Research Library
Published Year: 2024. Publication Type: Journal Article
Publication Title: Nicotine and Tobacco Research.
Association of Cigarette–E-Cigarette Transitions With Respiratory Symptom Resolution
Authors: Berlowitz, Jonathan B, Xie, Wubin, Harlow, Alyssa F, Kathuria, Hasmeena, Benjamin, Emelia J, Stokes, Andrew C
ISBN/ISSN: 1469-994X. DOI: 10.1093/ntr/ntae224.
Website/Url: https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntae224/7853016
Abstract:
Abstract
Introduction
Adults increasingly use e-cigarettes for cigarette cessation because of the perceived reduced risk. While e-cigarette use is associated with reduced toxicant exposure compared with smoking, it is unclear whether transitioning from cigarettes to e-cigarettes is associated with resolution of respiratory symptoms.
Methods
Data were obtained from the Population Assessment of Tobacco and Health (PATH) study waves 1–5. US adult participants were separated into observations with cigarette–e-cigarette exposure intervals determined from PATH waves 1–2, 2–3, and 3–4. Observations were included if the participant reported exclusively smoking at baseline and reported a baseline cough or wheeze. Mixed-effect Poisson models measured the association between cigarette–e-cigarette transitions over the two-wave exposure interval (from smoking to nonuse, exclusive e-cigarette use, continued smoking, or dual use) and the reported resolution of the participant’s cough or wheeze.
Results
Among 5210 (3362 unique) observations, transitioning from cigarettes to e-cigarettes was associated with increased rates of wheeze resolution (incidence rate ratio [IRR] = 1.33; 95% confidence interval [CI] = 1.01 to 1.75) but not cough resolution (IRR = 1.18; 95% CI = 0.93 to 1.50) compared with persistent smoking. Cigarette to dual-use transitions were not associated with improvements in symptom resolution, and those who switched to dual use and maintained or increased their smoking intensity had 15% decreased rates of respiratory symptom resolution compared with persistent smoking.
Discussion
E-cigarette-assisted smoking cessation may increase rates of respiratory symptoms resolution among smokers who completely transition to e-cigarettes; however, there is risk for additional harm among those who initiate e-cigarette use without decreasing their smoking intensity.
Implications
Government agencies are increasingly weighing the risks and benefits of e-cigarette-assisted cigarette cessation given the reduced harm associated with e-cigarette use. This study provides novel evidence that completely transitioning from cigarettes to e-cigarettes is associated with increased rates of resolution from self-reported wheeze symptoms. However, risk exists in e-cigarette-assisted cigarette cessation, as those who transitioned from exclusive cigarette smoking to dual use and did not reduce their cigarette smoking intensity had decreased rates of respiratory symptom resolution compared with persistent smokers.
Tag:
Key: KE56Z2C5
Published Year: 2024. Publication Type: Journal Article
Publication Title: Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz.
Methoden, mit dem Rauchen aufzuhören – eine quantitative Online-Befragung zu förderlichen und hinderlichen Faktoren (RauS-Studie)
Authors: Werse, Bernd, Steimle, Larissa, Stöver, Heino
ISBN/ISSN: 1436-9990, 1437-1588. DOI: 10.1007/s00103-024-03970-x.
Website/Url: https://link.springer.com/10.1007/s00103-024-03970-x
Abstract:
Abstract
Background
Smoking is still the largest preventable health risk in Germany, which is why a higher success rate in smoking cessation would benefit both public and individual health. In order to achieve this, a better understanding of the smoking cessation methods used and the factors that facilitate and prevent smoking cessation is required. The RauS study therefore aimed to investigate which methods have been used in attempts to stop smoking, how successful these methods have been, and which factors have been perceived as helping or hindering smoking cessation.
Methods
From March to December 2022 a quantitative online survey was conducted among current or former smokers over 14 years of age ( N = 6192).
Results
Of the sample, 93% have tried to quit smoking at least once. In general, for the respondents who did or did not use e‑cigarettes/tobacco heaters, “personal willpower” was the most frequently used and perceived as the most helpful method. Among people who have used e‑cigarettes/tobacco heaters to quit smoking, e‑cigarettes with nicotine were used most frequently and were rated as the most helpful. Potential or concrete health consequences were most likely to be perceived as motivating. Rituals associated with smoking were the main barrier to quit smoking, while withdrawal symptoms played a much smaller role.
Discussion
Overall, the results show that the focus on “nicotine addiction” in smoking cessation should be reconsidered, and social and ritual dimensions should be addressed more strongly. For at least some of those affected, e‑cigarettes may be a helpful method of reducing harm and/or quitting smoking.
Tag:
Key: 26JGQA44
Published Year: 2024. Publication Type: Journal Article
Publication Title: European Heart Journal.
Prognosis after switching to electronic cigarettes following percutaneous coronary intervention: a Korean nationwide study
Authors: Kang, Danbee, Choi, Ki Hong, Kim, Hyunsoo, Park, Hyejeong, Heo, Jihye, Park, Taek Kyu, Lee, Joo Myung, Cho, Juhee, Yang, Jeong Hoon, Hahn, Joo-Yong, Choi, Seung-Hyuk, Gwon, Hyeon-Cheol, Song, Young Bin
ISBN/ISSN: 0195-668X, 1522-9645. DOI: 10.1093/eurheartj/ehae705.
Website/Url: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehae705/7828721
Abstract:
Abstract
Background and Aims
Despite the increasing popularity of electronic cigarettes (E-cigarettes), the prognostic impact of switching to E-cigarettes in smokers with coronary artery disease who have undergone percutaneous coronary intervention (PCI) remains unclear.
Methods
Using a nationwide cohort from the Korean National Health Insurance database, 17 973 adults (≥20 years) identified as smokers (based on a health screening examination within 3 years before PCI) who underwent health screening within 3 years after PCI were enrolled to determine changes in smoking habits. Patients were classified as continued combustible cigarette users, successful quitters, or switchers to E-cigarettes. The group switching to E-cigarettes was further divided into dual users (using both combustible and E-cigarettes) and those exclusively using E-cigarettes. Primary outcomes included major adverse cardiac events (MACEs), a composite of all-cause death, spontaneous myocardial infarction, and repeat revascularization.
Results
Among the total population, 8951 patients (49.8%) continued using combustible cigarettes, 1694 (9.4%) were switched to E-cigarettes, and 7328 (40.7%) successfully quit smoking after PCI. During a median follow-up of 2.4 years, the cumulative incidence of MACE was lower among E-cigarette switchers (10%) or quitters (13.4%) than among continued combustible cigarette users (17%). When continued combustible cigarette users were used as the reference, the multivariable-adjusted hazard ratios with 95% confidence intervals for MACE were 0.82 (0.69–0.98) for switchers to E-cigarettes and 0.87 (0.79–0.96) for successful quitters. Compared with dual users, entirely switching to E-cigarettes was associated with a significantly lower MACE risk (hazard ratio 0.71; 95% confidence interval 0.51–0.99).
Conclusions
Among smokers who underwent PCI for coronary artery disease, switching to E-cigarette use (particularly complete transition) or quitting smoking was associated with reduced MACE risk than with continued combustible cigarette use. Clinical Trial Registration
ClinicalTrials.gov NCT06338761
Tag: Cardiovascular, Public Health, Adverse Effects
Key: 6GH7XTHZ
Published Year: 2024. Publication Type: Journal Article
Publication Title: Addiction.
Electronic cigarettes and subsequent use of cigarettes in young people: An evidence and gap map
Authors: Conde, Monserrat, Hartmann‐Boyce, Jamie, Thomas, James, Pesko, Michael F., Cox, Sharon, Hastings, Janna, Notley, Caitlin, Lindson, Nicola, Livingstone‐Banks, Jonathan, Jackson, Sarah, Kale, Dimitra, Zhu, Sufen, Nolan, Rebecca, Begh, Rachna, Tudor, Kate
ISBN/ISSN: 0965-2140, 1360-0443. DOI: 10.1111/add.16583.
Website/Url: https://onlinelibrary.wiley.com/doi/10.1111/add.16583
Abstract:
Background and aims
The use of e‐cigarettes may influence later smoking uptake in young people. Evidence and gap maps (EGMs) are interactive on‐line tools that display the evidence and gaps in a specific area of policy or research. The aim of this study was to map clusters and gaps in evidence exploring the relationship between e‐cigarette use or availability and subsequent combustible tobacco use in people aged < 30 years.
Methods
We conducted an EGM of primary studies and systematic reviews. A framework and an interactive EGM was developed in consultation with an expert advisory group. A systematic search of five databases retrieved 9057 records, from which 134 studies were included. Systematic reviews were appraised using AMSTAR‐2, and all included studies were coded into the EGM framework resulting in the interactive web‐based EGM. A descriptive analysis of key characteristics of the identified evidence clusters and gaps resulted in this report.
Results
Studies were completed between 2015 and 2023, with the first systematic reviews being published in 2017. Most studies were conducted in western high‐income countries, predominantly the United States. Cohort studies were the most frequently used study design. The evidence is clustered on e‐cigarette use as an exposure, with an absolute gap identified for evidence looking into the availability of e‐cigarettes and subsequent cessation of cigarette smoking. We also found little evidence analysing equity factors, and little exploring characteristics of e‐cigarette devices.
Conclusions
This evidence and gap map (EGM) offers a tool to explore the available evidence regarding the e‐cigarette use/availability and later cigarette smoking in people under the age of 30 years at the time of the search. The majority of the 134 reports is from high‐income countries, with an uneven geographic distribution. Most of the systematic reviews are of lower quality, suggesting the need for higher‐quality reviews. The evidence is clustered around e‐cigarette use as an exposure and subsequent frequency/intensity of current combustible tobacco use. Gaps in evidence focusing on e‐cigarette availability, as well as on the influence of equity factors may warrant further research. This EGM can support funders and researchers in identifying future research priorities, while guiding practitioners and policymakers to the current evidence base.
Tag: Youth, Young Adults, Gateway
Key: L48W4LQ7
Published Year: 2024. Publication Type: Journal Article
Publication Title: Nicotine and Tobacco Research.
The Impact of New Jersey’s 2020 E-Cigarette Flavor Ban on E-Cigarette, Cigarette, and Cigar Sales in NJ
Authors: Hrywna, Mary, Delnevo, Cristine D, Giovenco, Daniel P, Miller Lo, Erin, Teotia, Arjun
ISBN/ISSN: 1469-994X. DOI: 10.1093/ntr/ntae151.
Website/Url: https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntae151/7697906
Abstract:
Introduction
On April 20, 2020, New Jersey (NJ) implemented a comprehensive ban on the sale of flavored e-cigarettes. This study compares sales of e-cigarettes, cigarettes, and cigars before and after the law.
Methods
Data were biweekly retailer scanner sales in NJ convenience stores for e-cigarettes, cigarettes, and cigars between August 2019 and December 2020. We used Joinpoint regression to assess sales trends for cigarettes (non-menthol, menthol), cigars (unflavored, flavored), and e-cigarettes (unflavored, fruit/sweet/concept flavor, menthol flavor) in the 36 weeks before and 36 weeks after a statewide ban on flavored e-cigarettes.
Results
Flavored e-cigarette sales, not including menthol, significantly decreased over the study period while menthol e-cigarette sales significantly increased until the e-cigarette flavor ban took effect, after which these sales rapidly declined through May 2020, then slowed. Unflavored e-cigarette sales declined through September 2019, then grew modestly until the flavored e-cigarette ban, after which sales significantly increased. Flavored cigar sales increased between March and May 2020, then declined; non-flavored cigar sales increased between mid-February and early July 2020, then declined. Cigarette sales were decreasing before the flavored e-cigarette ban but after, significantly increased until June 2020. Overall, there was no significant trend in the average biweekly percent change for cigarette sales.
Conclusions
Flavored e-cigarette sales were declining prior to the ban but the pace of the decline accelerated following federal and state restrictions on flavored e-cigarette sales, then slowed by the second half of 2020, with a brief period of increased cigarette and cigar sales immediately following the ban.
Implications
New Jersey’s 2020 statewide e-cigarette flavor ban offered the opportunity to observe how sales of e-cigarette, cigarette, and cigar products shifted after the change. The effect of the state law, at least in the short-term, was decreased sales of flavored e-cigarettes and increased sales of unflavored e-cigarettes. Research on long term policy effects is needed.
Tag: Regulations, Flavours, Population
Key: 3NMC4CRG
Published Year: 2024. Publication Type: Journal Article
Publication Title: BMC Pregnancy and Childbirth.
Vaping during pregnancy: a systematic review of health outcomes
Authors: Ussher, Michael, Brose, Leonie, Fleming, Joy
ISBN/ISSN: 1471-2393. DOI: 10.1186/s12884-024-06633-6.
Website/Url: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06633-6
Abstract:
Introduction
Smoking during pregnancy is harmful to maternal and child health. Vaping is used for smoking cessation but evidence on health effects during pregnancy is scarce. We conducted a systematic review of health outcomes of vaping during pregnancy.
Methods
We searched six databases for maternal/fetal/infant outcomes and vaping, including quantitative, English language, human studies of vaping during pregnancy, to November 10th, 2023. We assessed study quality with the Mixed-Methods Appraisal Tool. We focused on comparisons of exclusive-vaping with non-use of nicotine and tobacco products and with smoking. Presentation is narrative as the studies were of insufficient quality to conduct meta-analysis.
Results
We included 26 studies, with 765,527 women, with one randomised controlled trial (RCT) comparing vaping and nicotine replacement therapy for smoking cessation, 23 cohort studies and two case–control studies. While the RCT met 4/5 quality criteria, the quality of the cohort studies and case–control studies was poor; none adequately assessed exposure to smoking and vaping. For studies comparing exclusive-vaping with ‘non-use’, more reported no increased risk for vaping (three studies) than reported increased risk for maternal pregnancy/postpartum outcomes (one study) and for fetal and infant outcomes (20 studies no increased risk, four increased risk), except for birth-weight and neurological outcomes where two studies each observed increased and no increased risk. When the RCT compared non-users with those not smoking but vaping or using NRT, irrespective of randomisation, they reported no evidence of risk for vaping/NRT. For studies comparing exclusive-vaping and exclusive-smoking, most studies provided evidence for a comparable risk for different outcomes. One maternal biomarker study revealed a lower risk for vaping. For small-for-gestational-age/mean-birth-centile equal numbers of studies found lower risk for vaping than for smoking as found similar risk for the two groups (two each).
Conclusions
While more studies found no evidence of increased risk of exclusive-vaping compared with non-use and evidence of comparable risk for exclusive-vaping and exclusive-smoking, the quality of the evidence limits conclusions. Without adequate assessment of exposure to vaping and smoking, findings cannot be attributed to behaviour as many who vape will have smoked and many who vape may do so at low levels. .
Tag: Pregnancy
Key: 2LW2VYQL
Published Year: 2024. Publication Type: Journal Article
Publication Title: Addiction.
Nicotine strength of e‐liquids used by adult vapers in Great Britain: A population survey 2016 to 2024
Authors: Jackson, Sarah E., Cox, Sharon, Bauld, Linda, Arnott, Deborah, Shahab, Lion, Brown, Jamie
ISBN/ISSN: 0965-2140, 1360-0443. DOI: 10.1111/add.16576.
Website/Url: https://onlinelibrary.wiley.com/doi/10.1111/add.16576
Abstract:
Background and aims
In March 2024, the UK government announced plans to introduce a Vaping Products Duty that will tax e‐liquids based on their nicotine strength. This study examined trends in the nicotine strength of e‐liquids used by adult vapers and differences in those currently used across relevant subgroups.
Design
Nationally‐representative, cross‐sectional household survey, July 2016 to January 2024.
Setting Great Britain.
Participants 7981 adult vapers.
Measurements Participants were asked whether the e‐cigarette they mainly use contains nicotine (yes/no) and the e‐liquid strength (no nicotine, >0–≤ 6, 7–11, 12–19 or ≥20 mg/ml). We also collected information on the main device type used (disposable/refillable/pod), age, gender, occupational social grade, history of ≥1 mental health conditions, smoking status and (among past‐year smokers) level of cigarette addiction.
Findings
The proportion of vapers in England using high‐strength (≥20 mg/ml) e‐liquids increased from an average of 3.8% (95% confidence interval [CI] = 2.9–5.0) up to June 2021 to 32.5% (CI = 27.9–37.4) in January 2024 (the vast majority of whom [93.3% in January 2024] reported using exactly 20 mg/ml; the legal limit). This rise was most pronounced among those using disposable e‐cigarettes, those aged 18‐24 years and all smoking statuses (including never smokers) except long‐term (≥1y) ex‐smokers. Of those surveyed in 2022–2024 in Great Britain, overall, 89.5% (CI = 88.1–90.8) said they usually used e‐cigarettes containing nicotine, 8.7% (CI = 7.5–10.0) used nicotine‐free e‐cigarettes, and 1.8% (CI = 1.2–2.4) were unsure. The proportion using ≥20 mg/ml was higher among those mainly using disposable (47.9%) compared with pod (16.3%) or refillable (11.5%) devices; never smokers (36.0%), current smokers (28.8%) or recent (<1y) ex‐smokers (27.4%), compared with long‐term ex‐smokers (13.9%); and younger (16–24y; 44.2%) compared with older (≥25y; range 9.4–25.1%) age groups. There were no notable differences across other subgroups of interest.
Conclusions
Use of high‐strength nicotine e‐liquids in England appears to have increased sharply in recent years. Most adult vapers in Great Britain appear to use e‐cigarettes that contain nicotine but different subgroups use different strengths: nicotine strengths tend to be higher among those who mainly use disposable devices and those aged 16–24y, and lower among long‐term ex‐smokers.
Tag: Nicotine, Population, Trends
Key: X4AV5QH9
Published Year: 2024. Publication Type: Journal Article
Publication Title: Nicotine and Tobacco Research.
The Potential Impact of Oral Nicotine Pouches on Public Health: A Scoping Review
Authors: Travis, Nargiz, Levy, David T, Hartmann-Boyce, Jamie, Meza, Rafael, Ranganathan, Radhika, Oh, Hayoung, Goniewicz, Maciej L, Warner, Kenneth E
ISBN/ISSN: 1469-994X. DOI: 10.1093/ntr/ntae131.
Website/Url: https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntae131/7693924
Abstract:
Introduction
Oral nicotine pouches (ONPs) are a new class of nicotine products. This scoping review summarizes evidence on ONPs and explores their potential public health impact.
Aims and Methods
We conducted a structured literature search for empirical studies across three electronic databases through January 10, 2024. Outcomes included ONP product characteristics, use patterns, beliefs and perceptions, toxicity, and marketing and sales.
Results
Sixty-two studies were included, 17 were industry-funded. Most studies were from the United States. While large variations across studies were observed in ONP youth prevalence estimates, nationally representative U.S. studies find current use at 1.5% and lifetime use below 2.5% through 2023. Between 35% and 42% of U.S. adolescents and young adults have heard of ONPs, and 9-21% of tobacco-naïve youth were susceptible to trying them. U.S. adult-use estimates varied widely (0.8%–3% current; 3%–16% lifetime use) and were limited to populations with a history of tobacco use. The chemical composition of ONPs suggests fewer harmful/potentially harmful compounds at lower levels than cigarettes and smokeless tobacco (SLT), except formaldehyde. Industry-funded studies find substantially less cytotoxicity compared to cigarettes and suggest that higher nicotine-strength ONPs can deliver nicotine at levels comparable to or higher than SLT or cigarettes, although with slower nicotine release than cigarettes. Evidence on the cytotoxicity of ONPs relative to SLT is mixed.
Conclusions
ONPs appear to be less toxic than cigarettes and deliver comparable nicotine, presenting an alternative for combustible product users, although key data are mainly available from industry-funded studies. Data from independent research is critically needed. Industry marketing of ONPs may encourage initiation in youth and situational and dual use in adults.
Implications
The review provides an initial assessment of the potential role of ONPs in harm reduction and aims to determine unintended consequences of their use (youth uptake and dual-use) and identify populations that disproportionately use the product. This information is essential for tobacco regulatory bodies in determining the net public health impact of nicotine pouches.
Tag: Nicotine Pouches, Public Health
Key: 8P5YKILR