Abstract 16510: Acute Use Impairs Vascular Function in Exclusive Juul Users (the Jive Study)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sana Majid ◽  
Rachel J Keith ◽  
Jessica L Fetterman ◽  
Robert M Weisbrod ◽  
Comreen Vargees ◽  
...  
Keyword(s):  
Young Adults ◽  
Endothelial Function ◽  
Vascular Function ◽  
Electronic Cigarettes ◽  
Cardiovascular Effects ◽  
Acute Exposure ◽  
Cigarette Use ◽  
Vascular Effects ◽  
Youth And Young Adults ◽  
Long Term Impact

Introduction: The use of pod-based electronic cigarettes such as JUUL has especially increased among youth and young adults. Due to its popularity and high nicotine delivery as salts, JUUL warrants assessment of its cardiovascular effects. Hypothesis: JUUL use alters vascular function. Methods: In the JUUL Impact on Vascular Effects (JIVE) Study, we evaluated endothelial function and blood pressure (BP) in healthy young adults aged 18-40 who were either tobacco nonusers (N=23), exclusive combustible cigarette users (N=17) or exclusive JUUL users (N=15). Results: As shown in the figure, no differences were noted in baseline brachial artery FMD across the 3 groups. Both JUUL and combustible cigarette users had higher systolic and diastolic BP compared to nonusers (P<0.01). Following 10-minute structured use, JUUL decreased FMD more than nonuse (P<0.01) and was similar to combustible cigarette use (P=0.30 vs JUUL). These differences persisted in models adjusted for age, race and sex. Additionally, JUUL use induced an acute rise in systolic BP (6 ± 6mmHg) that differed from nonuse (0.3 ± 5 mmHg, P=0.001) but was similar to combustible cigarette use (8 mmHg, P=1.0). Urinary cotinine and nicotine levels were higher in combustible cigarette and JUUL users following acute exposure (general linear model adjusted for urinary creatinine with overall P<0.01, combustible cigarette vs nonusers P<0.01, JUUL vs nonusers P<0.01). Conclusions: Our results indicate that acute and chronic JUUL use are associated with higher BP, and acute use with a decrease in endothelial function similar to acute combustible cigarette use, thereby suggesting that JUUL alters vascular function both chronically and upon acute exposure in healthy young adults. Further studies are needed to evaluate the long-term impact of JUUL use on vascular health.

Electrical features, liquid composition and toxicant emissions from ‘pod-mod’-like disposable electronic cigarettes

2021 ◽  
pp. tobaccocontrol-2020-056362
Author(s):  
Soha Talih ◽  
Rola Salman ◽  
Eric Soule ◽  
Rachel El-Hage ◽  
Ebrahim Karam ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Young Adults ◽  
Electronic Cigarettes ◽  
Electrical Power ◽  
Liquid Composition ◽  
Gas Chromatography Mass Spectrometry ◽  
Aerosol Composition ◽  
Public Health Perspective ◽  
Nicotine Concentration ◽  
Youth And Young Adults

IntroductionUse of flavoured pod-mod-like disposable electronic cigarettes (e-cigarettes) has grown rapidly, particularly among cost-sensitive youth and young adults. To date, little is known about their design characteristics and toxicant emissions. In this study, we analysed the electrical and chemical characteristics and nicotine and pulmonary toxicant emission profiles of five commonly available flavoured disposable e-cigarettes and compared these data with those of a JUUL, a cartridge-based e-cigarette device that pod-mod-like disposables emulate in size and shape.MethodsDevice construction, electrical power and liquid composition were determined. Machine-generated aerosol emissions including particulate matter, nicotine, carbonyl compounds and heavy metals were also measured. Liquid and aerosol composition were measured by high-performance liquid chromatography, gas chromatography-mass spectrometry/flame ionisation detection, and inductively coupled plasma mass spectrometry.ResultsWe found that unlike JUUL, disposable devices did not incorporate a microcontroller to regulate electrical power to the heating coil. Quality of construction varied widely. Disposable e-cigarette power ranged between 5 and 9 W and liquid nicotine concentration ranged between 53 and 85 mg/mL (~95% in the protonated form). In 15 puffs, total nicotine yield for the disposables ranged between 1.6 and 6.7 mg, total carbonyls ranged between 28 and 138 µg, and total metals ranged between 1084 and 5804 ng. JUUL emissions were near the floors of all of these ranges.ConclusionsDisposable e-cigarettes are designed with high nicotine concentration liquids and are capable of emitting much higher nicotine and carbonyl species relative to rechargeable look-alike e-cigarettes. These differences are likely due to the lower quality in construction, unreliable labelling and lack of temperature control regulation that limits the power during operation. From a public health perspective, regulating these devices is important to limit user exposure to carbonyls and nicotine, particularly because these devices are popular with youth and young adults.

scholarly journals Cardiovascular autonomic effects of electronic cigarette use: a systematic review

2020 ◽  
Vol 30 (6) ◽  
pp. 507-519 ◽  
Author(s):  
Phoebe D. Garcia ◽  
Jeffrey A. Gornbein ◽  
Holly R. Middlekauff
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Electronic Cigarettes ◽  
Meta Analysis ◽  
Cardiovascular Effects ◽  
Tobacco Product ◽  
Cigarette Use ◽  
Prisma Statement ◽  
The Usa ◽  
Acute And Chronic Effects

Abstract Purpose Electronic cigarettes (ECs) are the fastest growing tobacco product in the USA, and ECs, like tobacco cigarettes (TCs), have effects on the cardiovascular autonomic nervous system, with clinical implications. The purpose of this review was to collect and synthesize available studies that have investigated the autonomic cardiovascular effects of EC use in humans. Special attention is paid to the acute and chronic effects of ECs, the relative contributions of the nicotine versus non-nicotine constituents in EC emissions and the relative effects of ECs compared to TCs. Methods Using the methodology described in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, we conducted a literature search of the Ovid PubMed and Embase databases on 6 December 2019 using keywords in titles and abstracts of published literature. Acute (minutes to hours) and chronic (days or longer) changes in heart rate variability (HRV), heart rate (HR) and blood pressure (BP) were used as estimates of cardiovascular autonomic effects. Results Nineteen studies were included in this systematic review, all of which used earlier generation EC devices. Acute EC vaping increased HR and BP less than acute TC smoking. Nicotine but not non-nicotine constituents in EC aerosol were responsible for the sympathoexcitatory effects. The results of chronic EC vaping studies were consistent with a chronic sympathoexcitatory effect as estimated by HRV, but this did not translate into chronic increases in HR or BP. Conclusions Electronic cigarettes are sympathoexcitatory. Cardiac sympathoexcitatory effects are less when vaping using the earlier generation ECs than when smoking TCs. Additional studies of the latest pod-like EC devices, which deliver nicotine similarly to a TC, are necessary.

scholarly journals Examining the relationship of vaping to smoking initiation among US youth and young adults: a reality check

2018 ◽  
Vol 28 (6) ◽  
pp. 629-635 ◽  
Author(s):  
David T Levy ◽  
Kenneth E Warner ◽  
K Michael Cummings ◽  
David Hammond ◽  
Charlene Kuo ◽  
...  
Keyword(s):  
Young Adults ◽  
Electronic Cigarettes ◽  
Population Level ◽  
Smoking Initiation ◽  
Data Sets ◽  
Youth Smoking ◽  
Increased Risk ◽  
Youth And Young Adults ◽  
The Usa ◽  
Multiple Data Sets

BackgroundThe 2018 National Academies of Sciences, Engineering, and Medicine Report found substantial evidence that electronic cigarette use (vaping) by youth is strongly associated with an increased risk of ever using cigarettes (smoking) and moderately associated with progressing to more established smoking. However, the Report also noted that recent increases in vaping have been associated with declining rates of youth smoking. This paper examines the temporal relationship between vaping and youth smoking using multiple data sets to explore the question of whether vaping promotes smoking initiation in the USA.MethodsUsing publicly available, nationally representative data on smoking and vaping among youth and young adults, we conducted a trend line analysis of deviations from long-term trends in smoking starting from when vaping became more prevalent.ResultsThere was a substantial increase in youth vaping prevalence beginning in about 2014. Time trend analyses showed that the decline in past 30-day smoking prevalence accelerated by two to four times after 2014. Indicators of more established smoking rates, including the proportion of daily smokers among past 30-day smokers, also decreased more rapidly as vaping became more prevalent.ConclusionsThe inverse relationship between vaping and smoking was robust across different data sets for both youth and young adults and for current and more established smoking. While trying electronic cigarettes may causally increase smoking among some youth, the aggregate effect at the population level appears to be negligible given the reduction in smoking initiation during the period of vaping’s ascendance.

scholarly journals Developing Pictorial Cigarillo Warnings: Insights From Focus Groups

2020 ◽  
Author(s):  
Jennifer Cornacchione Ross ◽  
Jessica L King ◽  
Allison J Lazard ◽  
Seth M Noar ◽  
Beth A Reboussin ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Focus Groups ◽  
Cognitive Effort ◽  
Cigarette Use ◽  
Focus Group Study ◽  
Cognitive Reactions ◽  
Pictorial Warnings ◽  
Youth And Young Adults ◽  
Selection Of

Abstract Introduction The Food and Drug Administration (FDA) selected six text-only warnings for cigarillos to be implemented on packaging and advertising. Pictorial warnings are more effective at discouraging cigarette use than text-only warnings, yet no research exists for cigarillos. We sought to understand what types of images might be most effectively paired with the cigarillo text warnings to inform broad principles for developing pictorial warnings, with a focus on young adults, who have the highest rate of cigarillo use. Methods We conducted five focus groups with a total of N = 30 young adult cigarillo users and susceptible nonusers (53% female, 50% White, and 33% Black). Participants were shown four to eight unique images for each of the six text statements and were asked about visual–verbal congruency, emotional and cognitive reactions, and perceived effectiveness of each image. Sessions were recorded and transcribed; two investigators independently coded transcripts for emergent themes. Results Participants reported images that were graphic or “gross” would best grab attention and discourage use of cigarillos. Participants preferred images that were a direct illustration of the information in the warning text, rather than abstract images that required more cognitive effort to understand. Participants also highlighted that including people in the images, especially youth and young adults making eye contact, helped them relate to the warnings, garner their attention, and positively influence their reactions. Conclusions We identified several principles to inform the selection of images to pair with the FDA-required cigarillo text statements. These insights may also apply to pictorial warnings for other tobacco products. Implications This focus group study identified principles for selecting images to develop pictorial warnings for the six FDA text-only cigarillo warnings. We found that young adult cigarillo users and susceptible nonusers preferred images that were graphic and gross, believable, congruent to the warning text, and included people. Images that match young adults’ visual expectations of a disease and are emotion-provoking may be most effective in pictorial warnings and highlight challenges for developing pictorial warnings for health effects that do not have a visible health consequence.

scholarly journals Electronic cigarettes in Canada: Prevalence of use and perceptions among youth and young adults

2014 ◽  
Vol 105 (2) ◽  
pp. e97-e102 ◽  
Author(s):  
Christine D. Czoli ◽  
David Hammond ◽  
Christine M. White
Keyword(s):  
Young Adults ◽  
Electronic Cigarettes ◽  
Youth And Young Adults

scholarly journals Electronic cigarettes and health with special focus on cardiovascular effects: position paper of the European Association of Preventive Cardiology (EAPC)

2020 ◽  
pp. 204748732094199
Author(s):  
Maryam Kavousi ◽  
Charlotta Pisinger ◽  
Jean-Claude Barthelemy ◽  
Delphine De Smedt ◽  
Konstantinos Koskinas ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Tobacco Smoking ◽  
European Association ◽  
Electronic Cigarettes ◽  
Cardiovascular Effects ◽  
Position Paper ◽  
Cigarette Use ◽  
Preventive Cardiology ◽  
The Impact

Background Tobacco use is the single largest preventable risk factor for premature death of non-communicable diseases and the second leading cause of cardiovascular disease. In response to the harmful effects of tobacco smoking, the use of electronic cigarettes (e-cigarettes) has emerged and gained significant popularity over the past 15 years. E-cigarettes are promoted as safe alternatives for traditional tobacco smoking and are often suggested as a way to reduce or quit smoking. However, evidence suggests they are not harmless. Discussion The rapid evolution of the e-cigarette market has outpaced the legislator’s regulatory capacity, leading to mixed regulations. The increasing use of e-cigarettes in adolescents and young individuals is of concern. While the long-term direct cardiovascular effects of e-cigarettes remain largely unknown, the existing evidence suggests that the e-cigarette should not be regarded as a cardiovascular safe product. The contribution of e-cigarette use to reducing conventional cigarette use and smoking cessation is complex, and the impact of e-cigarette use on long-term cessation lacks sufficient evidence. Conclusion This position paper describes the evidence regarding the prevalence of e-cigarette smoking, uptake of e-cigarettes in the young, related legislations, cardiovascular effects of e-cigarettes and the impact of e-cigarettes on smoking cessation. Knowledge gaps in the field are also highlighted. The recommendations from the population science and public health section of the European Association of Preventive Cardiology are presented.

Awareness and use of electronic cigarettes: Perceptions of health science programme students in Malaysia

2017 ◽  
Vol 76 (8) ◽  
pp. 1000-1008 ◽  
Author(s):  
Yin Hoong Goh ◽  
Juman Abdulelah Dujaili ◽  
Ali Qais Blebil ◽  
Syed Imran Ahmed
Keyword(s):  
Young Adults ◽  
Sensation Seeking ◽  
Electronic Cigarettes ◽  
Health Science ◽  
International Medical ◽  
Cigarette Use ◽  
Cross Sectional ◽  
Behavioural Characteristics ◽  
Medical University ◽  
The Impact

Objectives: In recent years, electronic nicotine delivery systems (ENDS) or e-cigarettes appear to be gaining in popularity despite controversy over their health effects and public health impacts. This paper is the first in Malaysia to assess sociodemographic and behavioural characteristics associated with ENDS awareness, perceptions and use among students enrolled in health science programmes. Design: Online self-reported use and perceptions of ENDS were assessed using a cross-sectional design. Setting: The study was conducted at the International Medical University, Malaysia. Method: An anonymous Internet-based, cross-sectional survey was conducted among a cohort of 404 undergraduate students at International Medical University, Malaysia, in September 2016. Data were collected over a period of 6 weeks. A 31-question web-based survey was developed to assess sociodemographic and behavioural characteristics associated with ENDS awareness, perceptions and use. Logistic regression analysis was performed to assess the impact of a set of predictors on e-cigarette use. Results: Almost 95% of respondents were aware of e-cigarettes, 13.8% reported ever-use and students had varied perceptions towards e-cigarettes. Characteristics associated with greater likelihood of ever-use included gender, ethnicity and parents educational level. Other correlates included prior conventional cigarette smoking, prior hookah smoking, parents’ tobacco use and higher sensation-seeking behaviour total score. Conclusion: In this sample of young adults, e-cigarette awareness was high and ever-use was evident especially among ever cigarette smokers. Nearly half of ever-users had not used an e-cigarette in the past 30 days of the survey and mostly reported flavoured over unflavoured e-cigarette use. These findings highlight the importance of e-cigarette surveillance and health promotion interventions targeting young adults.

Identifying message themes to prevent e-cigarette use among youth and young adults

2021 ◽  
pp. 106683
Author(s):  
Jessica M. Rath ◽  
Alexa R. Romberg ◽  
Siobhan N. Perks ◽  
Domonique Edwards ◽  
Donna M. Vallone ◽  
...  
Keyword(s):  
Young Adults ◽  
Cigarette Use ◽  
Youth And Young Adults
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