Electronic cigarettes in Canada: Prevalence of use and perceptions among 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.

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

Tobacco Control ◽

10.1136/tobaccocontrol-2018-054446 ◽

2018 ◽

Vol 28 (6) ◽

pp. 629-635 ◽

Cited By ~ 50

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.

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Electronic Cigarette Cessation in Youth and Young Adults: A Case Series

Tobacco Use Insights ◽

10.1177/1179173x211026676 ◽

2021 ◽

Vol 14 ◽

pp. 1179173X2110266

Author(s):

Gautam Sikka ◽

MopeninuJesu Oluyinka ◽

Raiza Schreiber ◽

Panagis Galiatsatos

Keyword(s):

Young Adults ◽

Peer Influence ◽

Electronic Cigarettes ◽

Case Series ◽

Electronic Cigarette ◽

Medical Regimen ◽

Tobacco Treatment ◽

Treatment Clinic ◽

Youth And Young Adults ◽

Cigarette Cessation

Introduction: Electronic cigarette (e-cigarette) usage use has increased exponentially, especially in youth and young adults. For many, the usage of these products results in a severe addiction, one that is difficult to discontinue. Further, e-cigarette cessation is challenging as there are no specific guidelines directing such medical management for patients and their respective clinicians. Here, we report a case series of patients who we are attempting to wean from e-cigarettes with medical guidance. Methods: Six patients who self-reported daily e-cigarette usage and were enrolled in our Tobacco Treatment Clinic (TTC) were followed for 12-months. An inventory of the e-cigarette product and usage was captured, along with responses to identify when the patients experienced majority of their cravings. Co-morbidities, if present, were documented. Documentation of interventions, counseling with or without pharmacological therapies, were captured. Primary outcome was cessation at 6-months. Results: The 6 patients enrolled in clinic ranged in age from 17 to 31 years, with 4 of the patients identifying as males and 2 as females. Patients were using e-cigarettes for 1 to 6 years prior to enrolling into the TTC. As for interventions, all patients received counseling and pharmacological interventions in the form of nicotine replacement therapies (NRTs). Three of the 6 patients were weaned off e-cigarettes by 6-months, with a fourth patient weaned off at the 8-month mark. Variables identified as barriers to cessation included non-compliance with medical regimen and peer influence. Discussion: Here we present a case series of attempting to wean persons from electronic cigarettes use. Given the lack of international guidelines in e-cigarette addiction management, we believe this case series will be of value for clinicians and their patients. Further studies are warranted to help patients with e-cigarette addiction in their attempt at cessation.

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

Circulation ◽

10.1161/circ.142.suppl_3.16510 ◽

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.

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