Transitions in electronic cigarette use among adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 1 and 2 (2013–2015)

Coleman, Blair; Rostron, Brian L.; Johnson, Sarah E.; Persoskie, Alexander; Pearson, Jennifer; Stanton, Cassandra A.; Choi, Kelvin; Anic, Gabriella M.; Goniewicz, Maciej Ł.; Cummings, K. Michael; Kasza, Karin A.; Silveira, Marushka L.; Delnevo, Cristine D.; Niaura, Raymond; Abrams, David B.; Kimmel, Heather L.; Borek, Nicolette; Compton, Wilson M.; Hyland, Andrew

doi:10.1136/tobaccocontrol-2017-054174

Cited by 101 publications

(99 citation statements)

References 25 publications

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“…This is also due to the recruited population having a mean average age of 29, whereas most solely e-cigarette users with no prior smoking history tend to be younger. Depending on the population and the wording of the questions, 25-70% of electronic cigarette users describe themselves as dual users (13,14). The participants classified as e-cigarette users reported using their e-cigarettes an average of 27.5 ± 5.0 days a month, with 9.8 ± 3.3 e-cigarette sessions (more than 2 puffs) per day.…”

Section: Patients' Serum Sample Collectionmentioning

confidence: 99%

Modeling Cardiovascular Risks of E-Cigarettes With Human-Induced Pluripotent Stem Cell–Derived Endothelial Cells

Lee

Ong

Zhou

et al. 2019

Journal of the American College of Cardiology

115

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Background: Electronic cigarettes (e-cigarettes) have experienced a tremendous increase in use. Unlike cigarette smoking, the effects of e-cigarettes and their constituents on mediating vascular health remain understudied. However, given their increasing popularity, it is imperative to evaluate the health risks of e-cigarettes, including the effects of their ingredients, especially nicotine and flavorings. Objectives: To investigate the effects of flavored e-cigarette liquids (e-liquids) and serum isolated from e-cigarette users on endothelial health and endothelial cell dependent macrophage activation. Methods: We used human induced pluripotent stem cell-derived endothelial cells (iPSC-ECs) and a high-throughput screening approach to assess endothelial integrity following exposure to 6 different e-liquids with varying nicotine concentrations and to serum from e-cigarette users. Results: The cytotoxicity of the e-liquids varied considerably, with the cinnamon-flavored product being most potent and leading to significantly decreased cell viability, increased reactive oxygen species (ROS) levels, caspase 3/7 activity, and low-density lipoprotein uptake, activation of oxidative stress-related pathway, and impaired tube formation and migration, confirming endothelial dysfunction. Upon exposure of ECs to e-liquid, conditioned media induced macrophage polarization into a pro-inflammatory state, eliciting the production of interleukin-1β (IL-1β) and IL-6, leading to increased ROS. After exposure of iPSC-ECs to serum of e-cigarette users, we observed increased ROS linked to endothelial dysfunction, as indicated by impaired pro-angiogenic properties. We also noted an increase in inflammatory cytokine expression in serum of e-cigarette users. Conclusions: Acute exposure to flavored e-liquids or e-cigarette use exacerbates endothelial dysfunction, which often precedes cardiovascular diseases.Abbreviations CRP = c-reactive protein CVD = cardiovascular disease E-cigarette = electronic cigarette E-liquids = electronic cigarette liquids iPSC-ECs = induced pluripotent stem cell-derived endothelial cells PG = propylene glycol PLT = platelet ROS = reactive oxygen species VG = vegetable glycerin Condensed Abstract E-cigarettes have seen a rapid increase in use although their effects on vascular health remain understudied. Here, we investigated the effects of flavored e-cigarette liquids (e-liquids) on endothelial health by exposing human induced pluripotent stem cell-derived endothelial cells (iPSC-ECs) to different e-liquids with varying nicotine concentrations. While cytotoxicity varied among the tested flavors, the cinnamon-flavored product was most potent leading to decreased cell viability, increased oxidative stress and caspase activity, and impaired tube formation confirming endothelial dysfunction; results which were further corroborated using e-cigarette

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Section: Patients' Serum Sample Collectionmentioning

confidence: 99%

Modeling Cardiovascular Risks of E-Cigarettes With Human-Induced Pluripotent Stem Cell–Derived Endothelial Cells

Lee

Ong

Zhou

et al. 2019

Journal of the American College of Cardiology

115

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“…However, these data are now outdated, as the findings suggested that both the regulatory environment and survey timing were probably associated with considerable variability in NVP use estimates. Also, given the rapid growth of the NVP market, the increase in number of products available, major public health endorsements of NVPs, changing public perceptions about NVPs [38][39][40], and/or the implementation of (stricter) regulations in various countries, estimates of NVP use have been shown to be variable over time [41]. Therefore, these data from 14 ITC countries, with differing levels of economic development and tremendous variability in regulations governing NVP sales and marketing, provide a fertile landscape for exploring the possible impact of regulatory policies on NVP use.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of awareness, ever‐use and current use of nicotine vaping products (NVPs) among adult current smokers and ex‐smokers in 14 countries with differing regulations on sales and marketing of NVPs: cross‐sectional findings from the ITC Project

et al. 2019

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Aims This paper presents updated prevalence estimates of awareness, ever‐use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. Design, Setting, Participants and Measurements A cross‐sectional analysis of adult (≥ 18 years) current smokers and ex‐smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013–17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country‐specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non‐daily). Findings NVP awareness and use were lowest in NRP countries. Generally, ever‐ and current use of NVPs were lower in MRP countries (ever‐use = 7.1–48.9%; current use = 0.3–3.5%) relative to LRP countries (ever‐use = 38.9–66.6%; current use = 5.5–17.2%) and RP countries (ever‐use = 10.0–62.4%; current use = 1.4–15.5%). NVP use was highest among high‐income countries, followed by upper–middle‐income countries, and then by lower–middle‐income countries. Conclusions With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products.

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“…Termed ‘dual use’, many individuals report concurrent use of electronic cigarettes (e‐cigarettes) and combustible cigarettes (cigarettes) . Dual use could attenuate harm by reducing use of cigarettes with partial substitution of nicotine from e‐cigarettes or increase harm by delaying quitting cigarettes and increasing cumulative exposure to tobacco toxicants .…”

Section: Introductionmentioning

confidence: 99%

“…Dual use could attenuate harm by reducing use of cigarettes with partial substitution of nicotine from e‐cigarettes or increase harm by delaying quitting cigarettes and increasing cumulative exposure to tobacco toxicants . Recent data suggest that, for many, dual use is not a path towards cigarette quitting . For example, although most report using e‐cigarettes for smoking cessation , 88% of dual users have continued dual use (44.3%) or cigarette‐only use (43.5%) over 1 year in one study .…”

Section: Introductionmentioning

confidence: 99%

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Twenty‐four‐hour subjective and pharmacological effects of ad‐libitum electronic and combustible cigarette use among dual users

et al. 2020

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Background and Aims Relative pharmacological effects of e-cigarettes and cigarettes during 24 hours of ad-libitum use have not been described. In this study, 24-hour blood plasma nicotine concentrations and 48-hour subjective effects with use of cigarettes and e-cigarettes were measured among dual users. Design Two-arm within-subject cross-over design with preferred e-cigarette or cigarette ad-libitum use over 48 hours. Setting Hospital research ward in San Francisco, California, USA. Participants Thirty-six healthy dual users of e-cigarettes and cigarettes (n = 8, 25% females). Measurements Twenty-four-hour blood plasma nicotine and cotinine concentrations and 48-hour self-reported nicotine withdrawal symptoms and rewarding effects. Findings Analyses used analysis of variance (ANOVA)-based mixed models with order of product (e-cigarette or cigarette) and product type (combustible cigarette or type of e-cigarette) as fixed effects, and subject as a repeated effect. During a 24-hour period, e-cigarettes produced lower nicotine exposure than cigarettes for the majority of users, although 25% received more nicotine from e-cigarettes, which was predicted by more frequent e-cigarette use or greater dependence. Compared to cigarette smoking, nicotine exposure for variable-power tank users was similar, while cig-a-like (t (30) = 2.71, P = 0.011, d = 0.745) and fixed-power tank users (t (30) = 3.37, P = 0.002, d = 0.993) were exposed to less nicotine. Cigarettes were rated higher than e-cigarettes on some desirable subjective effects (e.g. psychological reward, t (322) = 7.24 P < 0.001, d = 0.432), but withdrawal symptom reduction was comparable. No differences were found between e-cigarette types, but Bayes factors indicate that these measures were insensitive.Conclusions During a 24-hour period in a hospital setting in the United States, nicotine exposure for dual users of ecigarettes and cigarettes was similar when using cigarettes or variable-power tank devices only but was lower for those using cig-a-like or fixed-power devices only. Despite lower nicotine levels, all types of e-cigarette were effective in preventing withdrawal symptoms. E-cigarettes were rated less rewarding than cigarettes.

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Transitions in electronic cigarette use among adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 1 and 2 (2013–2015)

Cited by 101 publications

References 25 publications

Modeling Cardiovascular Risks of E-Cigarettes With Human-Induced Pluripotent Stem Cell–Derived Endothelial Cells

Modeling Cardiovascular Risks of E-Cigarettes With Human-Induced Pluripotent Stem Cell–Derived Endothelial Cells

Prevalence of awareness, ever‐use and current use of nicotine vaping products (NVPs) among adult current smokers and ex‐smokers in 14 countries with differing regulations on sales and marketing of NVPs: cross‐sectional findings from the ITC Project

Twenty‐four‐hour subjective and pharmacological effects of ad‐libitum electronic and combustible cigarette use among dual users

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