Rationale: Rates of adolescent electronic (e-) cigarette use are increasing, but there has been little study of the chronic effects of use.Components of e-cigarette aerosol have known pulmonary toxicity.Objectives: To investigate the associations of e-cigarette use with chronic bronchitis symptoms and wheeze in an adolescent population.Methods: Associations of self-reported use of e-cigarettes with chronic bronchitic symptoms (chronic cough, phlegm, or bronchitis) and of wheeze in the previous 12 months were examined in 2,086 Southern California Children's Health Study participants completing questionnaires in 11th and 12th grade in 2014.Measurements and Main Results: Ever e-cigarette use was reported by 502 (24.0%), of whom 201 (9.6%) used e-cigarettes during the last 30 days (current users). Risk of bronchitic symptoms was increased by almost twofold among past users (odds ratio [OR], 1.85; 95% confidence interval [CI], 1.37-2.49), compared with never-users, and by 2.02-fold (95% CI, 1.42-2.88) among current users. Risk increased with frequency of current use (OR, 1.66; 95% CI, 1.02-2.68) for 1-2 days and 2.52 (95% CI, 1.56-4.08) for 3 or more days in past 30 days compared with never-users. Associations were attenuated by adjustment for lifetime number of cigarettes smoked and secondhand smoke exposure. However, risk of bronchitic symptoms among past e-cigarette users remained elevated after adjustment for relevant potential confounders and was also observed among never-cigarette users (OR, 1.70; 95% CI, 1.11-2.59). There were no statistically significant associations of e-cigarette use with wheeze after adjustment for cigarette use.Conclusions: Adolescent e-cigarette users had increased rates of chronic bronchitic symptoms. Further investigation is needed to determine the long-term effects of e-cigarettes on respiratory health.
BACKGROUND: Use of electronic cigarettes (e-cigarettes) among adolescents has increased since their introduction into the US market in 2007. Little is known about the role of e-cigarette psychosocial factors on risk of e-cigarette or cigarette use in adolescence. METHODS:Information on e-cigarette and cigarette psychosocial factors (use and attitudes about use in the home and among friends) was collected from 11th-and 12th-grade participants in the Southern California Children's Health Study during the spring of 2014.RESULTS: Of 2084 participants, 499 (24.0%) had used an e-cigarette, including 200 (9.6%) current users (past 30 days); 390 participants (18.7%) had smoked a combustible cigarette, and 119 (5.7%) were current cigarette smokers. Cigarette and e-cigarette use were correlated. Nevertheless, 40.5% (n = 81) of current e-cigarette users had never smoked a cigarette. Psychosocial factors (home use of each product, friends' use of and positive attitudes toward e-cigarettes and cigarettes) and participant perception of the harm of e-cigarettes were strongly positively associated both with e-cigarette and cigarette use. Most youth who reported e-cigarette use had friends who used e-cigarettes, and almost half of current users reported that they did not believe there were health risks associated with e-cigarette use.CONCLUSIONS: Longitudinal studies of adolescents are needed to determine whether the strong association of e-cigarette psychosocial factors with both e-cigarette and cigarette use will lead to increased cigarette use or dual use of cigarettes and e-cigarettes, or whether e-cigarettes will serve as a gateway to cigarette use. WHAT'S KNOWN ON THIS SUBJECT:Electronic cigarette (e-cigarette) use in adolescence is increasing. E-cigarette use has been associated with cigarette use, but there has been little study of other psychosocial risk factors for e-cigarette use and their relationship with cigarette use. WHAT THIS STUDY ADDS:Approval and use of e-cigarettes and cigarettes among friends and family were strongly associated with cigarette and e-cigarette use in a cohort of adolescents in southern California.
We have carried out detailed microstructural studies of phase separation and grain boundary composition in Cu2ZnSnS4 based solar cells. The absorber layer was fabricated by thermal evaporation followed by post high temperature annealing on hot plate. We show that inter-reactions between the bottom molybdenum and the Cu2ZnSnS4, besides triggering the formation of interfacial MoSx, results in the out-diffusion of Cu from the Cu2ZnSnS4 layer. Phase separation of Cu2ZnSnS4 into ZnS and a Cu–Sn–S compound is observed at the molybdenum-Cu2ZnSnS4 interface, perhaps as a result of the compositional out-diffusion. Additionally, grain boundaries within the thermally evaporated absorber layer are found to be either Cu-rich or at the expected bulk composition. Such interfacial compound formation and grain boundary chemistry likely contributes to the lower than expected open circuit voltages observed for the Cu2ZnSnS4 devices.
Purpose There is a growing public health concern related to the rapid increase in the use of multiple tobacco products among adolescents. This study examined patterns of adolescent use of cigarettes, e-cigarettes, cigars/cigarillo, hookah/waterpipe, and smokeless/dip/chewing tobacco in a population of southern California adolescents. Methods Data from 2,097 11th- and 12th-grade participants in the Southern California Children’s Health Study were collected via self-report in 2014. Study participants were asked about lifetime and current (past 30 days) use of cigarettes, cigars/cigarillos/little cigars, e-cigarettes, hookah/waterpipe, and smokeless/dip/chewing tobacco. Latent class analysis (LCA) was used to identify patterns of tobacco use. Results Hookah/waterpipe tobacco use had the highest current prevalence (10.7%) followed by e-cigarettes (9.6%). The prevalence of use of smokeless/dip/chewing tobacco was lowest, with 2.2% of adolescents reporting current use. The LCA suggested four distinct classes, comprising nonusers (72.3% of the sample), polytobacco experimenters (13.9%), e-cigarette/hookah users (8.2%), and polytobacco users (5.6%). Multinomial logistic regression based on these four classes found that males had double the odds to be polytobacco users relative to nonusers compared to females (odds ratio, 2.3; 95% confidence interval, 1.26–4.25). Conclusions By identifying naturally occurring configurations of tobacco product use in teens, these findings may be useful to practitioners and policymakers to identify the need for tobacco control interventions that address specific tobacco products and particular combinations of polytobacco use. LCA can be used to identify segments of the population overrepresented among certain tobacco use classes (e.g., boys) that may benefit most from targeted polyproduct intervention approaches.
Morbidity and falls are problematic for older people. Wearable devices are increasingly used to monitor daily activities. However, sensors often require rigid attachment to specific locations and shuffling or quiet standing may be confused with walking. Furthermore, it is unclear whether clinical gait assessments are correlated with how older people usually walk during daily life. Wavelet transformations of accelerometer and barometer data from a pendant device worn inside or outside clothing were used to identify walking (excluding shuffling or standing) by 51 older people (83 ± 4 years) during 25 min of 'free-living' activities. Accuracy was validated against annotated video. Training and testing were separated. Activities were only loosely structured including noisy data preceding pendant wearing. An electronic walkway was used for laboratory comparisons. Walking was classified (accuracy ≥97 %) with low false-positive errors (≤1.9%, κ ≥ 0.90). Median free-living cadence was lower than laboratory-assessed cadence (101 vs. 110 steps/min, p < 0.001) but correlated (r = 0.69). Free-living step time variability was significantly higher and uncorrelated with laboratory-assessed variability unless detrended. Remote gait impairment monitoring using wearable devices is feasible providing new ways to investigate morbidity and falls risk. Laboratory-assessed gait performances are correlated with free-living walks, but likely reflect the individual's 'best' performance.
Purpose One concern regarding the recent increase in adolescent e-cigarette use is the possibility that e-cigarettes may be used by those who might not otherwise have used cigarettes, and that dual use, or transition to cigarette use alone, may follow. Methods Questionnaire data were obtained in 2014 from 11th/12th grade students attending schools in 12 communities included in the Southern California Children’s Health Study (CHS). We evaluated the cross-sectional association between e-cigarette use, the psychosocial environment (family and friends’ use and approval of e-cigarettes and cigarettes) and susceptibility to future cigarette use among never cigarette smokers (N=1694), using previously validated measures based on reported absence of a definitive commitment not to smoke. Results Among adolescents who had never used cigarettes, 31.8% of past e-cigarette users and 34.6% of current (past 30 day) e-cigarette users indicated susceptibility to cigarette use, compared to 21.0% of never e-cigarette users. The odds of indicating susceptibility to cigarette use were two times higher for current e-cigarette users compared to never users (OR=1.97; 95%CI: 1.21, 3.22). A social environment favorable to e-cigarettes (friends’ use of and positive attitudes toward use of e-cigarettes) was also associated with greater likelihood of susceptibility to cigarette use, independent of an individual’s e-cigarette use. Conclusions E-cigarette use in adolescence, and a pro-e-cigarette social environment, may put adolescents at risk for future use of cigarettes. E-cigarettes may contribute to subsequent cigarette use via nicotine addiction or social normalization of smoking behaviors.
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