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

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.

2020 ◽  
Author(s):  

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/


2020 ◽  
Vol 319 (4) ◽  
pp. L585-L595 ◽  
Author(s):  
Kielan Darcy McAlinden ◽  
Mathew Suji Eapen ◽  
Wenying Lu ◽  
Pawan Sharma ◽  
Sukhwinder Singh Sohal

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.


2021 ◽  
pp. 089719002110268
Author(s):  
Carla Daniel ◽  
Christa Haddad ◽  
Jamie L. McConaha ◽  
Philip Lunney

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.


2015 ◽  
Vol 17 (1) ◽  
pp. 60-75 ◽  
Author(s):  
William Schultz

Powered by philosophic argument, scientific evidence, and multibillion dollar pharmaceutical companies sponsoring multimillion dollar advertising campaigns, the chemical imbalance hypothesis has saturated our academic and popular culture. This saturation is, at least partially, responsible for the more than 10 billion dollars annually spent on antidepressant medication in the United States. But what is the “chemical imbalance” hypothesis? And what evidence supports it? This article will provide an account of the chemical imbalance hypothesis, a history of its development, and the evidence provided for its justification. This article will show that the evidence for the chemical imbalance hypothesis is unconvincing. It will discuss why, despite the unconvincing evidence, the hypothesis lingers. And, finally, it will suggest an alternative approach to mental illness that avoids some of the pitfalls of a biological reductionistic account of mind.


Author(s):  
Joshua O. Barker ◽  
Julia Vassey ◽  
Julia C. Chen-Sankey ◽  
Jon-Patrick Allem ◽  
Tess Boley Cruz ◽  
...  

(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.


2018 ◽  
Vol 21 (12) ◽  
pp. 1695-1699 ◽  
Author(s):  
Susanne Tanski ◽  
Jennifer Emond ◽  
Cassandra Stanton ◽  
Thomas Kirchner ◽  
Kelvin Choi ◽  
...  

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.


2020 ◽  
Vol 319 (6) ◽  
pp. H1234-H1239
Author(s):  
Nicholas D. Fried ◽  
Jason D. Gardner

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.


Stroke ◽  
2021 ◽  
Author(s):  
Neal S. Parikh ◽  
Melvin Parasram ◽  
Halina White ◽  
Alexander E. Merkler ◽  
Babak B. Navi ◽  
...  

Background and Purpose: Continued smoking after stroke is associated with a high risk of stroke recurrence and other cardiovascular disease. We sought to comprehensively understand the epidemiology of smoking cessation in stroke survivors in the United States. Furthermore, we compared smoking cessation in stroke and cancer survivors because cancer is another smoking-related condition in which smoking cessation is prioritized. Methods: We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, an annual, nationally representative health survey. Using pooled data from 2013 to 2019, we identified stroke and cancer survivors with a history of smoking. We used survey procedures to estimate frequencies and summarize quit ratios with attention to demographic and geographic (state-wise and rural-urban) factors for stroke survivors. The quit ratio is conventionally defined as the proportion of ever smokers who have quit. Then, we used multivariable logistic regression to compare quit ratios in stroke and cancer survivors while adjusting for demographics and smoking-related comorbidities. Results: Among 4 434 604 Americans with a history of stroke and smoking, the median age was 68 years (interquartile range, 59–76), and 45.4% were women. The overall quit ratio was 60.8% (95% CI, 60.1%–61.6%). Quit ratios varied by age group, sex, race and ethnicity, and several geographic factors. There was marked geographic variation in quit ratios, ranging from 48.3% in Kentucky to 71.5% in California. Furthermore, compared with cancer survivors, stroke survivors were less likely to have quit smoking (odds ratio, 0.72 [95% CI, 0.67–0.79]) after accounting for differences in demographics and smoking-related comorbidities. Conclusions: There were considerable demographic and geographic disparities in smoking quit ratios in stroke survivors, who were less likely to have quit smoking than cancer survivors. A targeted initiative is needed to improve smoking cessation for stroke survivors.


2017 ◽  
pp. 50-59
Author(s):  
Alisha Kamboj ◽  
Henry A. Spiller ◽  
Marcel J. Casavant ◽  
Thiphalak Chounthirath ◽  
Gary A. Smith

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.


Author(s):  
Leslie Iversen

Marijuana has a long history of medical use. This chapter discusses the modern revival of interest in marijuana in the United States, Europe, and elsewhere. The fully licensed cannabinoid medicines dronabinol (Marinol), nabilone (Cesamet), and nabiximols (Sativex) and their uses are discusses. Medical indications include multiple sclerosis, pain, nausea and vomiting, epilepsy, appetite stimulation, mood, sleep, and migraine. Apart from the treatment of spasticity and pain in multiple sclerosis, there is little or no scientific evidence of efficacy because of the lack of controlled clinical trials; nevertheless, there may be a significant placebo effect. The supply of cannabis to medical pharmacies is poorly controlled. The Dutch and Canadian models provide good quality control, but in the United States supplies are of patchy quality from state to state.


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