scholarly journals From Tobacco Cigarettes to Electronic Cigarettes: The Two Sides of a Nicotine Coin

2021 ◽  
Vol 2 ◽  
Author(s):  
Ahmad Besaratinia
Keyword(s):  
Electronic Cigarettes ◽  
Public Health Problem ◽  
The United States ◽  
Multiple Organ ◽  
Electronic Cigarette ◽  
Global Challenge ◽  
Current State ◽  
Quit Smoking ◽  
Tobacco Epidemic ◽  
Lower Health

Tobacco smoking-related diseases, including cardiovascular disease, pulmonary disease, stroke, and cancer in multiple organ sites, are the leading causes of preventable death, worldwide. Youth electronic cigarette use (vaping) is an evolving public health problem in the United States and around the world. Many of the same toxicants and carcinogens present in tobacco smoke are also found in electronic cigarette vapor, although mostly at substantially lower levels. The reduced concentrations of these chemicals in electronic cigarette vapor may imply lower health risk; however, they cannot equate to no risk. To date, the long-term health consequences of vaping are largely unknown. This “Perspective” provides a concise chronology of events leading up to an unprecedented global challenge, namely the convergence of global tobacco epidemic and youth vaping epidemic. Current state of knowledge, outstanding questions in the field, present challenges, and future directions in research are highlighted. The existing data show a continued and dynamic evolution of the converged epidemics. The goal should be to prevent youth vaping while improving smoking cessation strategies. In smokers who are unable or unwilling to quit smoking, the objective should be to provide “provably” safe or less-harmful alternatives, which should “completely” or “substantially” substitute tobacco cigarettes.

79 Electronic Cigarette-Related Injuries Presenting to Five Large Burn Centers, 2015–2019

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S54-S55
Author(s):  
Carmen E Flores ◽  
Paul J Chestovich ◽  
Syed F Saquib ◽  
Joseph T Carroll ◽  
Mariam Al-Hamad Daubs ◽  
...  
Keyword(s):  
Thermal Injury ◽  
Spontaneous Combustion ◽  
Electronic Cigarettes ◽  
Total Body Surface Area ◽  
Public Health Problem ◽  
Electronic Cigarette ◽  
Outpatient Basis ◽  
Burn Centers ◽  
Split Thickness Skin Grafting ◽  
Inpatient Basis

Abstract Introduction Electronic cigarettes are advertised as safer alternatives to smoking cigarettes yet can cause serious injury. As consumer use of electronic cigarettes has increased, burn centers have witnessed a rise in both inpatient and outpatient visits to treat thermal and blast injuries related to their use. Methods A multicenter retrospective chart review of ABA burn registry data from 5 large burn centers was performed from January 2015 to July 2019 to identify patients who sustained Electronic Nicotine Delivery Systems (ENDS)-related injuries. Results A total of 127 patients with electronic cigarette-related injuries were identified, of which 113 were male (89%) and 14 were female (11%). Mean age was 34.0 years (SD 13.5%, range 1–75 years). The majority of patients (n=92, 72%) were treated on an inpatient basis, and average length of stay was 6.7 days. Most patients sustained less than 10% total body surface area burns (mean 3.8%, SD 2.6%, range 0.1% to 16.5%). 66% (n=85) sustained 2nd degree burns, and 36% (n=46) sustained 3rd degree burns. Most patients were injured while using the ENDS (n=100, 78%), while 18% (n=24) of patients reported spontaneous combustion. 2 patients (1.5%) were injured while changing their device battery, and 2 patients (1.5%) were injured while modifying the device. 3% (n=4) were injured by second-hand mechanism. Burn injury was the most common injury pattern (100%), followed by blast injury (n=81, 63%). Flame burns were the most common (n=89, 70%) type of thermal injury, followed by contact burns (n= 70, 55%), flash burns (n=47, 37%), chemical burns (n=2, 1.5%), and electrical burns (n=1, 0.7%). The most commonly injured body region was the extremities. There were no ENDS-related deaths. Silvadene was the most common topical agent used in the initial management of thermal injuries, followed by Bacitracin and Xeroform. 63% (n=80) of patients did not require surgery, while 36% (n=46) required surgical excision, and 15% (n=20) required split-thickness skin grafting. Multiple surgeries were uncommon. 22% of patients required one operation, 12% required two operations, and 2% required 3 operations. Conclusions Our data recognizes use of ENDS as a growing public health problem with potential to cause thermal injury and secondary trauma. Most injuries occur during use, however many result from spontaneous combustion while the device is not being used. Treatment of ENDS-related injuries is institution-dependent. Most patients are treated on an inpatient basis however the majority of patients treated on outpatient basis have good outcomes.

The Pharmacist “Toolbox” for Smoking Cessation

2012 ◽  
Vol 25 (6) ◽  
pp. 591-599 ◽  
Author(s):  
William P. Wynn ◽  
Ron T. Stroman ◽  
Michaela M. Almgren ◽  
Kelly J. Clark
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Professionals ◽  
Electronic Cigarettes ◽  
The United States ◽  
Review Article ◽  
Prescription Medications ◽  
Over The Counter ◽  
Quit Smoking ◽  
Traditional Therapies

Annually there are 500 000 preventable deaths in the United States caused by smoking; as health care professionals, pharmacists have a unique opportunity to advise, assess, and assist patients to quit smoking. This review article provides pharmacists with a “toolbox” containing an overview of pharmacologic and nonpharmacologic methods for smoking cessation. Currently approved over-the-counter (OTC) and prescription medications (nicotine replacement therapy, varenicline, and bupropion) are summarized, and nonpharmacologic therapies discussed include cognitive therapy and hypnosis. In addition to traditional therapies some potential approaches to smoking cessation are addressed, including nicotine immunizations and electronic cigarettes.

Electronic Cigarette-Related Injuries Presenting to Five Large Burn Centers, 2015-2019

2021 ◽  
Author(s):  
Carmen E Flores ◽  
Paul J Chestovich ◽  
Syed Saquib ◽  
Joseph Carroll ◽  
Mariam Al-Hamad ◽  
...  
Keyword(s):  
Thermal Injury ◽  
Burn Injury ◽  
Electronic Cigarettes ◽  
Total Body Surface Area ◽  
Public Health Problem ◽  
Electronic Cigarette ◽  
Body Region ◽  
Outpatient Basis ◽  
Burn Centers ◽  
Thermal Injuries

Abstract Electronic cigarettes are advertised as safer alternatives to traditional cigarettes yet cause serious injury. US burn centers have witnessed a rise in both inpatient and outpatient visits to treat thermal injuries related to their use. A multicenter retrospective chart review of American Burn Association burn registry data from 5 large burn centers was performed from January 2015 to July 2019 to identify patients with electronic cigarette-related injuries. A total of 127 patients were identified. Most sustained less than 10% total body surface area burns (mean 3.8%). Sixty-six percent sustained 2nd degree burns. Most patients (78%) were injured while using their device. Eighteen percent of patients reported spontaneous device combustion. Two patients were injured while changing their device battery, and two were injured modifying their device. Three percent were injured by second-hand mechanism. Burn injury was the most common injury pattern (100%), followed by blast injury (3.93%). Flame burns were the most common (70%) type of thermal injury; however, most patients sustained a combination-type injury secondary to multiple burn mechanisms. The most injured body region was the extremities. Silver sulfadiazine was the most common agent used in initial management of thermal injuries. Sixty-three percent of patients did not require surgery. Of the 36% requiring surgery, 43.4% required skin grafting. Multiple surgeries were uncommon. Our data recognizes electronic cigarette use as a public health problem with potential to cause thermal injury and secondary trauma. Most patients are treated on an inpatient basis although most patients treated on outpatient basis have good outcomes.

Nicotine and Cotinine Levels With Electronic Cigarette

2015 ◽  
Vol 35 (2) ◽  
pp. 179-185 ◽  
Author(s):  
A. Marsot ◽  
N. Simon
Keyword(s):  
Peak Concentration ◽  
Electronic Cigarettes ◽  
Electronic Cigarette ◽  
Cigarette Use ◽  
Quit Smoking ◽  
Tobacco Cigarette ◽  
Nicotine Delivery ◽  
Pubmed Database ◽  
Urge To Smoke ◽  
Reasons For Use

Background: Since their introduction in 2004, electronic cigarettes (e-cigarettes) have gained popularity worldwide. E-cigarettes are marketed as nicotine delivery devices. Commonly reported reasons for use include to quit smoking, to reduce urge to smoke, or the perceived lower risk alternative to smoking. But what are the actual amounts of nicotine delivered? Aim: This review summarizes all the published studies concerning nicotine or cotinine levels following e-cigarette use. Methods: A literature search was conducted from the PubMed database, from 1985 to January 2014, using the following terms: electronic cigarette(s), e-cigarette(s), electronic nicotine delivery system, cotinine, and nicotine. Articles were excluded if they were not pertinent according to our criteria. References of all relevant articles were also evaluated. Results: Eight studies were included in this review. The following information was extracted from the articles: population size, age of participants, recruitment, inclusion and exclusion criteria, concentration of nicotine in refills liquids, study sample design, and observed concentrations. Following design of studies, plasma nicotine Cmax was observed between 0 and 5 ng/mL (no significant changes) or between 13.9 and 16.3 ng/mL (similar to a tobacco cigarette) with a Tmax between 70 and 75 minutes. Cotinine levels after “vaping” an e-cigarette are similar to a tobacco cigarette. Conclusion: This review summarizes e-cigarette studies that contain information on nicotine or cotinine levels. The peak concentration of nicotine appears to be dependent on the use and dose level of e-cigarette cartridge. The value of this peak concentration is similar to the value found with a tobacco cigarette. However, the time corresponding to the peak concentration is delayed compared to a tobacco cigarette.

Online Pro-Tobacco Marketing Exposure Is Associated With Dual Tobacco Product Use Among Underage US Students

2020 ◽  
Vol 34 (6) ◽  
pp. 648-651
Author(s):  
Hunter Marion ◽  
William Garner ◽  
Alex Estrada ◽  
Christopher Moorer ◽  
Ixel Acosta-Velazquez
Keyword(s):  
High School ◽  
High School Students ◽  
Electronic Cigarettes ◽  
The United States ◽  
Online Marketing ◽  
Electronic Cigarette ◽  
Dual Use ◽  
Cross Sectional Survey ◽  
School Students ◽  
Tobacco Marketing

Purpose: To understand the effect of pro-tobacco marketing on electronic cigarette and combustible cigarette dual use among US middle and high school students under 18 years of age. Design: Data were derived from the 2018 National Youth Tobacco Survey, an annual self-administered school-based cross-sectional survey. Setting: The survey was administered in public and private middle and high schools across the United States. Participants: The probability sample size was 15 238 middle and high school students with complete responses who were under 18 years of age during the study period. Measures: The study measured self-reported exposure to online combustible and electronic cigarette advertisements, dual use of combustible and electronic cigarettes during the past 30 days, exposure to the Real Cost antitobacco campaign advertisements, and other sociodemographic factors (eg, race/ethnicity, gender, and grade). Analysis: Logistic regressions were used to measure pro-tobacco marketing exposure and dual use as a function of pro-tobacco marketing exposure. Results: Descriptive analyses show that 59.0% of respondents were exposed to pro-tobacco online marketing, and 2.9% were dual users. Dual users (odds ratio [OR] = 1.73) and high school students (OR = 1.43) were more likely to report exposure to online pro-tobacco marketing. Conclusions: Findings indicate that a gap in electronic cigarette pro-tobacco marketing regulatory oversight may exist. Further policy action may be warranted to protect the public health of minors and other vulnerable populations who are most susceptible to pro-tobacco marketing.

scholarly journals Harsh and sweet sensations predict acute liking of electronic cigarettes, but flavor does not affect acute nicotine intake: a pilot laboratory study in men

2019 ◽  
Author(s):  
Allison N. Baker ◽  
Allysa J. Bakke ◽  
Steven Branstetter ◽  
John Hayes
Keyword(s):  
Electronic Cigarettes ◽  
The United States ◽  
Electronic Cigarette ◽  
Nicotine Intake ◽  
Magnitude Scales ◽  
Perceptual Masking ◽  
Hedonic Scale ◽  
Minute Session ◽  
Acute Intake

Introduction: Electronic cigarette (eCig) use is increasing in popularity, and thousands of flavors are available. Adolescent vaping rates in the United States have nearly doubled in the past year. Unlike combustible tobacco, added flavors are not currently regulated for electronic cigarette products. Here, we investigated the role of flavor in eCig liking and acute intake. Methods: Men (n=39) aged 18-45 vaped in a controlled laboratory setting after being randomized to one of four e-liquids: 6mg nicotine/ml Cherry, 18mg/ml Cherry, 6mg/ml Chocolate, or 18mg/ml Chocolate. They completed several questionnaires, and vaped ad libitum for 10 minutes. After the first puff, participants rated sensations (sweetness, bitterness, coolness, harshness/irritation) on general labeled magnitude scales (gLMS) and rated overall liking on a generalized hedonic scale. Once the 10-minute session ended, participants made another set of ratings. Results: Liking was generally stable across the vaping session and liking varied substantially across the 4 conditions. Across all conditions, sensory ratings predicted liking: harshness/irritation was negatively associated with first puff liking while perceived sweetness was positively associated with first puff liking. First puff liking associated with increased amount of e-liquid vaped, but not total nicotine intake. Participants appeared to titrate their nicotine intake regardless of assigned condition.Conclusion: Flavored eLiquids affect acute rated liking, but not acute nicotine intake. These data suggest individuals who regularly vape may titrate their nicotine intake, regardless of flavor, and contrary to expectations, acute liking did not predict total intake. However, more-liked flavors may potentially make higher nicotine levels more tolerable by adding pleasant sensations directly, rather than by perceptual masking that reduce aversive sensations.

scholarly journals Electronic cigarettes

2017 ◽  
Author(s):  
Spencer Kaspick ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Helen Heacock
Keyword(s):  
Smoking Cessation ◽  
Electronic Cigarettes ◽  
Smoking Status ◽  
Electronic Cigarette ◽  
Cigarette Use ◽  
Chi Square ◽  
Post Secondary ◽  
Quit Smoking ◽  
Quitting Smoking ◽  
Chi Squared

  Background: Electronic cigarettes are a widely-used, yet still emerging technology. As such, there is relatively little data regarding the reasons why people take up their use. Many claim to use them as a smoking-cessation method. Concern exists that experimentation in non-smokers may lead to nicotine addiction and subsequent smoking. The purpose of this study was to determine the primary reasons for the commencement of electronic cigarette use, and to suggest way in which these findings could affect current policies and regulations pertaining to electronic cigarettes. Methods: A survey examining electronic cigarette use was prepared. The survey contained questions respecting primary motivation for use, frequency of use, present and former smoking status as well as agreement with common perception about electronic cigarettes. Basic demographic information was also collected. The survey was posted to “www.reddit.com” and was accessible to users who used electronic cigarettes themselves via the “/r/electronic_cigarettes” sub-Reddit for a period of five days. Once responses were collected, Chi-square tests of independence were run to determine if any associations existed. Responses were also compared to previous studies of a similar nature to see if any similarities existed. Results: In total, 155 responses were received. The majority of the respondents were males (89.7%) between the ages of 19 and 28 (47.7%). 30.32% listed their occupation as “student”, and almost three-quarters of the respondents had some post-secondary experience. 78.1% of respondents were former smokers, and 61.3% identified their primary reason for electronic cigarette use as “to quit smoking.” Chi-squared tests for association between responses yielded statistically-significant associations between being a previous smoker and believing that electronic-cigarettes are healthier than conventional cigarettes, and between gender (specifically being male) and reasons for electronic cigarette use (specifically “to quit smoking”). However, the latter result was possibly skewed by a higher response rate from males as opposed to females. Conclusion: The high proportion of previous smokers among electronic cigarette users suggested that quitting smoking was the most common reason individuals take up electronic cigarette usage. It is therefore suggested that studies be done to determine if their use is less harmful than that of conventional cigarettes, and that existing legislation regarding their use in public be modified in light of this evidence. It is also suggested that they be given consideration as a legitimate means of smoking cessation.  

The New Addiction Treatment

2021 ◽  
Author(s):  
David A. Patterson Silver Wolf
Keyword(s):  
Success Rate ◽  
Failure Rate ◽  
Addiction Treatment ◽  
Public Health Problem ◽  
Cost Effective ◽  
The United States ◽  
Treatment Regimes ◽  
Current State ◽  
Percent Success

Addiction is this country’s most pervasive and damaging public health problem, yet most Americans receive care that results in a failure rate that is both astronomically high and shielded from public view. This book examines the current state of the addiction treatment business and explores the reasons why—unlike those for all other behavioral, psychological, or neurological disorders—the treatment of addiction has been frozen in amber and little improved since the founding of Alcoholics Anonymous in 1935. After describing the size and scope of the problem and examining actual recovery rates for those who undergo treatment, there is the assertion that there are effectively two kinds of treatment regimes in the United States: those that medical doctors receive and those for the rest of us. The former has about an 80 percent success rate, the latter about an 80 percent failure rate. Drawing from personal experience as a former patient and person in long-term recovery, as well as 22 years as a clinician, professor, and researcher, many of the impediments to effective treatment today are described. The book finally offers a plausible and cost-effective way to disrupt the dismal status quo and realistically aspire to an 80 percent success rate for everyone who receives professional help for a substance use disorder.

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 Use and perceptions of electronic cigarette by the adult population in France in 2017

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Quatremère ◽  
A Pasquereau ◽  
R Guignard ◽  
R Andler ◽  
J B Richard ◽  
...  
Keyword(s):  
Social Inequalities ◽  
Electronic Cigarettes ◽  
Smoking Status ◽  
Adult Population ◽  
Descriptive Analysis ◽  
Health Agency ◽  
Electronic Cigarette ◽  
Cross Sectional ◽  
Quit Smoking ◽  
Former Smokers

Abstract Background E-cigarette (EC) use is controversial because its benefit-risk ratio is still unclear. Since its introduction on the French market at the beginning of the 2010’s, French health authorities have published cautious recommendations. The study aims at describing uses and perceptions about EC among the adult population. Methods Santé Publique France’s Health Barometer, the French national public health agency, is a cross-sectional random survey conducted annually by phone, on a representative sample of the population aged 18-75 y/o in Mainland France. Descriptive analysis and logistic regressions were performed to analyze data collected from the 25,319 respondents of the 2017 edition. Results In 2017 in Mainland France, 3.8% of the population used an EC, 2.7% on a daily basis. Among EC daily users, 60.4% were men, 57.9% had a bachelor degree or higher qualifications. Less than 1% of EC users were never-smokers, 50.3% were daily or occasional smokers, 49.5% were former smokers. The number of daily ex-smokers who did quit smoking ( > = 6 months) and believed that vaping has helped them to, was estimated to be 700,000 since EC has been available in France. EC was perceived as equally or more harmful than regular cigarette by half of the population (51.5%), a proportion that has increased since 2014 (43.4%). Daily smokers perceived EC as more harmful, while being an EC user from high socioeconomic status was associated with the perception that EC is less harmful. The bans on EC in places where smoking is prohibited and on sales of EC to minors (<18 y/o) were appreciated by 66.9% and 77.5%, respectively. Conclusions These results show that in France, EC is strongly related to current or past smoking habits. A significant number of ex-smokers believe that EC has helped them quit smoking. Sociodemographic differences in the perception of EC harmfulness suggest social inequalities in access to information. Key messages Electronic cigarette users in France are few and most of them are smokers or former smokers. The perception of electronic cigarettes harmfulness depends on sociodemographic and smoking status.

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