Flavor Preference and Systemic Immunoglobulin Responses in E-Cigarette Users and Waterpipe and Tobacco Smokers: A Pilot Study

Electronic cigarette (e-cigarette) use has had an exponential increase in popularity since the product was released to the public. Currently, there is a lack of human studies that assess different biomarker levels. This pilot study attempts to link e-cigarette and other tobacco product usage with clinical respiratory symptoms and immunoglobulin response. Subjects completed surveys in order to collect self-reported data on tobacco product flavor preferences. Along with this, plasma samples were collected to test for immunoglobulin G (IgG) and E (IgE) levels. Our pilot study’s cohort had a 47.9% flavor preference towards fruit flavors and a 63.1% preference to more sweet flavors. E-cigarette and traditional cigarette smokers were the two subject groups to report the most clinical symptoms. E-cigarette users also had a significant increase in plasma IgE levels compared to non-tobacco users 1, and dual users had a significant increase in plasma IgG compared to non-tobacco users 2, cigarette smokers, and waterpipe smokers. Our pilot study showed that users have a preference toward fruit and more sweet flavors and that e-cigarette and dual use resulted in an augmented systemic immune response.

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Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015–17)

BMC Public Health ◽

10.1186/s12889-021-10341-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

S. L. Chau ◽

M. P. Wang ◽

Y. Wu ◽

D. Y. T. Cheung ◽

A. Kong ◽

...

Keyword(s):

Control Policy ◽

Tobacco Product ◽

Cigarette Use ◽

Related Factors ◽

Cigarette Smokers ◽

Tobacco Products ◽

Product Use ◽

Younger Age ◽

Current Cigarette ◽

Age And Sex

Abstract Background Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries. Method A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015–2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population. Results Eighty-four point one percent (95% CI 81.4–86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4–18.6%) were current polytobacco product users, 12.3% (10.2–14.8%) used one tobacco product and 2.52% (1.59–3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75–8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44–2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12–3.61), younger age (AORs range from 1.34–4.65, P for trend < .001) and less ready to quit (2.08, 1.09–3.97). Conclusions Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.

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Effect of a hypothetical modified risk tobacco product claim on heated tobacco product use intention and perceptions in young adults

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056479 ◽

2021 ◽

pp. tobaccocontrol-2021-056479

Author(s):

Julia C Chen-Sankey ◽

Afton Kechter ◽

Jessica Barrington-Trimis ◽

Rob McConnell ◽

Evan A Krueger ◽

...

Keyword(s):

Young Adults ◽

Tobacco Product ◽

Cigarette Use ◽

Dual Use ◽

Cigarette Smokers ◽

Web Based ◽

Experimental Effect ◽

Current Cigarette ◽

Product Claim ◽

Related Harm

IntroductionModified risk tobacco product (MRTP) claims for heated tobacco products (HTPs) that convey reduced exposure compared with conventional cigarettes may promote product initiation and transition among young people. We assessed the effects of a hypothetical MRTP claim for HTPs on young adults’ intention and perceptions of using HTPs and whether these effects differed by their current cigarette and e-cigarette use.MethodsWe embedded a randomised between-subjects experiment into a web-based survey administered among a cohort of 2354 Southern California young adults (aged 20–23) in 2020. Participants viewed depictions of HTPs with an MRTP claim (n=1190) or no claim (n=1164). HTP use intention and HTP-related harm and use perceptions relative to cigarettes and e-cigarettes were assessed.ResultsOverall, participants who viewed versus did not view the claim did not differ in HTP use intention (28.5% vs 28.7%) but were more likely to perceive HTPs as less harmful than cigarettes (11.4% vs 7.0%; p<0.001). The experimental effect on HTP use intention did not differ among past 30-day cigarette smokers versus non-smokers (interaction adjusted OR (AOR)=0.78, 95% CI 0.36 to 1.76) but differed among past 30-day e-cigarette users versus non-users (interaction AOR=1.67, 95% CI 1.02 to 2.68).DiscussionThe hypothetical MRTP claim may lower young adults’ HTP harm perceptions compared with cigarettes but may not change HTP use intention overall or differentially for cigarette smokers. The larger effect on HTP use intention among e-cigarette users than non-users raises the question of whether MRTP claims may promote HTP use or HTP and e-cigarette dual use among young e-cigarette users.

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E-cigarette use among youth in Lebanon: Findings from Waterpipe Dependence in Lebanese Youth ‘WDLY’

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1352 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

R Nakkash ◽

M Tleis ◽

T Asfar ◽

W Maziak

Keyword(s):

Nicotine Dependence ◽

Risk Perceptions ◽

School Health ◽

Eastern Mediterranean ◽

Eastern Mediterranean Region ◽

Tobacco Product ◽

Cigarette Use ◽

Global Youth Tobacco Survey ◽

Cigarette Smokers ◽

Gender Status

Abstract Introduction E-cigarette use is becoming popular among youth worldwide and represents an emerging threat to public health. No previous study has looked into the prevalence of e-cigarettes use in the Eastern Mediterranean region. We report here on the prevalence of e-cigarette use in a cohort of 496 school and university students from Lebanon (62% males; 17 - 23 years) and differences in perceived harm between e-cigarette smokers and nonsmokers. We used data from Wave 8 of an ongoing cohort study that started in 2015 investigating the development of nicotine dependence symptoms in waterpipe smokers compared to cigarettes in Grades 8 and 9. Methods In 2019, we added questions to examine e-cigarette use patterns, risk perceptions, dependence, and susceptibility for future use among this population. Results were described and compared by gender status, e-cigarette users vs. non-users and other modes of tobacco use. Results Overall, 14.5 % reported ever use of e-cigarette and 8 % reported current use (use in the last month). Most ever e-cigarette users were cigarette smokers (32.8%), waterpipe smokers (34.3%), or dual smokers (10.45%). Compared to ever users, non-users were more likely to perceive e-cigarettes as more harmful (42% vs. 27% respectively, p= .007) and more addictive (41 % vs. 36% respectively, p= .013) than conventional cigarettes. Among current users, 28 % used e-cigarettes within 5 minutes of waking up. Among non-users, males were more open than female to try e-cigarettes if offered by a close friend (28.8% vs. 17.1%). Conclusions Our study suggests significant nicotine dependence among current users. Qualitative studies are needed to better understand why youth are drawn to this new emerging tobacco product. Our preliminary results point to the need to monitor e-cigarette use nationally by introducing questions on e-cigarette use in national school wide surveys such as Global Youth Tobacco Survey or the Global School Health Survey. Key messages E-cigarette use is spreading among youth in Lebanon. Results reveal significant nicotine dependence among youth in Lebanon users of e-cigarette.

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Heat Not Burn Tobacco Product—A New Global Trend: Impact of Heat-Not-Burn Tobacco Products on Public Health, a Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17020409 ◽

2020 ◽

Vol 17 (2) ◽

pp. 409 ◽

Cited By ~ 10

Author(s):

Aleksandra Ratajczak ◽

Piotr Jankowski ◽

Piotr Strus ◽

Wojciech Feleszko

Keyword(s):

Public Health ◽

Systematic Review ◽

Smoking Status ◽

Global Scale ◽

Tobacco Product ◽

Cigarette Use ◽

Tobacco Products ◽

The Public ◽

Global Trend ◽

Reduced Risk

Introduction: The use of heat-not-burn tobacco products (HnB) is being adopted increasingly as an alternative to smoking combusted products, primarily cigarettes. Substantial controversy has accompanied their marketing and use in the public health context. In this study, we aimed to consider the probable impacts of HnB tobacco products use on public health. Methods: In May 2019, we conducted a systematic review of 15 studies concerning awareness and use of IQOS (abbrv. I Quit Ordinary Smoking) selected from three databases: Cochrane, PubMed, and Embase regarding public health. Results: All key outcomes varied by smoking status: more young adults who were currently smoking reported being aware of, interested in trying, and prone to trying heat-not-burn tobacco products. Interest in trying HnB products was also present among non-smokers, which raises concerns regarding new smokers. Interestingly, susceptibility to trying IQOS (25.1%) was higher than for traditional cigarettes (19.3%), but lower than for e-cigarettes (29.1%). Conclusions: Present studies suggest that HnB tobacco products have the potential to be a reduced risk product for public health compared to conventional cigarettes, considering indirectly the potential effects on the chronic diseases which are traditionally linked to traditional cigarette use as well as second hand exposure, but further studies are needed to determine whether this potential is likely to be realized. The process of HnB tobacco products becoming increasingly popular is of a global scale. Only small differences between countries on different continents regarding popularity and use of HnB tobacco products have been reported.

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Association of initial e-cigarette and other tobacco product use with subsequent cigarette smoking in adolescents: a cross-sectional, matched control study

Tobacco Control ◽

10.1136/tobaccocontrol-2019-055283 ◽

2020 ◽

pp. tobaccocontrol-2019-055283 ◽

Cited By ~ 6

Author(s):

Lion Shahab ◽

Emma Beard ◽

Jamie Brown

Keyword(s):

Propensity Score ◽

Cigarette Smoking ◽

Matched Control ◽

Tobacco Product ◽

Cigarette Use ◽

Cross Sectional ◽

Cigarette Smokers ◽

Group A ◽

Synthetic Controls ◽

Control Study

IntroductionThis study assessed whether initiating e-cigarette use increases the uptake of cigarette smoking in US adolescents compared with behavioural and synthetic controls.MethodsData come from 78 265 adolescents in the National Youth Tobacco Survey (2014–2017) of whom 38 630 provided information about the first tobacco product they had used in 2014/15. Ever, past 30 day and established (30 day use and 100+ lifetime cigarettes) cigarette smoking was compared in adolescents who first used an e-cigarette (exposure group), a non-cigarette combustible (CT) or other non-combustible tobacco (NT) product (behavioural controls), and propensity score matched adolescents without initial e-cigarette use (synthetic controls).ResultsRelative to behavioural controls, adolescents who tried e-cigarettes first were less likely to have ever smoked cigarettes (26% vs CT (42.4%; OR 0.48, 95% CI 0.40 to 0.57), or NT initiators (52.7%; OR 0.32, 95% CI 0.26 to 0.39)), to be past 30 day (6% vs CT (11.9%; OR 0.48, 95% CI 0.36 to 0.62), or NT initiators (20.0%; OR 0.26, 95% CI 0.19 to 0.35)) or be established cigarette smokers (0.7% vs CT (3.9%; OR 0.17, 95% CI 0.10 to 0.30), or NT initiators (8.4%; OR 0.08, 95% CI 0.04 to 0.13)). E-cigarette initiators were also less likely than synthetic controls (without initial e-cigarette use) to have ever smoked cigarettes (OR 0.76, 95% CI 0.62 to 0.93), be past 30 day (OR 0.71, 95% CI 0.55 to 0.91) or be established cigarette smokers (OR 0.26, 95% CI 0.13 to 0.51).ConclusionLess than 1% of US adolescents who use e-cigarettes first were established cigarette smokers. They were less likely to be smokers than adolescents who tried other combustible or non-combustible tobacco products first and propensity score matched adolescents without initial e-cigarette use.

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Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015-17)

10.21203/rs.3.rs-27896/v2 ◽

2020 ◽

Author(s):

Siu Long Chau ◽

Man Ping Wang ◽

Yongda Wu ◽

Yee Tak Cheung ◽

Cho-shing Kwong ◽

...

Keyword(s):

Risk Factors ◽

Control Policy ◽

Tobacco Product ◽

Cigarette Use ◽

Cigarette Smokers ◽

Product Use ◽

Related Risk ◽

Younger Age ◽

Current Cigarette ◽

Age And Sex

Abstract Background Poly-tobacco product use is increasingly popular, but little is known about the prevalence, trend, and risk factors of such use particularly in non-western countries.Method A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015-2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related risk factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population.Results 84.1% (95% CI 81.4-86.6%) were exclusive cigarette smokers. 15.9% (13.4-18.6%) were current poly-users, 12.3% (10.2-14.8%) used one tobacco product and 2.52% (1.59-3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75-8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44-2.50%). The changes in overall prevalence of PTU by number of products use varied in three years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12-3.61), younger age (AORs range from 1.34-4.65, P for trend < .001) and less ready to quit (2.08, 1.09-3.97). Conclusions Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.

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Other tobacco product and electronic cigarette use among homeless cigarette smokers

Addictive Behaviors ◽

10.1016/j.addbeh.2016.04.006 ◽

2016 ◽

Vol 60 ◽

pp. 124-130 ◽

Cited By ~ 23

Author(s):

Travis P. Baggett ◽

Eric G. Campbell ◽

Yuchiao Chang ◽

Nancy A. Rigotti

Keyword(s):

Tobacco Product ◽

Electronic Cigarette ◽

Cigarette Use ◽

Cigarette Smokers

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E-cigarettes and smoking in Irish teens: a logistic regression analysis of current (past 30-day) use of e-cigarettes

Journal of Public Health ◽

10.1007/s10389-021-01610-1 ◽

2021 ◽

Author(s):

Joan Hanafin ◽

Salome Sunday ◽

Luke Clancy

Keyword(s):

Higher Education ◽

Logistic Regression ◽

Regression Analysis ◽

Young People ◽

Cigarette Use ◽

Cigarette Smokers ◽

Familial Support ◽

School Survey ◽

Binge Drinkers ◽

Alcohol And Other Drugs

Abstract Aim Electronic cigarette (e-cigarette) use among Irish teenagers has risen significantly. In 2019, prevalence of current use (last 30 days) among 15–17-year-olds was 17.3%. We examine social determinants of adolescent e-cigarette current use. Subject and methods A stratified random sample of 50 schools in Ireland was surveyed in 2019, part of the European School Survey Project on Alcohol and other Drugs (ESPAD), with 3495 students aged 15, 16, and 17. Bivariate and multivariable logistic regression [providing adjusted odds ratios (AORs)] analyses were performed using Stata version 16. Results Current e-cigarette users were more likely to be male (AOR = 0.55, 95% CI:0.32–0.96, p < .01), younger (AOR = 0.34, 95% CI: 0.17–0.67, p = < .05), to participate in sport (AOR = 2.21, 95% CI: 1.05–4.65, p < .05), to have higher-educated parents (maternal higher education: AOR = 27.54, 95% CI: 1.50–505.77, p = < .05, paternal higher education: AOR = 2.44, 95% CI: 1.00–5.91, p < .05), and less likely to consider their families better off (AOR = 0.29, 95% CI: 0.13–0.65, p < .01), or to report familial support (AOR = 0.78, 95% CI: 0.64–0.95, p < .05). They were more likely to be cigarette smokers (AOR = 7.22, 95% CI: 3.97–13.12, p < .001), to report problem cannabis use (AOR = 3.12, 95% CI: 1.40–6.93, p < .01), to be ‘binge’ drinkers (AOR = 1.81, 95% CI : 1.00–3.32, p = .054), and to have friends who get drunk (AOR = 5.30, 95% CI: 1.34–20.86, p < .05). Conclusion Boys, smokers, binge drinkers, problem cannabis users, and sport-playing teenagers from higher-educated families, are at particular risk. As the number of young people using e-cigarettes continues to rise, including teenagers who have never smoked, improved regulation of e-cigarettes, similar to other tobacco-related products, is needed urgently to prevent this worrying new trend of initiation into nicotine addiction.

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Patterns of non-cigarette tobacco and nicotine use among current cigarette smokers and recent quitters: Findings from the 2020 ITC Four Country Smoking and Vaping Survey

Nicotine & Tobacco Research ◽

10.1093/ntr/ntab040 ◽

2021 ◽

Author(s):

Lin Li ◽

Ron Borland ◽

K Michael Cummings ◽

Shannon Gravely ◽

Anne C K Quah ◽

...

Keyword(s):

Smoking Cessation ◽

Cigarette Smoking ◽

Smoking Status ◽

Tobacco Product ◽

Cigarette Tobacco ◽

Cigarette Smokers ◽

Tobacco Products ◽

Patterns Of Use ◽

Levels Of Use ◽

Current Cigarette

Abstract Introduction This study explores patterns of use of non-cigarette tobacco and nicotine products among adult cigarette smokers and recent ex-smokers. Along with cigarette smoking status we explore differences as a function of countries with different product regulations, gender and age. Methods Data came from the ITC Four Country Smoking and Vaping Wave 3 Survey conducted between February-June 2020. The analytic sample consisted of 9112 current cigarette smokers (at least monthly) and 1184 recent ex-smokers (quit cigarettes ≤ 2 years) from Australia, Canada, England, and the US. Respondents were asked about their cigarette smoking and current use of the following non-cigarette products: combustible tobacco (cigars, cigarillos, pipe, waterpipe); non-combustible tobacco (smokeless tobacco, and heated tobacco products (HTPs)); and non-tobacco nicotine products (nicotine vaping products (NVPs), nicotine replacement therapy (NRT), and nicotine pouches)). Results Overall, NVPs (13.7%) and NRT (10.9%) were the most reported nicotine products used, followed by cigars (5.3%), cigarillos (4.2%), and HTPs (3.5%). More than 21% current and recent ex-smokers of cigarettes reported using a non-tobacco nicotine product and non-combustible product, with respondents in England reporting the highest levels of use (>26%). Males, younger respondents, and current non-daily cigarette smokers were more likely to use non-cigarette nicotine products. Notably, 11.6% of ex-cigarette smokers were using other combustible tobacco. Conclusion Considerable percentages of current cigarette smokers and ex-smokers use non-cigarette nicotine products, and there are unexpectedly high levels of use of other combustible products by those recent ex-smokers of cigarettes which is concerning and has important implications for definitions of smoking cessation. Implications The tobacco product market has evolved to include new products which add to existing non-cigarette tobacco products creating a much more diverse nicotine market. This brief report provides a snapshot of use of various combustible and non-combustible nicotine containing products among current cigarette smokers and recent ex-smokers in four western countries. Our results indicate that use of non-cigarette tobacco and nicotine products among these cigarette smokers and recent ex-smokers is not low, particularly among males, younger and non-daily cigarette smokers. Use of other combustible tobacco among respondents that recently quit cigarette smoking is concerning and has important implications for definitions of smoking cessation. Increased emphasis on researching non-cigarette nicotine product use is warranted in tobacco control generally and smoking cessation in particular.

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Psychometric Evaluation of the E-cigarette Dependence Scale

Nicotine & Tobacco Research ◽

10.1093/ntr/ntx271 ◽

2018 ◽

Vol 21 (11) ◽

pp. 1556-1564 ◽

Cited By ~ 5

Author(s):

Meghan E Morean ◽

Suchitra Krishnan-Sarin ◽

Steve Sussman ◽

Jonathan Foulds ◽

Howard Fishbein ◽

...

Keyword(s):

Nicotine Dependence ◽

Convergent Validity ◽

Cigarette Use ◽

Cigarette Smokers ◽

Test Criterion ◽

Scalar Invariant ◽

Wide Range ◽

Current Cigarette ◽

Dependence Scale ◽

Cigarette Dependence

Abstract Introduction Psychometrically sound measures of e-cigarette dependence are lacking. Methods We modified the PROMIS Item Bank v1.0—Smoking: Nicotine Dependence for All Smokers for use with e-cigarettes and evaluated the psychometrics of the 22-, 8-, and 4-item adapted versions, referred to as The E-cigarette dependence scale (EDS). Adults (1009) who reported using e-cigarettes at least weekly completed an anonymous survey in summer 2016 (50.2% male, 77.1% White, mean age 35.81 [10.71], 66.4% daily e-cigarette users, 72.6% current cigarette smokers). Psychometric analyses included confirmatory factor analysis, internal consistency, measurement invariance, examination of mean-level differences, convergent validity, and test-criterion relationships with e-cigarette use outcomes. Results All EDS versions had confirmable, internally consistent latent structures that were scalar invariant by sex, race, e-cigarette use (nondaily/daily), e-liquid nicotine content (no/yes), and current cigarette smoking status (no/yes). Daily e-cigarette users, nicotine e-liquid users, and cigarette smokers reported being more dependent on e-cigarettes than their counterparts. All EDS versions correlated strongly with one another, evidenced convergent validity with the Penn State E-cigarette Dependence Index and time to first e-cigarette use in the morning, and evidenced test-criterion relationships with vaping frequency, e-liquid nicotine concentration, and e-cigarette quit attempts. Similar results were observed when analyses were conducted within subsamples of exclusive e-cigarette users and duals-users of cigarettes and e-cigarettes. Conclusions Each EDS version evidenced strong psychometric properties for assessing e-cigarette dependence in adults who either use e-cigarette exclusively or who are dual-users of cigarettes and e-cigarettes. However, results indicated little benefit of the longer versions over the 4-item EDS, which provides an efficient assessment of e-cigarette dependence. Implications The availability of the novel, psychometrically sound EDS can further research on a wide range of questions related to e-cigarette use and dependence. In addition, the overlap between the EDS and the original PROMIS that was developed for assessing nicotine dependence to cigarettes provides consistency within the field.

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