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Hage, René, and Macé M. Schuurmans. "Vaping-assoziierte Lungenerkrankung «VAPI»." Praxis 109, no. 13 (October 2020): 1063–69. http://dx.doi.org/10.1024/1661-8157/a003529.
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Zusammenfassung. Elektronische Zigaretten sind kleine, handliche Geräte, die über ein Verdampfungssystem verfügen und damit die Inhalation von Aerosolgemischen ermöglichen. In letzter Zeit sind mehrere Erkrankungsfälle publiziert worden, die auf den Konsum von E-Zigaretten zurückgeführt werden können. In Fallserien ist ein Syndrom mit der Bezeichnung «Vaping-Associated Pulmonary Illness» (VAPI) beschrieben worden, das durch isolierte respiratorische Symptome oder durch kombinierte respiratorische, gastro-intestinale und konstitutionelle Symptome gekennzeichnet ist. VAPI kann rasch progredient sein und zu schwerer respiratorischer Insuffizienz sowie intensivmedizinischer Behandlungsbedürftigkeit führen. Trotz diverser Therapiestrategien sind bereits über 50 Todesfälle zu beklagen. Das Vitamin-E-Azetat wird von den inhalierten Substanzen am häufigsten mit VAPI assoziiert. Obwohl die Auslöser und Krankheitsmechanismen noch nicht umfassend untersucht und geklärt sind, fassen wir das bisherige Wissen zur Klinik, Pathologie, Radiologie und Therapie zusammen.
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Alavalapadu, Aparna, and Raphael Mattamal. "Vaping Associated Pulmonary Injury." International Journal of Integrative Pediatrics and Environmental Medicine 7 (February 1, 2022): 8–12. http://dx.doi.org/10.36013/ijipem.v7i.75.
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Vaping-associated pulmonary injury (VAPI) is a newly evolving medical condition caused by inhalation of substances including tetrahydrocannabinol- or nicotine-containing products via vaping. Vaping is the act of inhaling and exhaling an aerosol, which can contain fine particles that have been identified as toxic chemicals, produced by an e-cigarette or similar device. Presenting symptoms of VAPI include respiratory symptoms (dyspnea, chest pain, cough, and hypoxia), gastrointestinal symptoms (nausea, emesis, diarrhea, and abdominal pain), and constitutional symptoms (fever, chills, weight loss, and fatigue). The diagnosis and management of VAPI are being studied and it is considered a diagnosis of exclusion. Most patients are young, with male predominance, and history of vaping. The severity of presenting symptoms varies. Radiographic findings vary in severity with chest x-rays showing bilateral infiltrates, although those findings may be absent early in the disease course. Computed tomography of the chest can show bilateral ground-glass opacities with pleural effusions and pneumomediastinum. Management of VAPI is based upon clinical presentation with empiric antibiotics for CAP coverage and steroids if indicated for reducing lung inflammation.
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Levy, David T., Kenneth E. Warner, K. Michael Cummings, David Hammond, Charlene Kuo, Geoffrey T. Fong, James F. Thrasher, Maciej Lukasz Goniewicz, and Ron Borland. "Examining the relationship of vaping to smoking initiation among US youth and young adults: a reality check." Tobacco Control 28, no. 6 (November 20, 2018): 629–35. http://dx.doi.org/10.1136/tobaccocontrol-2018-054446.
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BackgroundThe 2018 National Academies of Sciences, Engineering, and Medicine Report found substantial evidence that electronic cigarette use (vaping) by youth is strongly associated with an increased risk of ever using cigarettes (smoking) and moderately associated with progressing to more established smoking. However, the Report also noted that recent increases in vaping have been associated with declining rates of youth smoking. This paper examines the temporal relationship between vaping and youth smoking using multiple data sets to explore the question of whether vaping promotes smoking initiation in the USA.MethodsUsing publicly available, nationally representative data on smoking and vaping among youth and young adults, we conducted a trend line analysis of deviations from long-term trends in smoking starting from when vaping became more prevalent.ResultsThere was a substantial increase in youth vaping prevalence beginning in about 2014. Time trend analyses showed that the decline in past 30-day smoking prevalence accelerated by two to four times after 2014. Indicators of more established smoking rates, including the proportion of daily smokers among past 30-day smokers, also decreased more rapidly as vaping became more prevalent.ConclusionsThe inverse relationship between vaping and smoking was robust across different data sets for both youth and young adults and for current and more established smoking. While trying electronic cigarettes may causally increase smoking among some youth, the aggregate effect at the population level appears to be negligible given the reduction in smoking initiation during the period of vaping’s ascendance.
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Carlos, W. Graham, Laura E. Crotty Alexander, Jane E. Gross, Charles S. Dela Cruz, Jonathan M. Keller, Susan Pasnick, and Shazia Jamil. "Vaping-associated Pulmonary Illness (VAPI)." American Journal of Respiratory and Critical Care Medicine 200, no. 7 (October 1, 2019): P13—P14. http://dx.doi.org/10.1164/rccm.2007p13.
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Invernizzi-Prats, Juan Manuel. "Vaping or vaping, safe or harmful." DEL NACIONAL 10, no. 2 (December 30, 2018): 164–66. http://dx.doi.org/10.18004/rdn2018.010.02.164-166.
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Singh, Anshika, Qiuxue Tan, Nicole M. Saccone, and David H. Lindner. "A Case of Vaping TCH Oil Leading to Vaping Associated Pulmonary Injury: Our Approach to Its Diagnosis, Management, and Recommendations." Case Reports in Pulmonology 2020 (January 5, 2020): 1–5. http://dx.doi.org/10.1155/2020/6138083.
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Vaping’s popularity has grown exponentially since its introduction to the US market in 2003. Its use has sky-rocketed since the unveiling of the vaping pods in 2017 which may account for the advent of the vaping related illnesses we are now seeing. Substances such as nicotine solution, tetrahydrocannabinol (THC) oil, cannabidiol (CBD) oil, and butane hash oil (BHC) packaged in cartridges available in various flavors and concentrations are aerosolized by the heating of metal coils in the e-cigarette/vaping devices. Cases from all over the country have recently been coming to light in which vaping has led to severe acute pulmonary disease or vaping-associated-pulmonary-injury (VAPI). A vast majority of the presenting patients in the reported cases have required hospitalization and intensive care, needing supplemental oxygen and even endotracheal intubation and mechanical ventilation. 98% of patients present with respiratory symptoms (dyspnea, hypoxia, chest pain, cough, hemoptysis), 81% of patients have gastrointestinal symptoms (nausea, vomiting, diarrhea, and abdominal pain), and 100% of patients have constitutional symptoms such as fever, chills, and fatigue/malaise on presentation. Although based on history and clinical presentation it is reasonable to have a high suspicion for VAPI, diagnostic workup to rule out alternative underlying causes such as infection, malignancy, or autoimmune process should be performed before establishing the diagnosis. Computed Tomography (CT) scans of the chest have predominantly shown ground-glass opacity in the lungs, often with areas of lobular or subpleural sparing. Although lung biopsies have been performed on a relatively low number of cases, lung injury patterns so far have shown acute fibrinous pneumonitis, diffuse alveolar hemorrhage, or organizing pneumonia, usually bronchiolocentric, and accompanied by bronchiolitis. Treatment plans that have led to clinical improvement in the reported cases center around high-dose systemic steroids, although there are a lack of data regarding the best regimen and the absolute need for corticosteroids. The role of antibiotics appears to be limited once infection has definitively been ruled out. We present the case of a young male who vaped THC oil and developed severe acute pulmonary injury requiring mechanical ventilation and showed a remarkable response to high dose steroid therapy with improvement in clinical symptoms and resolution of diffuse ground glass opacity on repeat HRCT scan.
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Nolen, Lindsey. "Vaping." Oncology Times 41, no. 22 (November 2019): 11–14. http://dx.doi.org/10.1097/01.cot.0000615188.31656.0c.
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Cerepani, Mary Jo, Michael Lynch, and Denise R. Ramponi. "Vaping." Advanced Emergency Nursing Journal 42, no. 2 (2020): 90–95. http://dx.doi.org/10.1097/tme.0000000000000295.
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Elghblawi, Ebtisam. "Vaping." World Family Medicine Journal/Middle East Journal of Family Medicine 17, no. 11 (November 2019): 49–50. http://dx.doi.org/10.5742/mewfm.2019.93695.
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Gao, Yankun, Zidian Xie, Li Sun, Chenliang Xu, and Dongmei Li. "Electronic Cigarette–Related Contents on Instagram: Observational Study and Exploratory Analysis." JMIR Public Health and Surveillance 6, no. 4 (November 5, 2020): e21963. http://dx.doi.org/10.2196/21963.
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Background Instagram is a popular social networking platform for users to upload pictures sharing their experiences. Instagram has been widely used by vaping companies and stores to promote electronic cigarettes (e-cigarettes), as well as by public health entities to communicate the risks of e-cigarette use (vaping) to the public. Objective We aimed to characterize current vaping-related content on Instagram through descriptive analyses. Methods From Instagram, 42,951 posts were collected using vaping-related hashtags in November 2019. The posts were grouped as (1) pro-vaping, (2) vaping warning, (3) neutral to vaping, and (4) not related to vaping based on the attitudes to vaping expressed within the posts. From these Instagram posts and the corresponding 18,786 unique Instagram user accounts, 200 pro-vaping and 200 vaping-warning posts as well as 200 pro-vaping and 200 vaping-warning user accounts were randomly selected for hand coding. Furthermore, follower counts and media counts of the Instagram user accounts as well as the “like” counts and hashtags of the posts were compared between pro-vaping and vaping-warning groups. Results There were more posts in the pro-vaping group (41,412 posts) than there were in the vaping-warning group (1539 posts). The majority of pro-vaping images were product display images (163/200, 81.5%), and the most popular image type in vaping-warning posts was educational (95/200, 47.5%). The highest proportion of pro-vaping user account type was vaping store (110/189, 58.1%), and the store account type had the highest mean number of posts (10.33 posts/account). The top 3 vaping-warning user account types were personal (79/155, 51%), vaping-warning community (37/155, 23.9%), and community (35/155, 22.6%), of which the vaping-warning community had the highest mean number of posts (3.68 posts/account). Pro-vaping user accounts had more followers (median 850) and media (median 232) than vaping-warning user accounts had (follower count: median 191; media count: 92). Pro-vaping posts had more “likes” (median 22) and hashtags (mean 20.39) than vaping-warning posts had (“like” count: median 12; hashtags: mean 7.16). Conclusions Instagram is dominated by pro-vaping content, and pro-vaping posts and user accounts seem to have more user engagement than vaping-warning accounts have. These results highlight the importance of regulating e-cigarette posts on social media and the urgency of identifying effective communication content and message delivery methods with the public about the health effects of e-cigarettes to ameliorate the epidemic of vaping in youth.
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Knopf, Alison. "Frequent nicotine vaping associated with vaping cannabis." Brown University Child & Adolescent Psychopharmacology Update 22, no. 12 (November 13, 2020): 1–4. http://dx.doi.org/10.1002/cpu.30538.
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Knopf, Alison. "Frequent nicotine vaping associated with vaping cannabis." Brown University Child and Adolescent Behavior Letter 36, no. 12 (November 3, 2020): 7. http://dx.doi.org/10.1002/cbl.30509.
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Warner, Kenneth E. "How to Think—Not Feel—about Tobacco Harm Reduction." Nicotine & Tobacco Research 21, no. 10 (April 30, 2018): 1299–309. http://dx.doi.org/10.1093/ntr/nty084.
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Abstract Introduction The debate over tobacco harm reduction (THR) has divided the tobacco control community into two camps, one expressing serious reservations about THR whereas the other believes that reduced-risk products like e-cigarettes will disrupt the cigarette market. The often emotional debate would benefit from dispassionate data-based evaluation of evidence. Methods After briefly discussing harm reduction in public health and specifically in tobacco control, this paper identifies major issues concerning e-cigarettes and reviews relevant evidence. Issues include: e-cigarettes’ risks compared to cigarette smoking; the effect of vaping on youth smoking; vaping’s impact on adult smoking cessation; the net long-term public health implications of vaping; and differences in views on policy issues. The intent is to provide a broad overview of issues and evidence, directing readers to more detailed reviews of specific issues. Findings Principal findings include the following: (1) while longitudinal studies suggest that vaping increases never-smoking young people’s odds of trying smoking, national survey data indicate that adolescents’ 30-day smoking prevalence decreased at an unprecedented rate precisely whereas vaping increased. Use of all other tobacco products also declined. (2) Recent population-level studies add evidence that vaping is increasing adult smoking cessation. (3) Vaping is likely to make a positive contribution to public health. Conclusions THR can be a complement to, not a substitute for, evidenced-based tobacco control interventions. Tobacco control professionals need to focus on objective assessment of and discussion about the potential costs and benefits of THR. Implications Participants on both sides of the divisive THR debate need to examine the complicated issues and evidence more objectively. This entails considering both the potential benefits and costs associated with reduced-risk products like e-cigarettes. Furthermore, it requires examining different kinds of evidence when considering specific issues. For example, those concerned by longitudinal study findings that vaping increases students’ trial of cigarettes should consider US national survey evidence that youth smoking has decreased at an unprecedented rate. A review of the major issues suggests that the potential of vaping to assist adult smokers to quit outweighs the potential negatives.
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Gravely, Shannon, Hua-Hie Yong, Jessica L. Reid, Katherine A. East, Coral E. Gartner, David T. Levy, K. Michael Cummings, et al. "Do Current Smokers and Ex-Smokers Who Use Nicotine Vaping Products Daily Versus Weekly Differ on Their Reasons for Vaping? Findings from the 2020 ITC Four Country Smoking and Vaping Survey." International Journal of Environmental Research and Public Health 19, no. 21 (October 29, 2022): 14130. http://dx.doi.org/10.3390/ijerph192114130.
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This study examined reasons why adults who currently smoke or formerly smoked cigarettes use nicotine vaping products (NVPs) by vaping frequency (daily vs. weekly) stratified by smoking status. This cross-sectional study included 3070 adults from the 2020 ITC Four Country Smoking and Vaping Survey (Australia, Canada, England, United States) who reported using a NVP (vaping) at least weekly and who either currently smoke (n = 2467) or formerly smoked (n = 603). Respondents were asked to select the reason(s) they use NVPs, including to manage their smoking (reduce/quit or remain quit) and/or for reasons unrelated to managing smoking (e.g., to save money, enjoyment, flavours). We found that both current and former smokers endorsed an average of six reasons for vaping, with those vaping daily reporting significantly more reasons than those vaping weekly. Among current smokers, 72.8% reported vaping may help them quit smoking, 13.0% reported vaping to reduce smoking but not to quit, and 14.2% reported vaping only for reasons other than to reduce or quit smoking. The most common reason for vaping among current smokers was to reduce smoking (81.3%). Current smokers vaping daily were significantly more likely than those vaping weekly to report using a NVP to reduce smoking, for enjoyment, to reduce harm to themselves and others, to quit smoking, likeable flavours, and to save money. The most common reason cited for vaping by respondents who formerly smoked was enjoyment, with those who vaped daily more likely than those who vaped weekly to report vaping for enjoyment and to reduce harm to themselves. Nearly all reported vaping to help stay abstinent from smoking (92.3%), with no significant difference by vaping frequency. In conclusion, a majority of respondents reported using NVPs to manage their smoking (reduce/quit smoking or remain quit), particularly those vaping daily. Those who were vaping daily also endorsed a greater number of reasons other than managing smoking relative to those who were vaping weekly.
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Holliday, R., E. McColl, A. Weke, and Z. Sayeed. "Vaping misrepresentations." British Dental Journal 232, no. 12 (June 24, 2022): 840–41. http://dx.doi.org/10.1038/s41415-022-4409-1.
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Newnham, David. "Vaping wars." Nursing Standard 29, no. 24 (February 11, 2015): 27. http://dx.doi.org/10.7748/ns.29.24.27.s32.
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Chaumont, Martin, Philippe van de Borne, Alfred Bernard, Alain Van Muylem, Guillaume Deprez, Julien Ullmo, Eliza Starczewska, et al. "Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials." American Journal of Physiology-Lung Cellular and Molecular Physiology 316, no. 5 (May 1, 2019): L705—L719. http://dx.doi.org/10.1152/ajplung.00492.2018.
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When heated by an electronic cigarette, propylene glycol and glycerol produce a nicotine-carrying-aerosol. This hygroscopic/hyperosmolar aerosol can deposit deep within the lung. Whether these deposits trigger local inflammation and disturb pulmonary gas exchanges is not known. The aim of this study was to assess the acute effects of high-wattage electronic cigarette vaping with or without nicotine on lung inflammation biomarkers, transcutaneous gas tensions, and pulmonary function tests in young and healthy tobacco smokers. Acute effects of vaping without nicotine on arterial blood gas tensions were also assessed in heavy smokers suspected of coronary artery disease. Using a single-blind within-subjects study design, 25 young tobacco smokers underwent three experimental sessions in random order: sham-vaping and vaping with and without nicotine at 60 W. Twenty heavy smokers were also exposed to sham-vaping ( n = 10) or vaping without nicotine ( n = 10) in an open-label, randomized parallel study. In the young tobacco smokers, compared with sham-vaping: 1) serum club cell protein-16 increased after vaping without nicotine (mean ± SE, −0.5 ± 0.2 vs. +1.1 ± 0.3 µg/l, P = 0.013) and vaping with nicotine (+1.2 ± 0.3 µg/l, P = 0.009); 2) transcutaneous oxygen tension decreased for 60 min after vaping without nicotine (nadir, −0.3 ± 1 vs. −15.3 ± 2.3 mmHg, P < 0.001) and for 80-min after vaping with nicotine (nadir, −19.6 ± 2.8 mmHg, P < 0.001). Compared with sham vaping, vaping without nicotine decreased arterial oxygen tension for 5 min in heavy-smoking patients (+5.4 ± 3.3 vs. −5.4 ± 1.9 mmHg, P = 0.012). Acute vaping of propylene glycol/glycerol aerosol at high wattage with or without nicotine induces airway epithelial injury and sustained decrement in transcutaneous oxygen tension in young tobacco smokers. Intense vaping conditions also transiently impair arterial oxygen tension in heavy smokers.
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Ford, Allison, Isabelle Uny, Judith Lowes, Felix Naughton, Sue Cooper, Tim Coleman, Peter Hajek, et al. "A Qualitative Study of Factors Influencing Adherence among Pregnant Women Taking Part in a Trial of E-Cigarettes for Smoking Cessation." International Journal of Environmental Research and Public Health 18, no. 2 (January 7, 2021): 430. http://dx.doi.org/10.3390/ijerph18020430.
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Use of e-cigarettes (vaping) has potential to help pregnant women stop smoking. This study explored factors influencing adherence among participants in the vaping arm of the first trial of vaping for smoking cessation in pregnancy. We conducted semi-structured telephone interviews (n = 28) with women at three-months postpartum. Interviews were analysed using thematic analysis, informed by the Theoretical-Domains Framework, Necessity-Concerns Framework and Perceptions and Practicalities Approach. Interviewees generally reported high levels of vaping. We found that: (1) intervention adherence was driven by four necessity beliefs—stopping smoking for the baby, and vaping for harm reduction, smoking cessation or as a last resort; (2) necessity beliefs outweighed vaping concerns, such as dependence and safety; (3) adherence was linked to four practicalities themes, acting as barriers and facilitators to vaping—device and e-liquid perceptions, resources and support, whether vaping became habitual, and social and environmental factors; and (4) intentional non-adherence was rare; unintentional non-adherence was due to device failures, forgetting to vape, and personal circumstances and stress. Pregnant smokers provided with e-cigarettes, and with generally high levels of vaping, had positive beliefs about the necessity of vaping for smoking cessation which outweighed concerns about vaping. Non-adherence was mainly due to unintentional factors.
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Fagan, Matthew J., Katie M. Di Sebastiano, Wei Qian, Scott T. Leatherdale, and Guy Faulkner. "The Energy to Smoke: Examining the Longitudinal Association between Beverage Consumption and Smoking and Vaping Behaviours among Youth in the COMPASS Study." International Journal of Environmental Research and Public Health 18, no. 8 (April 7, 2021): 3864. http://dx.doi.org/10.3390/ijerph18083864.
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This study examined the longitudinal association between changes in sugar-sweetened and/or caffeinated beverage consumption and smoking/vaping behaviour among Canadian adolescents. Using longitudinal data from the COMPASS study (2015/16 to 2017/18), four models were developed to investigate whether beverage consumption explained variability in smoking and vaping behaviour in adolescence: (1) smoking initiation, (2) vaping initiation, (3) current smoking status, and (4) current vaping status. Models were adjusted for demographic factors. Multinomial logit models were used for model 1, 2, and 3. A binary logistic regression model was used for model 4. An association between change in frequency of beverage consumption and smoking/vaping behaviour was identified in all models. A one-day increase in beverage consumption was associated with smoking initiation (OR = 1.38, 95% CI: 1.25, 1.51), vaping initiation (OR = 1.23, 95% CI: 1.14, 1.32), identifying as a current smoker (OR = 1.17, 95% CI: 1.01, 1.35), and currently vaping (OR = 1.08, 95% CI: 1.04, 1.11). Change in high-energy drink consumption was the best predictor of smoking behaviours and vaping initiation but not current vaping status. Given the health consequences of smoking and vaping and their association with high-energy drink and coffee consumption, policy initiatives to prevent smoking/vaping initiation, and to limit youth access to these beverages, warrant consideration.
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Ford, Allison, Isabelle Uny, Judith Lowes, Felix Naughton, Sue Cooper, Tim Coleman, Peter Hajek, et al. "A Qualitative Study of Factors Influencing Adherence among Pregnant Women Taking Part in a Trial of E-Cigarettes for Smoking Cessation." International Journal of Environmental Research and Public Health 18, no. 2 (January 7, 2021): 430. http://dx.doi.org/10.3390/ijerph18020430.
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Use of e-cigarettes (vaping) has potential to help pregnant women stop smoking. This study explored factors influencing adherence among participants in the vaping arm of the first trial of vaping for smoking cessation in pregnancy. We conducted semi-structured telephone interviews (n = 28) with women at three-months postpartum. Interviews were analysed using thematic analysis, informed by the Theoretical-Domains Framework, Necessity-Concerns Framework and Perceptions and Practicalities Approach. Interviewees generally reported high levels of vaping. We found that: (1) intervention adherence was driven by four necessity beliefs—stopping smoking for the baby, and vaping for harm reduction, smoking cessation or as a last resort; (2) necessity beliefs outweighed vaping concerns, such as dependence and safety; (3) adherence was linked to four practicalities themes, acting as barriers and facilitators to vaping—device and e-liquid perceptions, resources and support, whether vaping became habitual, and social and environmental factors; and (4) intentional non-adherence was rare; unintentional non-adherence was due to device failures, forgetting to vape, and personal circumstances and stress. Pregnant smokers provided with e-cigarettes, and with generally high levels of vaping, had positive beliefs about the necessity of vaping for smoking cessation which outweighed concerns about vaping. Non-adherence was mainly due to unintentional factors.
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Gendall, Philip, and Janet Hoek. "Role of flavours in vaping uptake and cessation among New Zealand smokers and non-smokers: a cross-sectional study." Tobacco Control 30, no. 1 (February 14, 2020): 108–10. http://dx.doi.org/10.1136/tobaccocontrol-2019-055469.
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BackgroundConcerns about the effects of vaping have prompted calls to restrict e-cigarette flavours. Vaping proponents have criticised these proposals, which they argue may discourage smokers from taking up vaping or trigger relapse to smoking. We explored the role flavours play in vaping uptake and cessation among New Zealand cigarette smokers and vaping-susceptible never smokers (VSNS), and examined current vapers’ preferred flavours.MethodsWe conducted an online survey of 1005 New Zealanders aged 18–70 years that included 324 current vapers (vaped in the last 30 days) and 302 ‘past’ vapers (reported past vaping, but not within the last month). We asked respondents their reasons for vaping and explored current vapers’ preferred e-cigarette flavours; we analysed the data using descriptive statistics and logistic regression.ResultsIrrespective of smoking status, flavour was one of the main reasons respondents gave for vaping (smokers 83%; former smokers 77%; VSNS 80%). Flavour was less important to former vapers; 47% of smokers, 57% of former smokers and 64% of VSNS cited flavour as a reason for originally taking up vaping. Fruit flavours were most popular among all three groups; smokers also favoured tobacco flavour, while former smokers also favoured mint or menthol, and never smokers also favoured confectionery/sweets/lolly flavours.ConclusionsFlavours play a major role in vaping initiation for current smokers, former smokers and vaping-susceptible non-smokers, and remain important to those who continue vaping. Our findings highlight the need for regulation that allows some flavour diversity without the extravagant marketing currently used to promote vaping and e-liquids.
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Meacham, Meredith C., Erin A. Vogel, and Johannes Thrul. "Vaping-Related Mobile Apps Available in the Google Play Store After the Apple Ban: Content Review." Journal of Medical Internet Research 22, no. 11 (November 13, 2020): e20009. http://dx.doi.org/10.2196/20009.
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Background In response to health concerns about vaping devices (eg, youth nicotine use, lung injury), Apple removed 181 previously approved vaping-related apps from the App Store in November 2019. This policy change may lessen youth exposure to content that glamorizes vaping; however, it may also block important sources of information and vaping device control for adults seeking to use vaping devices safely. Objective Understanding the types of nicotine and cannabis vaping–related apps still available in the competing Google Play Store can shed light on how digital apps may reflect information available to consumers. Methods In December 2019, we searched the Google Play Store for vaping-related apps using the keywords "vape" and "vaping" and reviewed the first 100 apps presented in the results. We reviewed app titles, descriptions, screenshots, and metadata to categorize the intended substance (nicotine or cannabis/tetrahydrocannabinol) and the app’s purpose. The most installed apps in each purpose category were downloaded and evaluated for quality and usability with the Mobile App Rating Scale. Results Of the first 100 apps, 79 were related to vaping. Of these 79 apps, 43 (54%) were specific to nicotine, 3 (4%) were specific to cannabis, 1 (1%) was intended for either, and for the remaining 31 (39%), the intended substance was unclear. The most common purposes of the apps were making do-it-yourself e-liquids (28/79, 35%) or coils (25/79, 32%), games/entertainment (19/79, 24%), social networking (16/79, 20%), and shopping for vaping products (15/79, 19%). Of the 79 apps, at least 4 apps (5%) paired with vaping devices to control temperature or dose settings, 8 apps (10%) claimed to help people quit smoking using vaping, and 2 apps (3%) had the goal of helping people quit vaping. Conclusions The majority of vaping-related apps in the Google Play Store had features either to help users continue vaping, such as information for modifying devices, or to maintain interest in vaping. Few apps were for controlling device settings or assisting with quitting smoking or vaping. Assuming that these Google Play Store apps were similar in content to the Apple App Store apps that were removed, it appears that Apple’s ban would have a minimal effect on people who vape with the intention of quitting smoking or who are seeking information about safer vaping via mobile apps.
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Yingst, Jessica M., Courtney Lester, Susan Veldheer, Sophia I. Allen, Ping Du, and Jonathan Foulds. "E-cigarette users commonly stealth vape in places where e-cigarette use is prohibited." Tobacco Control 28, no. 5 (August 10, 2018): 493–97. http://dx.doi.org/10.1136/tobaccocontrol-2018-054432.
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Introduction‘Stealth vaping’ is the practice of vaping discreetly in places where electronic cigarette (e-cigarette) use is prohibited. While anecdotal evidence suggests that stealth vaping is common, there have been no formal studies of the behaviour. The purpose of this study is to examine stealth vaping behaviour among experienced e-cigarette users.MethodsData were collected from the follow-up survey of a large longitudinal cohort study of adult experienced e-cigarette users conducted in January 2017. To measure stealth vaping behaviour, participants were asked ‘Have you ever ‘stealth vaped’, that is to say, used an e-cig in a public place where it was not approved and attempted to conceal your e-cig use? (yes/no)’. Participants indicating yes completed additional questions about the frequency of stealth vaping and were asked to select all the locations where they commonly stealth vape. Frequencies were used to examine the overall prevalence, frequency and common locations for stealth vaping. A logistic regression model was run to predict stealth vaping.ResultsApproximately two-thirds (64.3%, n=297/462) of the sample reported ever stealth vaping, of which 52.5% (n=156/297) reported stealth vaping in the past week. Among stealth vapers (n=297), 31% reported owning a smaller device solely for stealth vaping. The most common places to stealth vape included at work (46.8%), followed by bars/nightclubs (42.1%), restaurants (37.7%), at the movies (35.4%) and in airports/on airplanes (11.7%). Predictors of stealth vaping were greater dependence and owning a smaller device solely for stealth vaping.ConclusionsStealth vaping is a common behaviour for many experienced e-cigarette users. More research is needed to understand the reasons for stealth vaping and its potential health and safety implications. This information could help researchers and regulators to design interventions to minimise the public health impact of stealth vaping.
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Lyu, Joanne Chen, Garving K. Luli, and Pamela M. Ling. "Vaping discussion in the COVID-19 pandemic: An observational study using Twitter data." PLOS ONE 16, no. 12 (December 8, 2021): e0260290. http://dx.doi.org/10.1371/journal.pone.0260290.
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Background With the spread of COVID-19, significant concerns have been raised about the potential increased risk for electronic cigarette (e-cigarette) users for COVID-19 infection and related syndromes. Social media is an increasingly popular source for health information dissemination and discussion, and can affect health outcomes. Objective This study aims to identify the topics in the public vaping discussion in COVID-19–related Twitter posts in order to get insight into public vaping-related perceptions, attitudes and concerns, and to discern possible misinformation and misconceptions around vaping in the COVID-19 pandemic. Methods Using the tweets ID database maintained by Georgia State University’s Panacea Lab, we downloaded the tweets related to COVID-19 from March 11, 2020, when the World Health Organization declared COVID-19 a pandemic, to February 12, 2021. We used R to analyze the tweets that contained a list of 79 keywords related to vaping. After removing duplicates and tweets created by faked accounts or bots, the final data set consisted of 11,337 unique tweets from 7,710 different users. We performed the latent Dirichlet allocation (LDA) algorithm for topic modeling and carried out a sentiment analysis. Results Despite fluctuations, the number of daily tweets was relatively stable (average number of daily tweets = 33.4) with a sole conspicuous spike happening on a few days after August 11, 2020 when a research team published findings that teenagers and young adults who vape face a much higher risk of COVID-19 infection than their peers who do not vape. Topic modeling generated 8 topics: linkage between vaping and risk of COVID-19 infection, vaping pneumonia and the origin of COVID-19, vaping and spread of COVID-19, vaping regulation, calling for quitting vaping, protecting youth, similarity between e-cigarette or vaping-associated lung injury (EVALI) and COVID-19, and sales information. Daily sentiment scores showed that the public sentiment was predominantly negative, but became slightly more positive over the course of the study time period. Conclusions While some content in the public discourse on vaping before the COVID-19 pandemic continued in Twitter posts during the COVID-19 time period, new topics emerged. We found a substantial amount of anti-vaping discussion and dominantly negative sentiment around vaping during COVID-19, a sharp contrast to the predominantly pro-vaping voice on social media in the pre-COVID-19 period. Continued monitoring of social media conversations around vaping is needed, and the public health community may consider using social media platforms to actively convey scientific information around vaping and vaping cessation.
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Shi, Jiamin, Rui Fu, Hayley Hamilton, and Michael Chaiton. "A machine learning approach to predict e-cigarette use and dependence among Ontario youth." Health Promotion and Chronic Disease Prevention in Canada 42, no. 1 (January 2022): 21–28. http://dx.doi.org/10.24095/hpcdp.42.1.04.
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Introduction We developed separate random forest algorithms to predict e-cigarette (vaping) ever use and daily use among Ontario youth, and subsequently examined predictor importance and statistical interaction. Methods This cross-sectional study used a representative sample of Ontario elementary and high school students in 2019 (N = 6471). Vaping frequency over the last 12 months was used to define ever-vaping and daily vaping. We considered a large set of individual characteristics as potential correlates for ever-vaping (176 variables) and daily vaping (179 variables). Using cross-validation, we developed random forest algorithms and evaluated model performance based on the C-index, a measure to assess the discriminatory ability of a model, for both outcomes. Further, the top 10 correlates were identified by relative importance score calculation and their interaction with sociodemographic characteristics. Results There were 2064 (31.9%) ever-vapers, and 490 (7.6%) of the respondents were daily users. The random forest algorithms for both outcomes achieved high performance, with C-index over 0.90. The top 10 correlates of daily vaping included use of caffeine, cannabis and tobacco, source and type of e-cigarette and absence in last 20 school days. Those of ever-vaping included school size, use of alcohol, cannabis and tobacco; 9 of the top 10 ever-vaping correlates demonstrated interactions with ethnicity. Conclusion Machine learning is a promising methodology for identifying the risks of ever-vaping and daily vaping. Furthermore, it enables the identification of important correlates and the assessment of complex intersections, which may inform future longitudinal studies to customize public health policies for targeted population subgroups.
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Fu, Rui, Robert Schwartz, Nicholas Mitsakakis, Lori M. Diemert, Shawn O’Connor, and Joanna E. Cohen. "Predictors of perceived success in quitting smoking by vaping: A machine learning approach." PLOS ONE 17, no. 1 (January 14, 2022): e0262407. http://dx.doi.org/10.1371/journal.pone.0262407.
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Prior research has suggested that a set of unique characteristics may be associated with adult cigarette smokers who are able to quit smoking using e-cigarettes (vaping). In this cross-sectional study, we aimed to identify and rank the importance of these characteristics using machine learning. During July and August 2019, an online survey was administered to a convenience sample of 889 adult smokers (age ≥ 20) in Ontario, Canada who tried vaping to quit smoking in the past 12 months. Fifty-one person-level characteristics, including a Vaping Experiences Score, were assessed in a gradient boosting machine model to classify the status of perceived success in vaping-assisted smoking cessation. This model was trained using cross-validation and tested using the receiver operating characteristic (ROC) curve. The top five most important predictors were identified using a score between 0% and 100% that represented the relative importance of each variable in model training. About 20% of participants (N = 174, 19.6%) reported success in vaping-assisted smoking cessation. The model achieved relatively high performance with an area under the ROC curve of 0.865 and classification accuracy of 0.831 (95% CI [confidence interval] 0.780 to 0.874). The top five most important predictors of perceived success in vaping-assisted smoking cessation were more positive experiences measured by the Vaping Experiences Score (100%), less previously failed quit attempts by vaping (39.0%), younger age (21.9%), having vaped 100 times (16.8%), and vaping shortly after waking up (15.8%). Our findings provide strong statistical evidence that shows better vaping experiences are associated with greater perceived success in smoking cessation by vaping. Furthermore, our study confirmed the strength of machine learning techniques in vaping-related outcomes research based on observational data.
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Canchola, Alexa, Ruth Meletz, Riste Ara Khandakar, Megan Woods, and Ying-Hsuan Lin. "Temperature dependence of emission product distribution from vaping of vitamin E acetate." PLOS ONE 17, no. 3 (March 24, 2022): e0265365. http://dx.doi.org/10.1371/journal.pone.0265365.
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Nearly two years after vitamin E acetate (VEA) was identified as the potential cause of the 2019–2020 outbreak of e-cigarette, or vaping product-associated lung injuries (EVALI), the toxicity mechanisms of VEA vaping are still yet to be fully understood. Studies since the outbreak have found that e-liquids such as VEA undergo thermal degradation during the vaping process to produce various degradation products, which may pose a greater risk of toxicity than exposure to unvaped VEA. Additionally, a wide range of customizable parameters–including the model of e-cigarette used, puffing topography, or the applied power/temperature used to generate aerosols–have been found to influence the physical properties and chemical compositions of vaping emissions. However, the impact of heating coil temperature on the chemical composition of VEA vaping emissions has not been fully assessed. In this study, we investigated the emission product distribution of VEA vaping emissions produced at temperatures ranging from 176 to 356°C, corresponding to a variable voltage vape pen set at 3.3 to 4.8V. VEA degradation was found to be greatly enhanced with increasing temperature, resulting in a shift towards the production of lower molecular weight compounds, such as the redox active duroquinone (DQ) and short-chain alkenes. Low temperature vaping of VEA resulted in the production of long-chain molecules, such as phytol, exposure to which has been suggested to induce lung damage in previous studies. Furthermore, differential product distribution was observed in VEA degradation products generated from vaping and from pyrolysis using a tube furnace in the absence of the heating coil at equivalent temperatures, suggesting the presence of external factors such as metals or oxidation that may enhance VEA degradation during vaping. Overall, our findings indicate that vaping behavior may significantly impact the risk of exposure to toxic vaping products and potential for vaping-related health concerns.
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Chaumont, Martin, Vanessa Tagliatti, El Mehdi Channan, Jean-Marie Colet, Alfred Bernard, Sofia Morra, Guillaume Deprez, et al. "Short halt in vaping modifies cardiorespiratory parameters and urine metabolome: a randomized trial." American Journal of Physiology-Lung Cellular and Molecular Physiology 318, no. 2 (February 1, 2020): L331—L344. http://dx.doi.org/10.1152/ajplung.00268.2019.
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Propylene glycol and glycerol are e-cigarette constituents that facilitate liquid vaporization and nicotine transport. As these small hydrophilic molecules quickly cross the lung epithelium, we hypothesized that short-term cessation of vaping in regular users would completely clear aerosol deposit from the lungs and reverse vaping-induced cardiorespiratory toxicity. We aimed to assess the acute effects of vaping and their reversibility on biological/clinical cardiorespiratory parameters [serum/urine pneumoproteins, hemodynamic parameters, lung-function test and diffusing capacities, transcutaneous gas tensions (primary outcome), and skin microcirculatory blood flow]. Regular e-cigarette users were enrolled in this randomized, investigator-blinded, three-period crossover study. The periods consisted of nicotine-vaping (nicotine-session), nicotine-free vaping (nicotine-free-session), and complete cessation of vaping (stop-session), all maintained for 5 days before the session began. Multiparametric metabolomic analyses were used to verify subjects’ protocol compliance. Biological/clinical cardiorespiratory parameters were assessed at the beginning of each session (baseline) and after acute vaping exposure. Compared with the nicotine- and nicotine-free-sessions, a specific metabolomic signature characterized the stop-session. Baseline serum club cell protein-16 was higher during the stop-session than the other sessions ( P < 0.01), and heart rate was higher in the nicotine-session ( P < 0.001). Compared with acute sham-vaping in the stop-session, acute nicotine-vaping (nicotine-session) and acute nicotine-free vaping (nicotine-free-session) slightly decreased skin oxygen tension ( P < 0.05). In regular e-cigarette-users, short-term vaping cessation seemed to shift baseline urine metabolome and increased serum club cell protein-16 concentration, suggesting a decrease in lung inflammation. Additionally, acute vaping with and without nicotine decreased slightly transcutaneous oxygen tension, likely as a result of lung gas exchanges disturbances.
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Esquer, Carolina, Oscar Echeagaray, Fareheh Firouzi, Clarissa Savko, Grant Shain, Pria Bose, Abigail Rieder, et al. "Fundamentals of vaping-associated pulmonary injury leading to severe respiratory distress." Life Science Alliance 5, no. 2 (November 22, 2021): e202101246. http://dx.doi.org/10.26508/lsa.202101246.
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Vaping of flavored liquids has been touted as safe alternative to traditional cigarette smoking with decreased health risks. The popularity of vaping has dramatically increased over the last decade, particularly among teenagers who incorporate vaping into their daily life as a social activity. Despite widespread and increasing adoption of vaping among young adults, there is little information on long-term consequences of vaping and potential health risks. This study demonstrates vaping-induced pulmonary injury using commercial JUUL pens with flavored vape juice using an inhalation exposure murine model. Profound pathological changes to upper airway, lung tissue architecture, and cellular structure are evident within 9 wk of exposure. Marked histologic changes include increased parenchyma tissue density, cellular infiltrates proximal to airway passages, alveolar rarefaction, increased collagen deposition, and bronchial thickening with elastin fiber disruption. Transcriptional reprogramming includes significant changes to gene families coding for xenobiotic response, glycerolipid metabolic processes, and oxidative stress. Cardiac systemic output is moderately but significantly impaired with pulmonary side ventricular chamber enlargement. This vaping-induced pulmonary injury model demonstrates mechanistic underpinnings of vaping-related pathologic injury.
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Antin, Tamar M. J., Catherine Hess, Emily Kaner, Sharon Lipperman-Kreda, Rachelle Annechino, and Geoffrey Hunt. "Pathways of Nicotine Product Use: A Qualitative Study of Youth and Young Adults in California." Nicotine & Tobacco Research 22, no. 5 (March 1, 2019): 722–27. http://dx.doi.org/10.1093/ntr/ntz028.
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Abstract Introduction Existing research on youth’s adoption of alternative nicotine delivery systems (ANDS) has focused on identifying pathways of nicotine product use, specifically examining whether vaping encourages progression to smoking. Few studies have considered other pathways of initiation. Qualitative studies suggest that meanings of vaping vary significantly, suggestive of the need for a more nuanced understanding of the role of vaping for youth with different pathways into vaping and smoking. Methods We conducted in-depth qualitative interviews with 49 Californian youth between 15 and 25 years old who reported ever vaping nicotine to gain a deeper understanding of their initiation pathways of vaping and smoking, paying special attention to youth’s experiences and reasons for ANDS initiation and use. Categorizing participants into initiation pathways by self-reported use and age of initiation of ANDS and cigarettes, we then compared the meaning and role of vaping across three distinct pathways of use: (1) smoking to vaping, (2) vaping to smoking, and (3) vaping only. Results The most common pathway reported was smoking to vaping (74%), eight participants began vaping before smoking, and five participants reported only vaping but never smoking. Analysis of participants’ narratives emphasized that youth in our study, regardless of initiation pathway, were generally aware of the health consequences of smoking and negotiated their use of nicotine products considering relative risks. Conclusion Findings from this study suggest that ANDS serve as a transitional tool for youth who are keenly aware of the health consequences of smoking, thus challenging conventional discourses about ANDS as a threat to youth’s health. Implications This qualitative study queries concerns about the potential of alternative nicotine delivery systems (ANDS) to serve as a gateway into cigarette smoking for youth and young adults. Findings suggest that most of the youth participants discussed and considered relative risks in their pathways of initiation, highlighting the need to acknowledge harm reduction in constructing public health messaging and policies for smoking cessation.
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Knopf, Alison. "MTF shows increase in teen vaping, especially marijuana vaping." Brown University Child & Adolescent Psychopharmacology Update 22, no. 2 (January 15, 2020): 6. http://dx.doi.org/10.1002/cpu.30467.
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Morean, Meghan E., Danielle R. Davis, Krysten W. Bold, Grace Kong, Asti Jackson, Juhan Lee, Lavanya Rajesh Kumar, and Suchitra Krishnan-Sarin. "Psychometric Evaluation of the Short-Form Vaping Consequences Questionnaire for Use With High School Adolescents Who Use and Do Not Use E-cigarettes." Nicotine & Tobacco Research 24, no. 5 (November 13, 2021): 699–709. http://dx.doi.org/10.1093/ntr/ntab237.
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Abstract Introduction Assessing youth vaping expectancies using a psychometrically sound measure can improve understanding of e-cigarette susceptibility and use. Aims and Methods We evaluated the psychometric properties of the Short-Form Vaping Consequences Questionnaire (SF-VCQ), an expectancy measure previously validated with adults, within a sample of 1753 high school adolescents who completed an online, school-based survey in Fall 2020 (51.6% female; 15.56 [1.22] years old; 46.6% non-Hispanic white; 26.9% reported lifetime but no past-30-day vaping; 12.6% reported past-30-day vaping). Analyses included confirmatory factor analysis, internal consistency, measurement invariance, between-group differences, and test-criterion relationships. Results The four-factor structure was confirmed and was scalar invariant by lifetime and past-month vaping status, sex, and race. All subscales were internally reliable (mean α = 0.94). The subscales were sensitive to differences based on sex, race, vaping susceptibility among never users, and lifetime and past-month vaping status. For example, students who vaped in the past-month held weaker expectancies for negative consequences but stronger expectancies for positive reinforcement, negative reinforcement, and appetite/weight control compared to lifetime vapers. Unadjusted relationships within the subsamples of lifetime and past-month vapers provided evidence of convergent validity. Evidence for concurrent validity was observed for all samples after accounting for covariates. For example, expectancies for positive reinforcement, negative reinforcement, and appetite/weight control remained significantly associated with past-month vaping frequency. Conclusions The SF-VCQ evidenced excellent internal reliability, scalar measurement invariance, and construct, convergent, and concurrent validity in samples of never, lifetime, and past-month adolescent e-cigarette users. Findings support using the SF-VCQ for assessing youths’ vaping-related expectancies. Implications The current study established the psychometric properties of the SF-VCQ for use among adolescents with and without vaping experience, including measurement invariance that permits direct comparisons of expectancies across these two groups. When considered in concert with previously published research in adults, the SF-VCQ provides researchers with a measure that can be used with both youth and adult samples. Observed relationships between positive expectancies and vaping susceptibility in vaping naïve youth and indices of vaping frequency in youth with vaping experience suggest that challenging positive expectancies may be a valuable addition to prevention and intervention efforts to reduce youth vaping.
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Dai, Hongying, Athena Ramos, Niran Tamraker, Marshall Cheney, Kaeli Samson, and Brandon Grimm. "School Personnel’s Responses to School-based Vaping Prevention Program: A Qualitative Study." Health Behavior and Policy Review 8, no. 2 (March 1, 2021): 130–47. http://dx.doi.org/10.14485/hbpr.8.2.4.
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Objective: In this qualitative study, we sought to assess 3 topics of interest: (1) current status of vaping and school-based prevention; (2) school personnel’s perceptions of vaping; and (3) challenges in implementing school-based vaping prevention programs. Methods: We conducted 5 focus groups using a semi-structured interview guide during October through December 2019. School personnel (eg, principals, teachers [N = 32]) from 30 middle and high schools were recruited across diverse regions in Nebraska. Results: Eight themes arose from the thematic analysis in 3 topic areas. School personnel attributed student vaping to easy access, low perception of harm, addiction, and proliferation of stealthy products for concealed use. Whereas schools showed strong support for addressing youth vaping on school grounds, few schools had adopted a comprehensive e-cigarette prevention and cessation program. The top challenges to current school-based vaping prevention programs include lack of time, knowledge, and coordinated efforts. Participants also recognized the significance of parental engagement in the prevention effort. Conclusions: There is a considerable variation in school policies and actions to address youth vaping. An evidence based youth vaping program that involves schools, parents, students, and communities needs to be developed and disseminated in school settings.
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Bowker, Katharine, Michael Ussher, Sue Cooper, Sophie Orton, Tim Coleman, and Katarzyna Anna Campbell. "Addressing and Overcoming Barriers to E-Cigarette Use for Smoking Cessation in Pregnancy: A Qualitative Study." International Journal of Environmental Research and Public Health 17, no. 13 (July 4, 2020): 4823. http://dx.doi.org/10.3390/ijerph17134823.
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E-cigarettes may have a role in supporting pregnant women who would otherwise smoke to stop smoking. The study aimed to understand pregnant women’s vaping experiences, in particular how vaping to stop smoking is facilitated and how barriers to this are overcome. We conducted semi structured telephone interviews (n = 15) with pregnant or postpartum women who vaped during pregnancy, either exclusively (n = 10) or dual-used (n = 5) (smoked and vaped). Thematic analysis was used to analyse the interviews. Two themes emerged. First, ‘facilitating beliefs’: inherent beliefs that helped women overcome barriers to vaping. These included understanding the relative safety of vaping and economic gains compared with smoking and pregnancy being a motivator to stop smoking. Second, ‘becoming a confident vaper’: accumulating sufficient skill and confidence to comfortably vape. This included experimentation with e-cigarettes to ensure nicotine dependence and sensory needs were met. Seeking social support and employing strategies to address social stigma were also important. Positive beliefs about vaping and becoming proficient at vaping were viewed as ways to overcome barriers to vaping. The theoretical domain framework informed intervention recommendations to assist pregnant smokers who have tried but cannot stop smoking to switch to vaping.
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Lim, Carmen C. W., Gary C. K. Chan, Elle Wadsworth, Daniel Stjepanović, Vivian Chiu, Jack Y. C. Chung, Tianze Sun, et al. "Trends and Socio-Demographic Differences of Cannabis Vaping in the USA and Canada." International Journal of Environmental Research and Public Health 19, no. 21 (November 3, 2022): 14394. http://dx.doi.org/10.3390/ijerph192114394.
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Given the rise in cannabis vaping, it is important to highlight the heterogeneity in vaping different cannabis product because of the potential differences in their health risks. This study aims to estimate the trends and socio-demographic correlates of the use of various cannabis vaping products across jurisdiction with different legal status. Data from the 2018 (n = 27,169) and 2019 (n = 47,747) waves of the International Cannabis Policy Study (ICPS) were used. Respondents aged 16–65 completed web-based surveys. In 2019, proportions of past year vaping of cannabis oil, dried flower and concentrates in the overall sample were highest in U.S. jurisdictions where cannabis was legalized for non-medical use (17.4%, 6.0%, 4.9%), followed by U.S. jurisdiction where non-medical cannabis use is illegal (13.7%, 5.8%, 2.9%), and lowest in Canada (8.1%, 4.4%, 2.1%). Vaping dried flower decreased from 2019 to 2018 in U.S. legal jurisdictions and Canada, while vaping cannabis oil and concentrates increased in all jurisdictions (p < 0.001). The odds of vaping all forms of products were higher among younger respondents (16–55 years), males, respondents with some college education, and persons with low-risk perceptions on daily cannabis vaping. In both ICPS surveys (2018 and 2019), cannabis oil was the most frequently vaped products, followed by dried flower, and concentrates. Detailed measures of product forms for cannabis vaping should be considered in future surveys.
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Davis, Danielle R., Meghan E. Morean, Krysten W. Bold, Deepa Camenga, Grace Kong, Asti Jackson, Patricia Simon, and Suchitra Krishnan-Sarin. "Cooling e-cigarette flavors and the association with e-cigarette use among a sample of high school students." PLOS ONE 16, no. 9 (September 1, 2021): e0256844. http://dx.doi.org/10.1371/journal.pone.0256844.
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Introduction E-liquid flavor is typically presented by flavor category (e.g. menthol, mint, fruit, dessert). Cooling sensations produced by flavor additives such as menthol enhance appeal of e-cigarettes among youth, but not all e-liquids that produce cooling sensations are labeled as menthol. Sensory experiences produced by flavors may allow for a new way to capture e-cigarette flavor use. This study aims to examine use of flavors that produce cooling sensations among youth and its association with e-cigarette use behaviors. Methods A 2019 survey of high school students (n = 4875) examined use of e-cigarette flavors that produced cooling sensations (cooling flavors) among past 30-day e-cigarette users. E-cigarette use behaviors (flavor use, nicotine use, frequency of use) were examined between those who did and did not use cooling flavors. A binary logistic regression was used to examine associations between vaping frequency, nicotine (vs. non-nicotine) use, and vaping cooling flavors while controlling for demographics, number of flavors vaped in the past month, and vaping age of onset. Results 51.6% (n = 473/916) of the analytic sample endorsed vaping cooling flavors. There were no demographic differences by vaping cooling flavors. Vaping cooling flavors was associated with vaping more frequently (AOR:1.04,95% CI:1.03,1.05) and vaping nicotine (AOR:2.37,95% CI:1.53,3.67). Conclusion Vaping cooling flavors was associated with greater nicotine vaping and frequency of e-cigarette use. Assessing sensory experience, such as cooling, in addition to flavor category may more fully capture e-cigarette flavor use and its impacts on youth e-cigarette use behaviors.
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Freitas-Lemos, Roberta, Jeffrey S. Stein, Allison N. Tegge, Brent A. Kaplan, Bryan W. Heckman, K. Michael Cummings, and Warren K. Bickel. "The Illegal Experimental Tobacco Marketplace I: Effects of Vaping Product Bans." Nicotine & Tobacco Research 23, no. 10 (May 5, 2021): 1744–53. http://dx.doi.org/10.1093/ntr/ntab088.
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Abstract Objectives Banning vaping products may have unintended outcomes, such as increased demand for illegal products. This study experimentally examined the effects of a vaping ban and a flavored vaping ban on the probability of purchasing illicit vaping products, and factors affecting purchasing from a hypothetical illegal marketplace. Methods A crowdsourced sample of exclusive cigarette smokers, exclusive e-cigarette users, and frequent dual users (n = 150) completed hypothetical purchasing trials in an Experimental Tobacco Marketplace under three conditions (no ban, vaping ban, and flavored vaping ban). Participants chose to purchase in a hypothetical legal experimental tobacco marketplace (LETM) or illegal experimental tobacco marketplace (IETM). Vaping products were available in each marketplace depending on the condition. Other tobacco products were always available in the LETM. A hypothetical illicit purchase task with five fine amounts assessed the effect of monetary penalties. Results Participants from all groups were more likely to purchase from the IETM when product availability in the LETM was more restricted, with e-cigarette users being most affected. The likelihood of purchasing illegal products was systematically decreased as monetary penalties associated with the IETM increased, with e-cigarette users showing greater persistence in defending their illicit purchases. Conclusions Restricting vaping products from the marketplace may shift preference towards purchasing vaping products in the illegal marketplace. Nevertheless, penalties imposed on consumer’s behavior might be effective in preventing illicit trade. The IETM is a methodological extension that supports the utility and flexibility of the ETM as a framework for understanding the impact of different tobacco regulatory policies. Implications This study suggests that limiting or banning vaping products as a possible strategy to reduce the adverse effects of vaping products could result in some tobacco-users seeking banned products from illegal sources. Monetary fines were shown to reduce illegal purchases. Therefore, policymakers should consider implementing strategies that may mitigate illegal purchases.
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Sanchez, Sherald, Anasua Kundu, Elizabeth Limanto, Peter Selby, Neill Bruce Baskerville, and Michael Chaiton. "Smartphone Apps for Vaping Cessation: Quality Assessment and Content Analysis." JMIR mHealth and uHealth 10, no. 3 (March 28, 2022): e31309. http://dx.doi.org/10.2196/31309.
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Background As the prevalence of electronic cigarette (e-cigarette) use, or vaping, continues to grow, particularly among young people, so does the need for research and interventions to address vaping. Objective This study examines the quality of free vaping cessation apps, their contents and features, popularity among users, and adherence to evidence-based principles. Methods A systematic search of existing apps for vaping cessation was conducted in December 2020. Eligible apps were free, in English, and included features specifically targeting vaping cessation. Each app included in the analysis was used daily for at least seven consecutive days, assessed using the Mobile App Rating Scale, and rated by at least two authors (AK, EL, or SS) based on adherence to evidence-based practices. Intraclass correlation coefficient (ICC) estimates were computed to assess interrater reliability (excellent agreement; ICC 0.92; 95% CI 0.78-0.98). Results A total of 8 apps were included in the quality assessment and content analysis: 3 were developed specifically for vaping cessation and 5 focused on smoking cessation while also claiming to address vaping cessation. The mean of app quality total scores was 3.66 out of 5. Existing vaping cessation apps employ similar approaches to smoking cessation apps. However, they are very low in number and have limited features developed specifically for vaping cessation. Conclusions Given the lack of vaping cessation interventions at a time when they are urgently needed, smartphone apps are potentially valuable tools. Therefore, it is recommended that these apps apply evidence-based practices and undergo rigorous evaluations that can assess their quality, contents and features, and popularity among users. Through this process, we can improve our understanding of how apps can be effective in helping users quit vaping.
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Wamamili, Ben, Sheleigh Lawler, Mark Wallace-Bell, Coral Gartner, David Sellars, Randolph C. Grace, Ryan Courtney, and Pat Coope. "Cigarette smoking and e-cigarette use among university students in Queensland, Australia and New Zealand: results of two cross-sectional surveys." BMJ Open 11, no. 2 (February 2021): e041705. http://dx.doi.org/10.1136/bmjopen-2020-041705.
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ObjectivesExamine the patterns of cigarette smoking and e-cigarette use (vaping), the perceived harm of e-cigarettes compared with tobacco cigarettes, and associations between smoking and vaping with student characteristics.DesignCross-sectional studies.SettingThe University of Queensland (UQ), Australia and eight New Zealand (NZ) universities.ParticipantsStudents at UQ: 4957 (70.8% aged <25 years, 63.0% women) and NZ: 1854 (82.5% aged <25 years, 60.1% women).MethodsΧ2 tests compared smoking by age and gender, and vaping by age, gender and smoking status. Two-sided p<0.05 was considered significant and 95% CIs reported where appropriate. Multinomial logistic regression examined associations between smoking and vaping (exclusive smoking, exclusive vaping, dual use and non-use) with age, gender and student type (domestic vs international).ResultsSmoking (UQ vs NZ, 95% CI): ever 45.2% (43.8% to 46.6%) vs 50.0% (47.7% to 52.3%), current 8.9% (8.1% to 9.7%) vs 10.4% (9.1% to 11.9%) and daily 5.2% (4.6% to 5.8%) vs 5.6% (4.6% to 6.7%), and not smoking in indoor 98.3% vs 87.7% or outdoor smoke-free spaces 83.8% vs 65.3%.Vaping (UQ vs NZ, 95% CI): ever 20.9% (19.8% to 22.1%) vs 37.6% (35.4% to 39.9%), current 1.8% (1.5% to 2.2%) vs 6.5% (5.4% to 7.7%) and daily 0.7% (0.5% to 1.0%) vs 2.5% (1.9% to 3.4%), and not vaping in indoor 91.4% vs 79.6% or outdoor smoke-free spaces 84.4% vs 71.3%. Of respondents, 71.7% (70.3% to 73.2%) vs 75.3% (72.9% to 77.6%) perceived e-cigarettes as less harmful than tobacco cigarettes.Men were more likely than women to smoke and vape, and to believe that e-cigarettes are less harmful. Regression models containing all predictors for smoking and vaping were significant and the effect of gender was significant for dual use, exclusive smoking and exclusive vaping (all p<0.01). Men had higher odds for smoking, vaping or dual use.ConclusionsResults suggest significant differences in patterns of smoking and vaping of university students in Australia and NZ, and a strong influence of gender on smoking and vaping.
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Fox, Kristen R., Amy K. Ferketich, Judith A. Groner, Joseph R. Rausch, Vidu Garg, Steven P. Neville, Victoria R. Grant, and Jamie L. Jackson. "450 Gender Differences in the Association of Impulsive Behavior and Susceptibility to E-cigarette Use among Adolescents with Congenital Heart Defects." Journal of Clinical and Translational Science 6, s1 (April 2022): 89. http://dx.doi.org/10.1017/cts.2022.263.
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OBJECTIVES/GOALS: Adolescents with congenital heart defects (CHD) have an elevated risk for future cardiovascular events, but information about their risk for e-cigarette use (“vaping”) is unknown. This study aims to present preliminary findings on gender differences in the association of impulsive behavior and vaping susceptibility from an ongoing investigation. METHODS/STUDY POPULATION: Adolescents with CHD (12-18 years; N=63) reported their vaping susceptibility and completed subjective (UPPS-P)/objective (Iowa Gambling Task; IGT) assessments of impulsive behavior previously associated with tobacco use. The UPPS-P includes 5 facets: 1) negative urgency (impulsivity under negative emotions), 2) positive urgency (impulsivity under positive emotions), 3) lack of premeditation (acting without thinking), 4) lack of perseverance (inability to focus), and 5) sensation seeking (seeking thrilling experiences). The IGT is a computerized task that creates conflict between immediate reward and delayed punishment via selections from advantageous/disadvantageous card decks. Linear regressions stratified by gender determined associations between vaping susceptibility and impulsivity. RESULTS/ANTICIPATED RESULTS: Nearly 30% (29.7%) of adolescents with CHD were susceptible to vaping. Negative urgency was associated with vaping susceptibility among females (β = 0.44, p = .035) but not males (β = 0.25, p = .128). Positive urgency was associated with vaping susceptibility among males (β = 0.37, p = .021) and trended toward significance among females (β = 0.40, p = .058). Lack of premeditation was associated with vaping susceptibility among males (β = 0.36, p = .025) but not females (β = 0.15, p = .490). The association between lack of perseverance and vaping susceptibility trended toward significance among males (β = 0.30, p = .064) but not females (β = -0.18, p = .413). IGT performance was not associated with susceptibility to vaping among either gender. UPPS-P facets and IGT performance were not significantly correlated. DISCUSSION/SIGNIFICANCE: The association of impulsivity and vaping susceptibility appears to be characterized by emotion-based rash action (positive/negative urgency) for females and by decreased conscientiousness (lack of premeditation/perseverance) for males. If replicated, the findings have implications for assessment of vaping risk and tailored intervention.
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Opondo, Charles, Siân Harrison, Fiona Alderdice, Claire Carson, and Maria A. Quigley. "Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England." PLOS ONE 16, no. 6 (June 4, 2021): e0252817. http://dx.doi.org/10.1371/journal.pone.0252817.
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Objectives Exposure to tobacco products during pregnancy presents a potential harm to both mother and baby. This study sought to estimate the prevalence of vaping during pregnancy and to explore the factors and outcomes associated with vaping in pregnancy. Setting England. Participants Women who gave birth between 15th and 28th October 2017. Methods A cross-sectional population-based postal survey of maternal and infant health, the National Maternity Survey (NMS) 2018. The prevalence of vaping and patterns of cigarette smoking were estimated, and regression analysis was used to explore associations between maternal characteristics and vaping, and between vaping and birth outcomes. Outcome measures Unweighted and weighted prevalence of vaping with 95% confidence intervals, and unadjusted and adjusted relative risks or difference in means for the association of participant characteristics and secondary outcomes with vaping. Secondary outcome measures were: preterm birth, gestational age at birth, birthweight, and initiation and duration of breastfeeding. Results A total of 4,509 women responded to the survey. The prevalence of vaping in pregnancy was 2.8% (95%CI 2.4% to 3.4%). This varied according to the pattern of cigarette smoking in pregnancy: 0.3% in never-smokers; 3.3% in ex-smokers; 7.7% in pregnancy-inspired quitters; 9.5% in temporary quitters; and 17.7% in persistent smokers. Younger women, unmarried women, women with fewer years of formal education, women living with a smoker, and persistent smokers were more likely to vape, although after adjusting for pattern of cigarette smoking and maternal characteristics, persistent smoking was the only risk factor. We did not find any association between vaping and preterm birth, birthweight, or breastfeeding. Conclusions The prevalence of vaping during pregnancy in the NMS 2018 was low overall but much higher in smokers. Smoking was the factor most strongly associated with vaping. Co-occurrence of vaping with persistent smoking has the potential to increase the harms of tobacco exposure in pregnant women and their infants.
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Blackwell, Anna K. M., Daina Kosīte, Theresa M. Marteau, and Marcus R. Munafò. "Policies for Tobacco and E-Cigarette Use: A Survey of All Higher Education Institutions and NHS Trusts in England." Nicotine & Tobacco Research 22, no. 7 (October 5, 2019): 1235–38. http://dx.doi.org/10.1093/ntr/ntz192.
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Abstract Introduction There is an absence of evidence regarding the impact of treating tobacco smoking and vaping equivalently in workplace policies. We aimed to describe and compare smoking and vaping policies in acute nonspecialist NHS Trusts (n = 131) and Higher Education Institutions (HEIs) (n = 131) in England. Methods We conducted a census of smoking and vaping policies through organizational websites searches and direct requests for information. We recorded whether and where smoking and vaping were permitted. Results Smoking was prohibited indoors in all organizations. No NHS Trust permitted smoking freely outdoors, in contrast with 60% of HEIs. In 27% of NHS Trusts and 33% of HEIs smoking was permitted in designated areas, while in 73% of NHS Trusts and 8% of HEIs smoking was prohibited anywhere on site. Vaping was prohibited indoors in all NHS Trusts and all but one HEI, but permitted freely outdoors in 18% of NHS Trusts and 75% of HEIs. Vaping was permitted in designated outdoor spaces in 23% of NHS Trusts: 21% had areas shared with smokers; 2% had separate vaping areas. Vaping was permitted in designated outdoor areas in 18% of HEIs, all of which were shared with smokers. Vaping was prohibited anywhere on site in 54% of NHS Trusts and 6% of HEIs. Conclusions Policies vary considerably in whether vaping and smoking are treated equivalently. Smoking policies in most HEIs should be reviewed to include more effective tobacco control approaches. Evidence is needed on the impact of imposing shared or separate spaces on vapers and smokers. Implications This report provides a comprehensive review of smoking and vaping policies in two types of organization across England. It highlights key discrepancies between current public health recommendations for vaping and existing workplace policies, which often lead to smokers and vapers sharing spaces. The report identifies the need for evidence on the impact of imposing shared spaces on smokers and vapers to inform workplace policies that maximize public health benefit.
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Janmohamed, Kamila, Abdul-Nasah Soale, Laura Forastiere, Weiming Tang, Yongjie Sha, Jakob Demant, Edoardo Airoldi, and Navin Kumar. "Intersection of the Web-Based Vaping Narrative With COVID-19: Topic Modeling Study." Journal of Medical Internet Research 22, no. 10 (October 30, 2020): e21743. http://dx.doi.org/10.2196/21743.
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Background The COVID-19 outbreak was designated a global pandemic on March 11, 2020. The relationship between vaping and contracting COVID-19 is unclear, and information on the internet is conflicting. There is some scientific evidence that vaping cannabidiol (CBD), an active ingredient in cannabis that is obtained from the hemp plant, or other substances is associated with more severe manifestations of COVID-19. However, there is also inaccurate information that vaping can aid COVID-19 treatment, as well as expert opinion that CBD, possibly administered through vaping, can mitigate COVID-19 symptoms. Thus, it is necessary to study the spread of inaccurate information to better understand how to promote scientific knowledge and curb inaccurate information, which is critical to the health of vapers. Inaccurate information about vaping and COVID-19 may affect COVID-19 treatment outcomes. Objective Using structural topic modeling, we aimed to map temporal trends in the web-based vaping narrative (a large data set comprising web-based vaping chatter from several sources) to indicate how the narrative changed from before to during the COVID-19 pandemic. Methods We obtained data using a textual query that scanned a data pool of approximately 200,000 different domains (4,027,172 documents and 361,100,284 words) such as public internet forums, blogs, and social media, from August 1, 2019, to April 21, 2020. We then used structural topic modeling to understand changes in word prevalence and semantic structures within topics around vaping before and after December 31, 2019, when COVID-19 was reported to the World Health Organization. Results Broadly, the web-based vaping narrative can be organized into the following groups or archetypes: harms from vaping; Vaping Regulation; Vaping as Harm Reduction or Treatment; and Vaping Lifestyle. Three archetypes were observed prior to the emergence of COVID-19; however, four archetypes were identified post–COVID-19 (Vaping as Harm Reduction or Treatment was the additional archetype). A topic related to CBD product preference emerged after COVID-19 was first reported, which may be related to the use of CBD by vapers as a COVID-19 treatment. Conclusions Our main finding is the emergence of a vape-administered CBD treatment narrative around COVID-19 when comparing the web-based vaping narratives before and during the COVID-19 pandemic. These results are key to understanding how vapers respond to inaccurate information about COVID-19, optimizing treatment of vapers who contract COVID-19, and possibly minimizing instances of inaccurate information. The findings have implications for the management of COVID-19 among vapers and the monitoring of web-based content pertinent to tobacco to develop targeted interventions to manage COVID-19 among vapers.
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Borchert, Dietmar H., Hagen Kelm, Meghan Morean, and Andrea Tannapfel. "Reporting of pneumothorax in association with vaping devices and electronic cigarettes." BMJ Case Reports 14, no. 12 (December 2021): e247844. http://dx.doi.org/10.1136/bcr-2021-247844.
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Vaping may lead to spontaneous pneumothorax, but there are few published reports on this phenomenon. We present a case of vaping-related pneumothorax and make recommendations for structured reporting of this emerging cause for pneumothorax. A normal-weight 34-year-old male presented to our emergency department with dyspnoea and back pain increasing over 24 hours. Chest X-ray showed a large right-sided pneumothorax. Three years ago, he had quit smoking cigarettes and switched to vaping. CT scan revealed bullae, and the patient received apical lung resection. Histology revealed mild alveolitis. Vaping is an emerging cause of lung injury. This report demonstrates a potential association between vaping and pneumothorax. However, structured reporting and future research are needed to establish a definitive (or causal) relationship between vaping and pneumothorax.
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Chadi, Nicholas, Ellie Vyver, and Richard E. Bélanger. "Protecting children and adolescents against the risks of vaping." Paediatrics & Child Health 26, no. 6 (September 17, 2021): 358–65. http://dx.doi.org/10.1093/pch/pxab037.
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Abstract Youth vaping presents significant risks for the health and safety of Canadian children and adolescents. This statement provides background information about vaping, vaping products, and related devices, discusses the short- and long-term harms known to be associated with their use, and offers prevention and cessation strategies for youth who vape or are at risk for starting. Youth vaping is associated with increased risk for tobacco and other substance use, mental health problems, pulmonary and cardiovascular disease, and unintentional injuries. Vaping should not be used as a smoking cessation tool for youth, due to lack of effectiveness and evidence of harm. Many preventive and treatment strategies used for tobacco cessation, including behavioural and pharmacological options, can be adapted to help youth quit vaping. Recommendations for community stakeholders and policy makers are included.
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Xie, Zidian, Jinlong Ruan, Yifan Jiang, Bokai Zhang, Tianlang Chen, Jiebo Luo, and Dongmei Li. "Potential Impact of FDA Flavor Enforcement Policy on Vaping Behavior on Twitter." International Journal of Environmental Research and Public Health 19, no. 19 (October 7, 2022): 12836. http://dx.doi.org/10.3390/ijerph191912836.
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In January 2020, the FDA announced an electronic cigarette (e-cigarette) flavor enforcement policy to restrict the sale of all unauthorized cartridge-based flavored e-cigarettes except tobacco and menthol flavors, which was implemented on 6 February 2020. This study aimed to understand the potential influence of this policy on one vaping behavior change—quitting vaping—using Twitter data. Twitter posts (tweets) related to e-cigarettes were collected between June 2019 and October 2020 through a Twitter streaming API. Based on the geolocation and keywords related to quitting vaping, tweets mentioning quitting vaping from the US were filtered. The demographics (age and gender) of Twitter users who mentioned quitting vaping were further inferred using a deep learning algorithm (deepFace). The proportion of tweets and Twitter users mentioning quitting vaping were compared between before and after the announcement and implementation of the flavor policy. Compared to before the FDA flavor policy, the proportion of tweets (from 0.11% to 0.20% and 0.24%) and Twitter users (from 0.15% to 0.70% and 0.86%) mentioning quitting vaping were significantly higher after the announcement and implementation of the policy (p-value < 0.001). In addition, there was an increasing trend in the proportion of female and young adults (18–35 years old) mentioning quitting vaping on Twitter after the announcement and implementation of the policy compared to that before the policy. Our results showed that the FDA flavor enforcement policy did have a positive impact on quitting vaping on Twitter. Our study provides an initial evaluation of the potential influence of the FDA flavor enforcement policy on user vaping behavior.
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Chadi, Nicholas, Claudia Minato, and Richard Stanwick. "Cannabis vaping: Understanding the health risks of a rapidly emerging trend." Paediatrics & Child Health 25, Supplement_1 (June 2020): S16—S20. http://dx.doi.org/10.1093/pch/pxaa016.
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Abstract The rapid emergence of youth vaping has completely changed the landscape of adolescent substance use in Canada and has become a pressing public health issue of our time. While nicotine remains the most common substance encountered in vaping devices, cannabis vaping is now reported by one-third of youth who vape. Though cannabis vaping is thought to generate fewer toxic emissions than cannabis smoking, it has been associated with several cases of acute lung injury and often involves high-potency forms of cannabis, exposing youth to several acute and long-term health risks. The low perceived riskiness of cannabis as a substance and of vaping as a mode of consumption may bring a false sense of security and be particularly appealing for youth who may be looking for a ‘healthier way’ to use substances. While research is still lacking on how best to support youth who may have already initiated cannabis vaping, concerted efforts among paediatric providers, public health experts, schools, communities, and families are urgently needed to limit the spread of cannabis vaping among Canadian youth.
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Noar, Seth M., Nisha C. Gottfredson, Talia Kieu, Jacob A. Rohde, Marissa G. Hall, Haijing Ma, Nicholas J. Fendinger, and Noel T. Brewer. "Impact of Vaping Prevention Advertisements on US Adolescents." JAMA Network Open 5, no. 10 (October 13, 2022): e2236370. http://dx.doi.org/10.1001/jamanetworkopen.2022.36370.
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ImportanceUnderstanding whether prevention advertisements reduce susceptibility to vaping is important owing to concerning levels of adolescent vaping.ObjectiveTo examine whether vaping prevention advertisements from the US Food and Drug Administration (FDA) national Real Cost campaign lead to lower susceptibility to vaping among adolescents.Design, Setting, and ParticipantsFor this 3-group randomized clinical trial with parallel assignment, participants were US adolescents aged 13 to 17 years who were susceptible to vaping or current e-cigarette users, recruited from online panels. Adolescents were randomized to 1 of 2 Real Cost vaping prevention trial groups (health harms– or addiction-themed advertisements) or to a control group (investigator-created neutral videos about vaping). Adolescents completed 4 weekly online surveys at visits 1 to 4 over a 3-week period. Data were analyzed from December 1, 2021, to August 25, 2022.InterventionsAdolescents saw 3 randomly ordered 30-second video advertisements online at each of 3 weekly study visits (visits 1, 2, and 3).Main Outcomes and MeasuresThe primary trial outcome was susceptibility to vaping. Surveys also assessed susceptibility to smoking cigarettes to examine any spillover effects of vaping prevention advertisements on smoking outcomes. Both susceptibility measures had 3 items and ranged from 1 (indicating not susceptible) to 4 (indicating highly susceptible). The primary analyses compared Real Cost groups (combined) with the control group, while exploratory analyses compared the Real Cost groups with each other.ResultsParticipants were 1514 adolescents (1140 [75.3%] boys; mean [SD] age, 15.22 [1.18] years), including 504 randomized to the Real Cost health harms group, 506 randomized to the Real Cost addiction group, and 504 randomized to the control group. Adolescents in the Real Cost groups (combined) had lower susceptibility to vaping at visit 4 than those in the control group (b = −0.21; 95% CI, −0.32 to −0.10). The Real Cost groups did not differ from one another on susceptibility to vaping (visit 4: b = −0.05; 95% CI, −0.17 to 0.07). Adolescents in the Real Cost groups (combined) also had lower susceptibility to smoking cigarettes than those in the control group (b = −0.21; 95% CI, −0.32 to −0.10). For both vaping and smoking, Real Cost groups had less positive attitudes (vaping: b = −0.27; 95% CI, −0.40 to −0.14; smoking: b = −0.23; 95% CI, −0.39 to −0.08) compared with the control group.Conclusions and RelevanceThese findings suggest that vaping prevention advertisements from the FDA Real Cost campaign led to lower adolescent susceptibility to vaping and had beneficial spillover effects on cigarette smoking outcomes. Tobacco prevention campaigns can help reduce youth tobacco use.Trial RegistrationClinicalTrials.gov Identifier: NCT04836455
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Gravely, Shannon, Gang Meng, K. Michael Cummings, Andrew Hyland, Ron Borland, David Hammond, Richard J. O’Connor, et al. "Changes in Smoking and Vaping over 18 Months among Smokers and Recent Ex-Smokers: Longitudinal Findings from the 2016 and 2018 ITC Four Country Smoking and Vaping Surveys." International Journal of Environmental Research and Public Health 17, no. 19 (September 27, 2020): 7084. http://dx.doi.org/10.3390/ijerph17197084.
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This descriptive study of smokers (smoked at least monthly) and recent ex-smokers (quit for ≤2 years) examined transitions over an 18 month period in their smoking and vaping behaviors. Data are from Waves 1 (W1: 2016) and 2 (W2: 2018) of the ITC Four Country Smoking and Vaping Survey, a cohort study of adult (≥18+) smokers, concurrent users (smoke and vape), and recent ex-smokers from Australia, Canada, England, and the United States (US). Respondents (N = 5016) were classified according to their smoking and vaping status, which resulted in eight subgroups: (1) exclusive daily smokers (2) exclusive non-daily smokers; (3–6) concurrent users (subdivided into four groups by each combination of daily/non-daily smoking and daily/non-daily vaping); (7) ex-smokers who vape; (8) ex-smokers not vaping. The analyses focused first on describing changes between groups from W1 to W2. Second, transition outcomes were assessed based on changes in smoking and vaping between W1 and W2. Transitions focused on smoking were: no change in smoking (continued smoking at the same frequency); decreased smoking; increased smoking; discontinued smoking; relapsed (ex-smokers at W1 who were smoking at W2). Transitions focused on vaping were: initiated vaping; switched from smoking to vaping. Overall, this study found that the vast majority of smokers were smoking 18 months later. Non-daily smokers were more likely than daily smokers to have discontinued smoking (p < 0.0001) and to have switched to exclusive vaping (p = 0.034). Exclusive non-daily smokers were more likely than exclusive daily smokers to have initiated vaping (p = 0.04). Among all W1 daily smokers, there were no differences in discontinued smoking between daily smokers who vaped (concurrent users) and exclusive daily smokers; however, concurrent users were more likely than exclusive daily smokers to have decreased to non-daily smoking (p < 0.001) or to have switched to vaping by W2 (p < 0.001). Among all W1 non-daily smokers, there were no significant differences in increased smoking or discontinued smoking between concurrent users or exclusive smokers. Most ex-smokers remained abstinent from smoking, and there was no difference in relapse back to smoking between those who vaped and those who did not.
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Martínez, Úrsula, Víctor Martínez-Loredo, Vani N. Simmons, Lauren R. Meltzer, David J. Drobes, Karen O. Brandon, Amanda M. Palmer, et al. "How Does Smoking and Nicotine Dependence Change After Onset of Vaping? A Retrospective Analysis of Dual Users." Nicotine & Tobacco Research 22, no. 5 (March 18, 2019): 764–70. http://dx.doi.org/10.1093/ntr/ntz043.
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Abstract Introduction Although some smokers switch to exclusive use of electronic cigarettes (e-cigarettes), others become dual users of combustible cigarettes and e-cigarettes. Little is known about how the onset of vaping affects the use of and dependence on combustible cigarettes or total nicotine use and dependence, which may influence health-related and cessation outcomes. Using self-report data of current combustible and e-cigarette use and retrospective recall of pre-vaping smoking in a sample of dual users, the aims of this study were (1) to compare pre- and post-vaping number of cigarettes per day and combustible cigarette dependence; (2) to compare pre- and post-vaping total nicotine use frequency (number of vaping sessions and cigarettes smoked per day), and total nicotine dependence; and (3) to examine predictors of nicotine dependence. Methods We used baseline data from a smoking cessation trial with 2896 dual users. Nicotine use frequency and the Heaviness of Smoking Index were used as measures of nicotine use and dependence, respectively. Results Participants decreased cigarettes/day from pre- (M = 19.24, SD = 9.01) to post-vaping (M = 11.15, SD = 8.02, p < .0001) and combustible cigarette dependence declined from pre- (M = 3.55, SD = 1.51) to post-vaping (M = 2.11, SD = 1.60, p < .0001). Total daily nicotine use frequency increased after initiating vaping (M = 19.25, SD = 9.01 vs. M = 29.46, SD = 8.61; p < .0001), as did total nicotine dependence (M = 3.55, SD = 1.51 vs. M = 4.68, SD = 1.38; p < .0001). Hierarchical regression analyses indicated that variables associated with greater overall nicotine dependence included: younger age, lower education, more years smoking, higher pre-vaping nicotine dependence, using e-cigarettes more days per month, more puffs per vaping session, higher e-liquid nicotine concentration, and longer vaping history. Conclusions Dual use leads to a reduction in the number of combustible cigarettes, but total nicotine use and dependence increases. Implications In dual users, a reduction in smoking following onset of vaping may offer some harm reduction via reduction in cigarette intake. However, the increase in total nicotine use and dependence could affect the ability to quit either or both products.