependence ◽  
The United States ◽  
Tobacco Product ◽  
Regulatory Science ◽  
Tobacco Products ◽  
The Past ◽  
Product Use ◽  
Treatment Research

Abstract The patterns of tobacco product use in the United States have changed during the past several decades. Currently, a large proportion of tobacco users report using multiple tobacco products (MTPs). The prevalence of MTP use varies significantly by cigarette smoking frequency, as well: nearly half (46.9%) of all non-daily smokers report using other tobacco products within the past 30 days. Despite this, much of extant tobacco dependence treatment efforts, tobacco regulatory science research, and tobacco product research, in general, has focused largely on single product use (ie, cigarette smoking). To effectively design interventions and model the potential impact of regulations on tobacco products aimed at reducing tobacco use, as well as effectively study tobacco users, it is essential to consider actual use patterns in the population of tobacco users. Implications: MTP use is increasingly common in the United States. This commentary highlights the impact that MTP use has for efforts to treat tobacco dependence, tobacco regulatory science efforts, as well as on tobacco research, in general.

scholarly journals In Vitro Models, Standards, and Experimental Methods for Tobacco Products

2019 ◽  
Vol 30 (1) ◽  
pp. 16-21 ◽  
Author(s):  
T. Aghaloo ◽  
J.J. Kim ◽  
T. Gordon ◽  
H.P. Behrsing
Keyword(s):  
Cigarette Smoking ◽  
Electronic Cigarettes ◽  
Testing Machine ◽  
The United States ◽  
In Vitro Models ◽  
In Vivo Studies ◽  
Tobacco Products ◽  
Direct Exposure

Traditional tobacco products have well-known systemic and local oral effects, including inflammation, vasoconstriction, delayed wound healing, and increased severity of periodontal disease. Specifically in the oral cavity and the lung, cigarette smoking produces cancer, increased infectivity, acute and chronic inflammation, changes in gene expression in epithelial lining cells, and microbiome changes. In recent years, cigarette smoking has greatly decreased in the United States, but the use of new tobacco products has gained tremendous popularity. Without significant knowledge of the oral sequelae of products such as electronic cigarettes, researchers must evaluate current in vitro and in vivo methods to study these agents, as well as develop new tools to adequately study their effects. Some in vitro testing has been performed for electronic cigarettes, including toxicologic models and assays, but these mostly study the effect on the respiratory tract. Recently, direct exposure of the aerosol to in vitro 3-dimensional tissue constructs has been performed, demonstrating changes in cell viability and inflammatory cytokines. For in vivo studies, a universal e-cigarette testing machine or standard vaping regime is needed. A standard research electronic cigarette has recently been developed by the National Institute of Drug Abuse, and other devices delivering aerosols with different nicotine concentrations are becoming available. One of the biggest challenges in this research is keeping up with the new products and the rapidly changing technologies in the industry.

The rise of electronic nicotine delivery systems and the emergence of electronic-cigarette-driven disease

2020 ◽  
Vol 319 (4) ◽  
pp. L585-L595 ◽  
Author(s):  
Kielan Darcy McAlinden ◽  
Mathew Suji Eapen ◽  
Wenying Lu ◽  
Pawan Sharma ◽  
Sukhwinder Singh Sohal
Keyword(s):  
United States ◽  
Cigarette Smoking ◽  
Electronic Cigarettes ◽  
Scientific Evidence ◽  
The United States ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cellular Processes ◽  
Increased Risk

In 2019, the United States experienced the emergence of the vaping-associated lung injury (VALI) epidemic. Vaping is now known to result in the development and progression of severe lung disease in the young and healthy. Lack of regulation on electronic cigarettes in the United States has resulted in over 2,000 patients and 68 deaths. We examine the clinical representation of VALI and the delve into the scientific evidence of how deadly exposure to electronic cigarettes can be. E-cigarette vapor is shown to affect numerous cellular processes, cellular metabolism, and cause DNA damage (which has implications for cancer). E-cigarette use is associated with a higher risk of developing crippling lung conditions such as chronic obstructive pulmonary disease (COPD), which would develop several years from now, increasing the already existent smoking-related burden. The role of vaping and virus susceptibility is yet to be determined; however, vaping can increase the virulence and inflammatory potential of several lung pathogens and is also linked to an increased risk of pneumonia. As it has emerged for cigarette smoking, great caution should also be given to vaping in relation to SARS-CoV-2 infection and the COVID-19 pandemic. Sadly, e-cigarettes are continually promoted and perceived as a safer alternative to cigarette smoking. E-cigarettes and their modifiable nature are harmful, as the lungs are not designed for the chronic inhalation of e-cigarette vapor. It is of interest that e-cigarettes have been shown to be of no help with smoking cessation. A true danger lies in vaping, which, if ignored, will lead to disastrous future costs.

Electronic Cigarettes: Their Role in the Lives of College Students

2021 ◽  
pp. 089719002110268
Author(s):  
Carla Daniel ◽  
Christa Haddad ◽  
Jamie L. McConaha ◽  
Philip Lunney
Keyword(s):  
United States ◽  
College Students ◽  
Smoking Cessation ◽  
Healthcare Professionals ◽  
Electronic Cigarettes ◽  
The United States ◽  
Descriptive Statistics ◽  
Cigarette Use ◽  
Tobacco Products ◽  
High Prevalence

Background: Electronic cigarettes have increased in popularity amongst college-aged adults. Although often advertised as smoking cessation tools, students have taken to them as their primary exposure to nicotine. For many reasons, e-cigarettes are extremely convenient and have become the most common tobacco products among this generation. Objective: To assess perceptions and reasons for e-cigarette use in college students Methods: A 20 question online Qualtrics® survey was distributed to college students aged 18 and above across the United States. All responses were anonymous and data were analyzed using quantitative and qualitative inferential and descriptive statistics. Results: Of those who used e-cigarettes, 67.7% are not likely to smoke when they are upset or sad, 56.8% disagree that stress is a factor, and 83.5% cited that alcohol was involved when smoking. Most respondents, 74% (n = 467), associated smoking with emotions of happiness, joy or peace. 43.7% who associated e-cigarettes with happiness or peace were more likely to agree that stress was an influence versus 26.5% for those who did not (p = 0.004). Conclusion: Results show a high prevalence of e-cigarette usage among college-aged students. Emotional pleasurable connections with e-cigarettes, similar to traditional cigarettes, play a role in their use. This information will allow healthcare professionals to tailor educational messages surrounding cessation.

Efectos en la salud de los sistemas electrónicos de administración de nicotina (SEAN)

2020 ◽  
Vol 63 (6) ◽  
pp. 7-19
Author(s):  
Guadalupe Ponciano-Rodríguez ◽  
Carlos Alberto Chávez Castillo
Keyword(s):  
United States ◽  
Lung Disease ◽  
Electronic Cigarettes ◽  
Scientific Evidence ◽  
Premature Death ◽  
The United States ◽  
Tobacco Products ◽  
Psychological Therapies ◽  
Quit Smoking ◽  
History Of

Without a doubt, smoking continues to be the leading cause of disease, disability, and premature death worldwide. How ever, the advent of the new Electronic Administration Systems of Nicotine (SEAN), among which the electronic cigarette stands out, has had explosive growth and in some countries has depleted tobacco cigarettes, especially among young people who feel attracted by its striking flavors and the deployment of technology that is used in its design and operation. The SEANs initially emerged in 2003 as a supposed help to quit smoking, at 16 years from this date no clinical studies are confirming their superiority over existing medications for this purpose: nicotine, bupropion and varenicline replacement therapies, or over psychological therapies such as emotional and cognitive-behavioral rational. On the other side, a large amount of evidence has been accumulated on the deleterious effect they have on the health of consumers, the risk they represent is unquestionable and this is confirmed by recent reports from the Centers for Disease Control of the United States (CDC) that indicate 2142 hospitalized cases with acute lung disease and 42 deaths from this cause, 79% being people under 35 years. This outbreak of lung disease has determined that the ban on SEAN in the United States will be planted. Also, the Food and Drug Administration (FDA) approved the sale of hybrid cigarettes or “Heets” (Heat-not-burn tobacco products), which uses heated tobacco, and are now available in our country. There is no doubt that as health professionals, we must inform with scientific evidence about the risks that SEANs pose to their consumers, we must also learn from the history of smoking to prevent the morbidity and mortality associated with these new tobacco products. Keywords: Electronic nicotine delivery systems (ENDS); electronic cigarettes; JUUL®; heets; toxicity; health effects; damage.

scholarly journals Categorizing IQOS-Related Twitter Discussions

2021 ◽  
Vol 18 (9) ◽  
pp. 4836
Author(s):  
Joshua O. Barker ◽  
Julia Vassey ◽  
Julia C. Chen-Sankey ◽  
Jon-Patrick Allem ◽  
Tess Boley Cruz ◽  
...  
Keyword(s):  
United States ◽  
News Media ◽  
The United States ◽  
Tobacco Product ◽  
Online Marketing ◽  
Tobacco Policy ◽  
Tobacco Products ◽  
Quit Smoking ◽  
Philip Morris ◽  
Clean Air

(1) Background: The heated tobacco product IQOS, by Philip Morris International, is now available in over 55 countries, including the United States. Social media sites such as Twitter are often used to promote or discuss tobacco products, though prior research has not examined how IQOS is presented on Twitter. (2) Methods: This study collected and categorized Twitter conversations involving IQOS. A manual content analysis was performed on N = 3916 English tweets related to IQOS published internationally between 1 January 2020 and 30 June 2020. (3) Results: Most tweets were either online marketing for IQOS (32.3%) or personal testimonials related to IQOS use (34.2%). Personal testimonial tweets made harm reduction claims about IQOS either as an avenue to quit smoking/tobacco use (3.4%), or in comparison to combustible cigarettes (2.0%). Tobacco policy-related tweets were detected (13.9%), split between discussions of United States (4.9%) and international (4.4%) policies. News media tweets (14.2%) were also detected. (4) Conclusions: Our study suggests IQOS may be understood as a less harmful alternative to vaping and combustible cigarettes. Discussions also suggest IQOS is likely to be used to avoid clean air policies or used in areas in which smoking is restricted.

scholarly journals Youth Access to Tobacco Products in the United States: Findings From Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health Study

2018 ◽  
Vol 21 (12) ◽  
pp. 1695-1699 ◽  
Author(s):  
Susanne Tanski ◽  
Jennifer Emond ◽  
Cassandra Stanton ◽  
Thomas Kirchner ◽  
Kelvin Choi ◽  
...  
Keyword(s):  
United States ◽  
Electronic Cigarettes ◽  
The United States ◽  
Tobacco Product ◽  
Tobacco Products ◽  
Population Assessment ◽  
Gas Stations ◽  
Usual Source ◽  
Convenience Stores ◽  
The Us

Abstract Objectives Tobacco products in the US market are growing in diversity. Little is known about how youth access tobacco products given this current landscape. Methods Data were drawn from 15- to 17-year-olds from the Wave 1 youth sample of the US nationally representative Population Assessment of Tobacco and Health (PATH) Study. Past 30-day tobacco users were asked about usual sources of access to 12 different tobacco products, and if they had been refused sale because of their age. Results Among 15- to 17-year-olds, social sources (“someone offered” or “asked someone”) were the predominant usual source of access for each tobacco product. “Bought by self” was the usual source of access for users of smokeless (excluding snus, 23.2%), cigarillos (21.0%), cigarettes (13.8%), hookah (12.0%), and electronic cigarettes (10.5%). Convenience stores and/or gas stations were the most often selected retail source for all products except hookah. Among youth who attempted purchase, 24.3% were refused sale of cigarettes, 23.9% cigarillos, and 13.8% smokeless tobacco. Conclusions Most 15- to 17-year-old tobacco users obtain tobacco products through social sources; however, among those who purchased tobacco, the majority report not being refused sale because of age. At the time of survey, cigarette and cigar sales to under 18 years were prohibited in all 50 states, and electronic cigarettes sales in 47 states and two territories. 2014 Annual Synar Reports signaled increasing trends in retail violations of state and/or district laws prohibiting tobacco product sales to under 18 years. Monitoring illicit youth sales, conducting compliance check inspections, and penalizing violations remain important to reduce youth tobacco access at retail venues. Implications Access to the spectrum of tobacco products by youth in the United States remains predominantly through social sources. However, of the minority of youth tobacco users in 2014 who purchased tobacco themselves, a few reported being refused sale: Convenience stores and/or gas stations were the most common retail source for tobacco products. The strategies of monitoring illicit youth sales, conducting compliance checks, and penalizing violations remain important to reduce youth tobacco access at retail venues. Limiting sources of youth tobacco access remains an important focus to reduce the burden of tobacco on the public health.

scholarly journals Informing iQOS Regulations in the United States: A Synthesis of What We Know

SAGE Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 215824401989882 ◽  
Author(s):  
Carla J. Berg ◽  
Yael Bar-Zeev ◽  
Hagai Levine
Keyword(s):  
United States ◽  
Tobacco Control ◽  
Tobacco Industry ◽  
The United States ◽  
Tobacco Product ◽  
Future Research ◽  
Tobacco Products ◽  
Philip Morris ◽  
International Collaborations ◽  
The U.S

The tobacco industry offers various products, including heated tobacco products (HTPs). Philip Morris International’s (PMI) “iQOS” has the greatest HTP market share, as well as research on its use and impact. iQOS was released in 2014 and is now in more than 40 countries. The U.S. Food and Drug Administration announced permission for PMI to sell iQOS in the United States in April 2019, and iQOS was launched in October 2019. Decisions pending its modified risk tobacco product (MRTP) application will occur subsequently. The U.S. regulatory efforts regarding iQOS could be informed by examining (a) Philip Morris USA other product marketing efforts and (b) the iQOS market in countries where it is available. This article briefly addresses these two points with extant literature and suggests that future research should address important gaps in what is currently known, including strategic international collaborations and research, which historically has been critical for advancing tobacco control globally.

Pediatric Exposure to E-Cigarettes, Nicotine, and Tobacco Products in the United States

2017 ◽  
pp. 50-59
Author(s):  
Alisha Kamboj ◽  
Henry A. Spiller ◽  
Marcel J. Casavant ◽  
Thiphalak Chounthirath ◽  
Gary A. Smith
Keyword(s):  
United States ◽  
Young Children ◽  
Electronic Cigarettes ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Data System ◽  
Tobacco Products ◽  
National Poison ◽  
National Poison Data System

OBJECTIVES To investigate the epidemiologic characteristics and outcomes of exposures to electronic cigarettes (e-cigarettes), nicotine, and tobacco products among young children in the United States. METHODS A retrospective analysis of exposures associated with nicotine and tobacco products among children younger than 6 years old was conducted by using National Poison Data System data. RESULTS From January 2012 through April 2015, the National Poison Data System received 29 141 calls for nicotine and tobacco product exposures among children younger than 6 years, averaging 729 child exposures per month. Cigarettes accounted for 60.1% of exposures, followed by other tobacco products (16.4%) and e-cigarettes (14.2%). The monthly number of exposures associated with e-cigarettes increased by 1492.9% during the study period. Children <2 years old accounted for 44.1% of e-cigarette exposures, 91.6% of cigarette exposures, and 75.4% of other tobacco exposures. Children exposed to e-cigarettes had 5.2 times higher odds of a health care facility admission and 2.6 times higher odds of having a severe outcome than children exposed to cigarettes. One death occurred in association with a nicotine liquid exposure. CONCLUSIONS The frequency of exposures to e-cigarettes and nicotine liquid among young children is increasing rapidly and severe outcomes are being reported. Swift government action is needed to regulate these products to help prevent child poisoning. Prevention strategies include public education; appropriate product storage and use away from children; warning labels; and modifications of e-cigarette devices, e-liquid, and e-liquid containers and packaging to make them less appealing and less accessible to children.

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