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 Sociodemographic Correlates of Electronic Nicotine Delivery Systems (ENDS) Use in the United States, 2016–2017

2019 ◽  
Vol 109 (9) ◽  
pp. 1224-1232 ◽  
Author(s):  
Claire Adams Spears ◽  
Dina M. Jones ◽  
Scott R. Weaver ◽  
Jidong Huang ◽  
Bo Yang ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Delivery Systems ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
Sociodemographic Correlates

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.

Electronic Nicotine Delivery Systems: A Policy Statement From the American Association for Cancer Research and the American Society of Clinical Oncology

2015 ◽  
Vol 33 (8) ◽  
pp. 952-963 ◽  
Author(s):  
Thomas H. Brandon ◽  
Maciej L. Goniewicz ◽  
Nasser H. Hanna ◽  
Dorothy K. Hatsukami ◽  
Roy S. Herbst ◽  
...  
Keyword(s):  
Cancer Research ◽  
Clinical Oncology ◽  
Tobacco Use ◽  
American Association ◽  
The United States ◽  
Delivery Systems ◽  
Policy Statement ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
American Society

Combustible tobacco use remains the number-one preventable cause of disease, disability, and death in the United States. Electronic nicotine delivery systems (ENDS), which include electronic cigarettes, are devices capable of delivering nicotine in an aerosolized form. ENDS use by both adults and youth has increased rapidly, and some have advocated these products could serve as harm-reduction devices and smoking cessation aids. ENDS may be beneficial if they reduce smoking rates or prevent or reduce the known adverse health effects of smoking. However, ENDS may also be harmful, particularly to youth, if they increase the likelihood that nonsmokers or former smokers will use combustible tobacco products or if they discourage smokers from quitting. The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO) recognize the potential ENDS have to alter patterns of tobacco use and affect the health of the public; however, definitive data are lacking. The AACR and ASCO recommend additional research on these devices, including assessing the health impacts of ENDS, understanding patterns of ENDS use, and determining what role ENDS have in cessation. Key policy recommendations include supporting federal, state, and local regulation of ENDS; requiring manufacturers to register with the US Food and Drug Administration and report all product ingredients, requiring childproof caps on ENDS liquids, and including warning labels on products and their advertisements; prohibiting youth-oriented marketing and sales; prohibiting child-friendly ENDS flavors; and prohibiting ENDS use in places where cigarette smoking is prohibited. This policy statement was developed by a joint writing group composed of members from the Tobacco and Cancer Subcommittee of the American Association for Cancer Research (AACR) Science Policy and Government Affairs (SPGA) Committee and American Society of Clinical Oncology (ASCO) Tobacco Cessation and Control Subcommittee of the Cancer Prevention Committee (CaPC). The statement was reviewed by both parent committees (ie, the AACR SPGA Committee and the ASCO CaPC) and was approved by the AACR Boards of Directors on August 6, 2014, and the ASCO Executive Committee on September 18, 2014. This policy statement was published jointly by invitation and consent in both Clinical Cancer Research and Journal of Clinical Oncology. Copyright 2015 American Association for Cancer Research and American Society of Clinical Oncology. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or storage in any information storage and retrieval system, without written permission by the American Association for Cancer Research and the American Society of Clinical Oncology.

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 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 Smoking and pregnancy: The era of electronic nicotine delivery systems

2020 ◽  
Vol 13 (4) ◽  
pp. 154-158
Author(s):  
Nikita Desai
Keyword(s):  
United States ◽  
Smoking Cessation ◽  
The United States ◽  
Delivery Systems ◽  
Medical Community ◽  
Cigarette Use ◽  
Safety And Efficacy ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
In Pregnancy

Electronic nicotine delivery systems have been commercially available in the United States since 2007. Despite a decrease in combustible cigarette use, electronic nicotine delivery systems use has dramatically increased among both adults and adolescents. These devices have been marketed as smoking cessation aids, although data on their efficacy are scarce. Pregnant women are an especially vulnerable population susceptible to claims of safety and efficacy, and the medical community remains inadequately informed on how to counsel these women. The purpose of this article is to review known literature regarding the use of electronic nicotine delivery systems in pregnancy, to understand the differences between cigarettes and electronic nicotine delivery systems use in pregnancy, and to further guide clinicians on how to advise the pregnant woman on their 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.

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