The Changing Face of Tobacco Use Among United States Youth

The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect current thinking on nodule management. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small nodules. The minimum threshold size for routine follow-up has been increased, and recommended follow-up intervals are now given as a range rather than as a precise time period to give radiologists, clinicians, and patients greater discretion to accommodate individual risk factors and preferences. The guidelines for solid and subsolid nodules have been combined in one simplified table, and specific recommendations have been included for multiple nodules. These guidelines represent the consensus of the Fleischner Society, and as such, they incorporate the opinions of a multidisciplinary international group of thoracic radiologists, pulmonologists, surgeons, pathologists, and other specialists. Changes from the previous guidelines issued by the Fleischner Society are based on new data and accumulated experience. Table. These are followed by graded ratings of each recommendation using the American College of Chest Physicians recommendations for evidence grading in clinical guidelines (9). Additional explanations are provided regarding the rationale for each recommendation, which is based on the consensus of a multidisciplinary team and a systematic review of the literature, further details of which are included in Appendix E1 [online]. The minimum threshold size for recommending follow-up is based on an estimated cancer risk in a nodule on the order of 1% or greater. This criterion is necessarily arbitrary, and we recognize that a higher threshold may be considered appropriate in some environments and that this threshold will ultimately depend on social and economic factors. Several general considerations regarding technical aspects of using these recommendations are also presented. Finally, in Appendix E1 (online), additional information regarding methods and risk factors is given. detected at CT in adult patients who are at least 35 years old. Separate guidelines have been issued for lung cancer screening, such as those from the American College of Radiology (ACR), and we support the use of those guidelines when interpreting the results of CT screening (8). Specific recommendations are provided for patients with multiple solid and subsolid nodules, and several other commonly encountered clinical situations are addressed.These guidelines are not intended for use in patients with known primary cancers who are at risk for metastases, nor are they intended for use in immunocompromised patients who are at risk for infection; in these patients, treatment should be based on the specific clinical situation. Also, because lung cancer is rare in children and adults younger than 35 years, these guidelines are no...

show abstract

“…Smokeless electronic cigarettes have been introduced, but possible risks associated with these products are as yet unproven (82).…”

Section: Tobacco and Other Inhaled Carcinogensmentioning

confidence: 99%

Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017

et al. 2017

View full text Add to dashboard Cite

show abstract

“…44 Second, the flavorings frequently used in EVPs are appealing to adolescents. 6,8,45 Third, use of EVPs may be considered more socially acceptable, particularly in indoor areas where conventional cigarette smoking is prohibited. 6 Fourth, EVPs have been relatively easy for youth to access; they are available in retail stores, mall kiosks, and the Internet.…”

Section: Figurementioning

confidence: 99%

Adolescent Risk Behaviors and Use of Electronic Vapor Products and Cigarettes

et al. 2017

View full text Add to dashboard Cite

show abstract

“…ECs are being marketed as a safer or less addictive alternative to conventional tobacco cigarettes despite the lack of scientific evidence to support these claims (Brandon et al, 2015; Harrell et al, 2014; Orellana-Barrios et al, 2015; Walton et al, 2015). In fact, there is concern that ECs could increase the health burden of tobacco dependence by undermining prevention or cessation efforts (Brandon et al, 2015; Lauterstein et al, 2014; Orellana-Barrios et al, 2015; Walton et al, 2015). Despite the unknown health consequences of ECs, their use is rapidly increasing, particularly among adolescents and current smokers (Lauterstein et al, 2014; Porter et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Abuse liability assessment of an e-cigarette refill liquid using intracranial self-stimulation and self-administration models in rats

LeSage

Staley

Muelken

et al. 2016

Drug and Alcohol Dependence

View full text Add to dashboard Cite

Background The popularity of electronic cigarettes (ECs) has increased dramatically despite their unknown health consequences. Because the abuse liability of ECs is one of the leading concerns of the Food and Drug Administration (FDA), models to assess it are urgently needed to inform FDA regulatory decisions regarding these products. The purpose of this study was to assess the relative abuse liability of an EC liquid compared to nicotine alone in rats. Because this EC liquid contains non-nicotine constituents that may enhance its abuse liability, we hypothesized that it would have greater abuse liability than nicotine alone. Methods Nicotine alone and nicotine dose-equivalent concentrations of EC liquid were compared in terms of their acute effects on intracranial self-stimulation (ICSS) thresholds, acquisition of self-administration, reinforcing efficacy (i.e., elasticity of demand), blockade of these behavioral effects by mecamylamine, nicotine pharmacokinetics and nicotinic acetylcholine receptor binding and activation. Results There were no significant differences between formulations on any measure, except that EC liquid produced less of an elevation in ICSS thresholds at high nicotine doses. Conclusions Collectively, these findings suggest that the relative abuse liability of this EC liquid is similar to that of nicotine alone in terms of its reinforcing and reinforcement-enhancing effects, but that it may have less aversive/anhedonic effects at high doses. The present methods may be useful for assessing the abuse liability of other ECs to inform potential FDA regulation of those products.

show abstract

The Changing Face of Tobacco Use Among United States Youth

Cited by 63 publications

References 60 publications

Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017

Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017

Adolescent Risk Behaviors and Use of Electronic Vapor Products and Cigarettes

Abuse liability assessment of an e-cigarette refill liquid using intracranial self-stimulation and self-administration models in rats

Contact Info

Product

Resources

About