Research Library
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: 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: 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: 2023. Publication Type: Journal Article
Publication Title: SSRN Electronic Journal.
E-cigarette Flavor Restrictions’ Effects on Tobacco Product Sales
Authors: Friedman, Abigail, Liber, Alex C., Crippen, Alyssa, Pesko, Michael
ISBN/ISSN: 1556-5068. DOI: 10.2139/ssrn.4586701.
Website/Url: https://www.ssrn.com/abstract=4586701
Abstract:
Over 375 US localities and 7 states have adopted permanent restrictions on sales of flavored electronic nicotine delivery systems (“ENDS”). These policies’ effects on combustible cigarette use (“smoking”), a more lethal habit, remain unclear. Matching new flavor policy data to retail sales data, we find a tradeoff of 15 additional cigarettes for every 1 less 0.7 mL ENDS pod sold due to ENDS flavor restrictions. Further, cigarette sales increase even among brands disproportionately used by underage youth. Thus, any public health benefits of reducing ENDS use via flavor restrictions may be offset by public health costs from increased cigarette sales.
Tag: Flavours, Regulations
Key: YG2BG2HL
Published Year: 2023. Publication Type: Journal Article
Publication Title: Internal and Emergency Medicine.
Clinical testing of the cardiovascular effects of e-cigarette substitution for smoking: a living systematic review
Authors: La Rosa, Giusy, Polosa, Riccardo, Qureshi, Maria, Vernooij, Robin
ISBN/ISSN: 1828-0447, 1970-9366. DOI: 10.1007/s11739-022-03161-z.
Website/Url: https://link.springer.com/10.1007/s11739-022-03161-z
Abstract:
Abstract Some persons who smoke have substituted e-cigarettes for tobacco cigarettes, either completely or partially. What effect does this have on cardiovascular functioning? We conducted a living systematic review on human clinical studies measuring the cardiovascular effects of e-cigarette substitution for smoking. The Scopus, PubMed, and CENTRAL Cochrane Library databases were searched on January 31 and April 29, 2021. Three secondary searches and a grey literature search were conducted. Included study designs were randomized controlled trials, quasi-experimental clinical trials, and cohort studies. Risk of bias and study quality were evaluated with the JBI Critical Appraisal tools and the Oxford Catalogue of Bias . The systematic review covered 25 studies comprising 1810 participants who smoked. Twenty studies were rated at high risk of bias, and five as some concerns. A tabular synthesis by direction of effect was conducted due to heterogeneity in the data. Nearly two-thirds of the test analyses indicated that e-cigarette use had no significance difference compared with tobacco cigarettes on heart rate, blood pressure, and in other cardiovascular tests. In two studies, participants with hypertension experienced a clinically relevant reduction in systolic blood pressure after 1 year of e-cigarette use. E-cigarette substitution incurs no additional cardiovascular risks, and some possible benefits may be obtained, but the evidence is of low to very low certainty. An update search on May 30, 2022 retrieved five studies that did not alter our conclusion. Registration PROSPERO #CRD42021239094.
Tag: Meta-analysis, Systematic Review, Cardiovascular
Key: INRCBEN2
Published Year: 2023. Publication Type: Journal Article
Publication Title: Nicotine & Tobacco Research.
Do Tobacco Companies Have an Incentive to Promote “Harm Reduction” Products?: The Role of Competition
Authors: Cummings, K Michael, Douglas, Clifford E, Meza, Rafael, Sanchez-Romero, Luz Maria, Liber, Alex, Sweanor, David, Thirlway, Frances, Levy, David T
ISBN/ISSN: 1469-994X. DOI: 10.1093/ntr/ntad014.
Website/Url: https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntad014/7000361
Abstract:
Abstract
Background
Some cigarette companies have started to talk about replacing cigarettes with less harmful alternatives, which might include nicotine vaping products (NVPs), heated tobacco products (HTPs) and oral nicotine delivery products (ONDPs). We consider market competition as a primary driver of whether cigarette companies follow through on their stated intentions.
Methods
We focus on the behavior of cigarette companies in the US. We compare competition in the pre- and post-2012 time periods, analyze the impact of the growth in NVPs on smoking prevalence and cigarette company profits, and examine the potential future role of competition.
Results
Since 2006, consumers have broadened their use of non-combustible nicotine delivery products (NCNDPs) to include, inter alia, NVPs, HTPs and ONDPs. US cigarette companies have acquired major stakes in each of these product categories which corresponds to a period of rapidly declining adult smoking prevalence, especially among younger adults (ages 18-24 years). The shifting dynamics of the nicotine product marketplace are also reflected in cigarette company stock prices. While cigarette companies are likely to promote HTPs and ONDPs over NVPs, their incentives will be directly related to competition from independent firms, which in turn will depend on government regulation.
Conclusions
While cigarette companies will back alternatives to combusted tobacco when threatened by competition, the prospects for their lasting conversion to NCNDPs will depend on the extent of such competition, which will be influenced by government regulation of tobacco products.
Implications
Regulations that limit competition from independent firms while also protecting cigarette company profits risk slowing or even reversing recent declines in smoking, especially among youth and young adults. Regulations that reduce the appeal and addictiveness of combusted tobacco products, such as higher cigarette taxes or a reduced nicotine standard, will encourage smokers to quit and/or switch to less harmful non-combusted forms of tobacco. The regulation of non-combustible nicotine delivery products and cigarettes should be proportionate to their relative risks, so that smokers have incentives to switch from combustibles to safer alternatives, and cigarette companies have incentives to promote safer products.
Tag: Industry
Key: M4NQC9HQ
Published Year: 2023. Publication Type: Journal Article
Publication Title: Nicotine & Tobacco Research.
Adoption of E-Cigarettes among Older Adults who Smoke to Reduce Harm and Narrow Age-Related Disparities: An Application of the Health Belief Model
Authors: McClernon, F Joseph, Cornacchione Ross, Jennifer, Denlinger-Apte, Rachel L, Rubenstein, Dana
ISBN/ISSN: 1469-994X. DOI: 10.1093/ntr/ntad016.
Website/Url: https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntad016/7005641
Abstract:
Extract
Tobacco Burden Among Older Adults
While the prevalence of combusted cigarette (CC) smoking among all other age groups of U.S. adults decreased between 2005 and 2020, the prevalence for those age ≥55 years remained stagnant.1,2 Indeed, 2021 estimates from the National Health Interview Survey (NHIS) suggest current smoking is as prevalent among adults ages ≥65 years (9.4%; 95% Confidence interval = 8.4, 10.5) as it is among adults ages 18–34 years (9.6%; 95% CI = 8.4, 11.0).3 Smoking in older adults carries burdensome health consequences: Among adults ≥65 years who report current cigarette smoking, 25.7% report smoking-related cancer and 46.9% report another smoking-related chronic disease.4 Furthermore, according to 2017 NHIS data, past-year quit attempts are less prevalent among adults 45–64 years (49.6%) and ≥65 years (47.2%) compared to adults 25–44 years (59.8%) as is the prevalence of quit interest (53.7%, 68.7%, and 72.7%, respectively).5 Older adults struggle with smoking cessation: Only 5% of adults ≥65 years who smoke successfully quit in the past year.4 The tobacco industry has played a role in these rates; they aggressively marketed “light” and “low-tar” cigarettes towards older adults while discouraging quitting and providing cigarettes at senior clubs and nursing homes.6
Tag: Perceptions
Key: RPLW99G9
Published Year: 2023. Publication Type: Journal Article
Publication Title: International Journal of Gynecology & Obstetrics.
Association between maternal e_cigarette use during pregnancy and low gestational weight gain
Authors: Munlyn, Ambra L., Griffiths, Malkijah E., Duong, Peter H., Moe, Aye A., Liu, Lufeiya, Thomas, Marjorie A., Wen, Xiaozhong
ISBN/ISSN: 0020-7292, 1879-3479. DOI: 10.1002/ijgo.14672.
Website/Url: https://onlinelibrary.wiley.com/doi/10.1002/ijgo.14672
Abstract:
Objective: To evaluate the risk of low gestational weight gain (GWG) in women who use electronic cigarettes (e-cigarettes), combustible cigarettes, or both e-cigarettes and combustible cigarettes (dual use) during pregnancy. Methods: We conducted a secondary analysis of the data from 176 882 singleton pregnancies in the 2016-2020 US Pregnancy Risk Assessment Monitoring System (PRAMS). Postpartum women self-reported their use of e-cigarettes and/or cigarettes during the last 3 months of pregnancy. Low GWG was defined as the total GWG less than 12.7 kg, less than 11.3 kg, less than 6.8 kg, and less than 5.0 kg (<28, <25, <15, and < 11 lb) for women with underweight, normal weight, overweight, and obesity, respectively. We used multivariable logistic regression to estimate the odds ratios (ORs) of low GWG, adjusting for confounders. Results: In this national sample, 921 (weighted percentage, 0.5%) of women were e-cigarette users and 1308 (0.7%) were dual users during late pregnancy. Compared with non-users during late pregnancy (40 090, 22.1%), cigarette users (4499, 28.0%) and dual users (427, 26.0%) had a higher risk of low GWG, but e-cigarette users had a similar risk (237, 22.1%). Adjustment for sociodemographic and pregnancy confounders moderately attenuated these associations: confounder-adjusted ORs 1.26 (95% confidence interval [CI] 1.18-1.35) for cigarette users, 1.18 (95% CI 0.96-1.44) for dual users, and 0.99 (95% CI 0.78-1.27) for e-cigarette users. Conclusions: Unlike combustible cigarette use, e-cigarette use during late pregnancy does not appear to be a risk factor for low GWG.
Tag: Pregnancy, Comparison, Cessation, Dual Use
Key: 3ZHL5DRS