Exhaled Carbon Monoxide Levels in Forty Resistant to Cessation Male Smokers after Six Months of Full Switch to Electronic Cigarettes (e-Cigs) or to A Tobacco Heating Systems (THS)

Cigarette smoke releases several toxic chemicals and carcinogens including carbon monoxide (CO). This study examined the levels of exhaled CO in smokers switching to electronic cigarettes (e-Cigs) or a tobacco heating system (THS) and their level of compliance six months after switching. On the basis of their own preferences, 40 male smokers unwilling or unable to stop smoking were switched to e-Cigs or THSs for six months (20 subjects in each group). Nicotine addiction and levels of carbon monoxide in the exhaled breath (eCO) were measured at baseline (the latter also at six months). The Shapiro Wilk test, graphical methods, Student T test or Mann–Whitney test were used to assess the normal distribution of variables and differences between the two groups after six months. The two groups showed no difference at baseline, but a significant higher addiction score in smokers choosing THS. E-Cig and THS showed significant reduced levels of eCO (both %COHb and COppm) after six months, which were within the range of non-smoker status. Reduced levels of %COHb did not significantly differ between the two groups, whilst the THS group had a significantly lower reduction in levels of COppm vs the e-Cig group (p < 0.05). Both e-Cigs and THSs are capable of significantly reducing eCO at least in the medium term, hence constituting a viable tobacco harm reduction approach in smokers who are unwilling or unable to stop smoking.

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Nicotine and Tobacco

ASAM Handbook of Addiction Medicine ◽

10.1093/med/9780197506172.003.0007 ◽

2020 ◽

pp. 149-182

Author(s):

Shadi Nahvi ◽

Darius A. Rastegar

Keyword(s):

Cardiovascular Disease ◽

Carbon Monoxide ◽

Smoking Cessation ◽

Lung Disease ◽

Tobacco Use ◽

Chronic Lung Disease ◽

Electronic Cigarettes ◽

Withdrawal Symptoms ◽

Tobacco Products ◽

Exhaled Carbon Monoxide

Nicotine is responsible for the psychoactive and habit-forming effects of tobacco. Approximately 30% of Americans use tobacco products; half of them are nicotine-dependent. Nicotine has mild stimulant effects. Overdose is rare in experienced users. Some may develop nausea, vomiting, weakness, and dizziness. Withdrawal symptoms include craving, irritability, anxiety, restlessness, and increased appetite. Smokers have elevated exhaled carbon monoxide and serum carboxyhemoglobin levels. Cotinine, a metabolite of nicotine, can be detected in blood and urine. Many medical conditions are associated with tobacco use (particularly smoking), including cardiovascular disease, chronic lung disease, and a variety of malignancies. A number of interventions can help increase smoking cessation rates, including physician advice, counseling, nicotine replacement, varenicline, and bupropion. Electronic cigarettes may help smokers quit or reduce their smoking.

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Innovative electrotechnological systems to provide the temperature modes of technological pipelines

Power and Autonomous equipment ◽

10.32464/2618-8716-2019-2-1-29-39 ◽

2019 ◽

Vol 2 (1) ◽

pp. 29-39 ◽

Cited By ~ 1

Author(s):

S. G. Konesev ◽

P. A. Khlyupin

Keyword(s):

Induction Heating ◽

Thermal Exposure ◽

Heating System ◽

The Arctic ◽

Process Conditions ◽

Heating Systems ◽

Fluid Properties ◽

Low Efficiency ◽

Extreme North ◽

Induction Heating System

Introduction: the systems of thermal effects on thermo-dependent, viscous and highly viscous liquids under conditions of the Arctic and the Extreme North are considered. Low efficiency and danger of heating systems based on burned hydrocarbons, heated liquids and steam are shown. Electrothermal heating systems used to maintain thermo-dependent fluids in a fluid state are considered. The evaluation of the effectiveness of the application of the most common electrothermal system — heating cables (tapes). The most effective electrothermal system based on induction technologies has been determined. Materials and methods: considered methods of thermal exposure to maintain the fluid properties of thermo-dependent fluids at low extreme temperatures. Results: presents an induction heating system and options for its implementation in the Extreme North and the Arctic. Conclusions: induction heating system to minimize loss of product quality, improve the system performance under changing process conditions, eliminate fire product, to reduce the influence of the human factor.

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Chemical Hazards

10.1093/oso/9780190662677.003.0011 ◽

2017 ◽

Author(s):

Michael Gochfeld ◽

Robert Laumbach

Keyword(s):

Heavy Metals ◽

Carbon Monoxide ◽

Target Organ ◽

Toxic Chemicals ◽

Detailed Understanding ◽

Adverse Health Effects ◽

Chemical Hazards ◽

Environmental Properties ◽

Organ Level ◽

Source Use

Building on the principles of toxicology, this chapter describes chemicals by structure, source, use, mechanism of action, environmental properties, and target organ. Major advances in toxic effects include more detailed understanding of the mechanisms by which toxic chemicals damage receptors at the subcellular, cellular, and organ level. The chapter describes properties of various types of inorganic and organic chemicals and their adverse health effects. It discusses asphyxiants, such as carbon monoxide and hydrogen sulfide; heavy metals, such as lead, mercury, and cadmium; organic solvents, such as benzene and trichlorethylene; pesticides, including chlorinated hydrocarbons and organophosphates; and a variety of other toxic chemicals to which people are exposed in the home, community, or workplace environment. Several cases are presented to illustrate various concepts concerning chemical hazards in occupational and environmental health.

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Impacts on Indoor Thermal Comfort and Heating Energy Use in Hellenic Dwellings from Occupant Behavioral Reactions

Applied Sciences ◽

10.3390/app11146254 ◽

2021 ◽

Vol 11 (14) ◽

pp. 6254

Author(s):

Elena G. Dascalaki ◽

Constantinos A. Balaras

Keyword(s):

Thermal Comfort ◽

Energy Use ◽

Energy Savings ◽

Local Heating ◽

Economic Recession ◽

Heating System ◽

Building Stock ◽

Heating Systems ◽

Indoor Thermal Comfort ◽

Energy Audits

In an effort to reduce the operational cost of their dwellings, occupants may even have to sacrifice their indoor thermal comfort conditions. Following the economic recession in Greece over recent years, homeowners have been forced to adapt their practices by shortening heating hours, lowering the indoor thermostat settings, isolating spaces that are not heated or even turning off their central heating system and using alternative local heating systems. This paper presents the results from over 100 occupant surveys using questionnaires and walk-through energy audits in Hellenic households that documented how occupants operated the heating systems in their dwellings and the resulting indoor thermal comfort conditions and actual energy use. The results indicate that the perceived winter thermal comfort conditions were satisfactory in only half of the dwellings, since the actual operating space heating periods averaged only 5 h (compared with the assumed 18 h in standard conditions), while less than half heated their entire dwellings and only a fifth maintained an indoor setpoint temperature of 20 °C, corresponding to standard comfort conditions. Mainstream energy conservation measures include system maintenance, switching to more efficient systems, reducing heat losses and installing controls. This information is then used to derive empirical adaptation factors for bridging the gap between the calculated and actual energy use, making more realistic estimates of the expected energy savings following building renovations, setting prudent targets for energy efficiency and developing effective plans toward a decarbonized building stock.

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Comparison of a preferred versus non-preferred waterpipe tobacco flavour: subjective experience, smoking behaviour and toxicant exposure

Tobacco Control ◽

10.1136/tobaccocontrol-2016-053344 ◽

2017 ◽

Vol 27 (3) ◽

pp. 319-324 ◽

Cited By ~ 13

Author(s):

Eleanor L Leavens ◽

Leslie M Driskill ◽

Neil Molina ◽

Thomas Eissenberg ◽

Alan Shihadeh ◽

...

Keyword(s):

Carbon Monoxide ◽

Subjective Experience ◽

Smoking Behaviour ◽

Toxicant Exposure ◽

P Values ◽

Smoking Topography ◽

Exhaled Carbon Monoxide ◽

Continued Use ◽

The Impact ◽

Survey Questionnaires

IntroductionOne possible reason for the rapid proliferation of waterpipe (WP) smoking is the pervasive use of flavoured WP tobacco. To begin to understand the impact of WP tobacco flavours, the current study examined the impact of a preferred WP tobacco flavour compared with a non-preferred tobacco flavoured control on user’s smoking behaviour, toxicant exposure and subjective smoking experience.MethodThirty-six current WP smokers completed two, 45-minute ad libitum smoking sessions (preferred flavour vs non-preferred tobacco flavour control) in a randomised cross-over design. Participants completed survey questionnaires assessing subjective smoking experience, exhaled carbon monoxide (eCO) testing, and provided blood samples for monitoring plasma nicotine. WP smoking topography was measured continuously throughout the smoking session.ResultsWhile participants reported an enhanced subjective smoking experience including greater interest in continued use, greater pleasure derived from smoking, increased liking and enjoyment, and willingness to continue use after smoking their preferred WP tobacco flavour (p values <0.05), no significant differences were observed in nicotine and carbon monoxide boost between flavour preparations. Greater average puff volume (p=0.018) was observed during the non-preferred flavour session. While not significant, measures of flow rate, interpuff interval (IPI), and total number of puffs were trending towards significance (p values <0.10), with decreased IPI and greater total number of puffs during the preferred flavour session.DiscussionThe current study is the first to examine flavours in WP smoking by measuring preferred versus control preparations to understand the impact on subjective experience, smoking behaviour and toxicant exposure. The pattern of results suggests that even this relatively minor manipulation resulted in significant changes in subjective experience. These results indicate a possible need for regulations restricting flavours in WP tobacco as with combustible cigarettes.

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Technology Pathways and Economic Analysis for Transforming High Temperature to Low Temperature District Heating Systems

Energies ◽

10.3390/en14113218 ◽

2021 ◽

Vol 14 (11) ◽

pp. 3218

Author(s):

Pedro Durán ◽

Herena Torio ◽

Patrik Schönfeldt ◽

Peter Klement ◽

Benedikt Hanke ◽

...

Keyword(s):

Sensitivity Analysis ◽

Renewable Energy ◽

High Temperature ◽

Low Temperature ◽

Economic Analysis ◽

District Heating ◽

Heating System ◽

District Heating System ◽

Heating Systems ◽

District Heating Systems

There are 1454 district heating systems in Germany. Most of them are fossil based and with high temperature levels, which is neither efficient nor sustainable and needs to be changed for reaching the 2050 climate goals. In this paper, we present a case study for transforming a high to low temperature district heating system which is more suitable for renewable energy supply. With the Carnot Toolbox, a dynamic model of a potential district heating system is simulated and then transformed to a low temperature supply. A sensitivity analysis is carried out to see the system performance in case space constrains restrict the transformation. Finally, an economic comparison is performed. Results show that it is technically possible to perform the transformation until a very low temperature system. The use of decentralized renewable sources, decentralized heat storage tanks and the placement of a heat pump on each building are the key points to achieve the transformation. Regarding the sensitivity analysis, the transformation is worth doing until the seasonal storage and solar collector field sizes are reduced to 60% and 80% of their values in the reference case, respectively. The economic analysis shows, however, that it is hard for highly efficient low temperature renewable based heat networks to compete with district heating systems based on a centralized fossile CHP solution. Thus, though the presented transformation is technically possible, there is a strong need to change existing economic schemes and policies for fostering a stronger promotion of renewable energy policies in the heat sector.

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How to Improve Effectiveness of Renewable Space Heating Programs by Better Understanding Homeowner—Installer Interactions

Energies ◽

10.3390/en14154625 ◽

2021 ◽

Vol 14 (15) ◽

pp. 4625

Author(s):

Alisa Freyre ◽

Stefano Cozza ◽

Matthias Rüetschi ◽

Meinrad Bürer ◽

Marlyne Sahakian ◽

...

Keyword(s):

Literature Review ◽

Financial Incentives ◽

Heating System ◽

Heat Pumps ◽

Single Family ◽

Heating Systems ◽

Current State ◽

Ex Post ◽

Improved Technology

In this paper, we perform a literature review on the current state of knowledge about homeowners in the context of the adoption of renewable heating systems. Despite a considerable number of studies about homeowners, homeowner–installer interactions, and ways to improve the effectiveness of renewable heating programs, based on homeowner knowledge, have not yet been studied in much detail. To address these knowledge gaps, we conduct a qualitative study on single-family house owners who installed heat pumps and took part in a renewable heating program in Geneva, Switzerland. We cover homeowner practices in choosing installers and heating system types, homeowners’ feedback about heat pump installation and use, as well as their experience in participation in the renewable heating program. Based on the literature review and the findings from the interviews, we provide the following recommendations on how to increase the effectiveness of renewable heating programs: (a) support for homeowners should not be limited to financial incentives; (b) partnership programs with installers could help to increase the quality of installation services and enable homeowners to choose qualified installers; and (c) assisting homeowners in pre-qualification and ex-post analysis, in learning how to operate their renewable heating systems and in solving problems during the post-installation period, can contribute to improved technology reputation, which can, in turn, increase technology uptake by other homeowners.

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Pictorial health warning labels on the waterpipe device are effective in reducing smoking satisfaction, puffing behaviour and exposure to CO: first evidence from a crossover clinical laboratory study

Tobacco Control ◽

10.1136/tobaccocontrol-2018-054682 ◽

2019 ◽

Vol 28 (e1) ◽

pp. e37-e42 ◽

Cited By ~ 5

Author(s):

Wasim Maziak ◽

Ziyad Ben Taleb ◽

Mohammad Ebrahimi Kalan ◽

Thomas Eissenberg ◽

James Thrasher ◽

...

Keyword(s):

Carbon Monoxide ◽

Clinical Laboratory ◽

Warning Labels ◽

Health Warning ◽

Before And After ◽

Regulatory Approach ◽

The Usa ◽

Exhaled Carbon Monoxide ◽

Positive Experiences ◽

Harmful Effects

ObjectivesThis study examined the effect of pictorial health warning labels (HWLs) on the waterpipe (WP) device on smokers’ experience, puffing behaviour, harm perception and exposure to respiratory toxicants.MethodsThirty WP smokers completed two 45 min ad libitum smoking sessions (WP without HWL vs WP with HWL) in a crossover design study. Exhaled carbon monoxide (eCO) was measured before and after each smoking session. Puff topography was recorded throughout the smoking session, and participants completed survey questionnaires assessing subjective smoking experiences and harm perception.ResultsSignificant differences were observed in eCO levels between the two study conditions, with lower levels of eCO boost recorded following smoking the WP fitted with HWL (16 ppm) compared with WP without HWL (22.7 ppm). Participants had more puffs, shorter interpuff intervals and a higher total puff volume during smoking the WP without HWL relative to WP with HWL (p values <0.05). We documented enhanced reports of satisfaction, taste and puff liking following smoking the WP without HWL compared with the WP with HWL. WP harm perception was significantly higher among participants after smoking the WP with HWL compared with WP without HWL.ConclusionThis pilot study shows that placing HWL on the WP device is effective in reducing WP smoker’s positive experiences, puffing parameters and exposure to carbon monoxide. HWLs lead also to more appreciation of WP harmful effects, making them a promising regulatory approach for addressing the spread of WP smoking among young adults in the USA.

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