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Special Issue "Electronic Cigarette Use and Public Health"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: 15 December 2017

Special Issue Editors

Guest Editor
Dr. Konstantinos Farsalinos

Department of Cardiology, Onassis Cardiac Surgery Center, Sygrou 356, Kallithea 17674, Greece
Website | E-Mail
Phone: +306977454837
Interests: electronic cigarettes; tobacco harm reduction; cardiovascular imaging
Guest Editor
Prof. Dr. Walton Sumner

Department of Internal Medicine, School of Medicine, Washington University School of Medicine
Website | E-Mail

Special Issue Information

Dear Colleagues,

Electronic cigarettes continue to gain popularity and acceptance by consumers, but the public health community is divided on the potential benefits or adverse effects from their use. Contradictory opinions on safety/risk assessment and population effects dominate the discussion. Despite all this, research on electronic cigarettes is intense and continuously growing. Important issues to be addressed include characterizing aerosol chemistry and the risk difference compared to smoking, improving the quality of products, assessing population effects in both adults and youth, evaluating the impact on the smoking status of users, examining use by never-smokers, and, of course, defining appropriate regulatory decisions since they are expected to affect population perceptions, acceptability and adoption of use. Additional issues such as the proper definition of current use and dual use, and the importance of determining frequency of use are vital in assessing the overall population effects. Electronic cigarettes remain an exciting field of research.

The International Journal of Environmental Research and Public Health invited me to be the Guest Editor for this Special Issue, titled “Electronic Cigarette Use and Public Health”. I invite you to submit your research, analyses and opinion, in order to better understand and explore the e-cigarette phenomenon, and advance the scientific debate and knowledge.

Dr. Konstantinos Farsalinos
Prof. Dr. Walton Sumner
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Electronic cigarettes
  • Public Health
  • Nicotine
  • Tobacco
  • Smoking

Published Papers (9 papers)

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Research

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Open AccessArticle Quit Methods Used by American Smokers, 2013–2014
Int. J. Environ. Res. Public Health 2017, 14(11), 1403; doi:10.3390/ijerph14111403
Received: 4 October 2017 / Revised: 2 November 2017 / Accepted: 15 November 2017 / Published: 17 November 2017
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Abstract
This report describes the quit methods used in the past 12 months by current and former smokers in the baseline Population Assessment of Tobacco and Health (PATH) Study during 2013–2014. Descriptive statistics were used to report the use of single and two or
[...] Read more.
This report describes the quit methods used in the past 12 months by current and former smokers in the baseline Population Assessment of Tobacco and Health (PATH) Study during 2013–2014. Descriptive statistics were used to report the use of single and two or more quit methods; survey weights were used to compute population estimates. Logistic regression was used to estimate the association between past year former smokers and single quit method, including individual characteristics. Results: Of 11,402 current smokers and 4919 former smokers, 4541 had tried and 839 had quit in the past 12 months. Unaided quit attempts were the most common; the number was almost as high as all single methods combined (n = 1797 and n = 1831 respectively). The most frequently used single method was help from friends and family (n = 676) followed by e-cigarettes (n = 587). Use of e-cigarettes was the only method with higher odds of users being a former smoker than unaided attempts (OR = 1.42, 95% CI 1.12–1.81). Current use of e-cigarettes among current (34%) and former (54%) smokers was significantly higher than current use of nicotine replacement therapy (NRT). Conclusions: In 2013–2014 e-cigarettes were used by American adult smokers as quit-smoking aids more frequently than NRT products or prescription drugs. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
Open AccessArticle Electronic Cigarette Use in Students and Its Relation with Tobacco-Smoking: A Cross-Sectional Analysis of the i-Share Study
Int. J. Environ. Res. Public Health 2017, 14(11), 1345; doi:10.3390/ijerph14111345
Received: 7 August 2017 / Revised: 30 October 2017 / Accepted: 2 November 2017 / Published: 5 November 2017
PDF Full-text (528 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
While young adults often try e-cigarettes, little is known about its use and the reasons for experimentation, particularly in relation with tobacco-smoking. In 2016, data were collected from 2720 French-speaking students participating in a web-based study on students’ health: the internet-based Students Health
[...] Read more.
While young adults often try e-cigarettes, little is known about its use and the reasons for experimentation, particularly in relation with tobacco-smoking. In 2016, data were collected from 2720 French-speaking students participating in a web-based study on students’ health: the internet-based Students Health Research Enterprise (i-Share) project. Univariate analyses and multivariable logistic regressions were performed to study the relationship between e-cigarette use and smoking status. Two out of five students declared having tried e-cigarettes and 3.6% were current users. Former smokers were more likely than current smokers to use e-cigarettes currently. Among those who had never smoked, 13.5% had tried e-cigarettes. Very few (0.3%) were current users, alternating e-liquids with and without nicotine. The three main reasons for trying e-cigarettes were curiosity, offer to try by someone, and attractiveness of e-liquid flavors. Among current smokers, previous attempts to quit smoking and a strong desire to stop tobacco were reported more in e-cigarette current users than in former users. In this large sample of French students, findings were consistent with the possibility that e-cigarettes might be used as smoking cessation or reduction aids by some young adults whereas other young never-smokers could be exposed to nicotine. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
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Open AccessArticle Symptoms during Adolescents’ First Use of Cigarettes and E-Cigarettes: A Pilot Study
Int. J. Environ. Res. Public Health 2017, 14(10), 1260; doi:10.3390/ijerph14101260
Received: 7 August 2017 / Revised: 11 October 2017 / Accepted: 16 October 2017 / Published: 20 October 2017
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Abstract
Symptoms adolescents experience during their first time using a cigarette predict their current use, but little is known regarding the symptoms experienced during first e-cigarette use. We conducted a pilot study to understand the symptoms adolescents experience when they first tried cigarettes and
[...] Read more.
Symptoms adolescents experience during their first time using a cigarette predict their current use, but little is known regarding the symptoms experienced during first e-cigarette use. We conducted a pilot study to understand the symptoms adolescents experience when they first tried cigarettes and e-cigarettes and the associations between these symptoms and current use. Participants were 41 adolescents in two U.S. cities who had tried cigarettes or e-cigarettes. We asked adolescents to recall the symptoms they experienced during their first cigarette or e-cigarette and categorized symptoms as negative (felt bad, coughing/chest pain, bad taste, upset stomach, dizzy/lightheaded) or positive (felt relaxed, rush/buzz). Adolescents reported fewer negative symptoms for first e-cigarette than first cigarette use (all p < 0.05). Current cigarette smoking was associated with endorsing fewer negative symptoms (OR = 0.49, 95% CI = [0.25, 0.95]) and more positive symptoms (OR = 7.11, 95% CI = [1.47, 34.33]) at first cigarette use. First e-cigarette use symptoms were not associated with current e-cigarette use. Adolescents reported fewer negative symptoms from first e-cigarette than from first cigarette, and e-cigarette symptoms did not influence use as they do for cigarettes. Additional research is needed to confirm these findings in longitudinal studies. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
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Open AccessArticle A Novel Vaping Machine Dedicated to Fully Controlling the Generation of E-Cigarette Emissions
Int. J. Environ. Res. Public Health 2017, 14(10), 1225; doi:10.3390/ijerph14101225
Received: 28 July 2017 / Revised: 5 October 2017 / Accepted: 6 October 2017 / Published: 14 October 2017
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Abstract
The accurate study of aerosol composition and nicotine release by electronic cigarettes is a major issue. In order to fully and correctly characterize aerosol, emission generation has to be completely mastered. This study describes an original vaping machine named Universal System for Analysis
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The accurate study of aerosol composition and nicotine release by electronic cigarettes is a major issue. In order to fully and correctly characterize aerosol, emission generation has to be completely mastered. This study describes an original vaping machine named Universal System for Analysis of Vaping (U-SAV), dedicated to vaping product study, enabling the control and real-time monitoring of applied flow rate and power. Repeatability and stability of the machine are demonstrated on flow rate, power regulation and e-liquid consumption. The emission protocol used to characterize the vaping machine is based on the AFNOR-XP-D90-300-3 standard (15 W power, 1 Ω atomizer resistance, 100 puffs collected per session, 1.1 L/min airflow rate). Each of the parameters has been verified with two standardized liquids by studying mass variations, power regulation and flow rate stability. U-SAV presents the required and necessary stability for the full control of emission generation. The U-SAV is recognised by the French association for standardization (AFNOR), European Committee for Standardization (CEN) and International Standards Organisation (ISO) as a vaping machine. It can be used to highlight the influence of the e-liquid composition, user behaviour and nature of the device, on the e-liquid consumption and aerosol composition. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
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Open AccessFeature PaperArticle The Prevalence and Characteristics of E-Cigarette Users in the U.S.
Int. J. Environ. Res. Public Health 2017, 14(10), 1200; doi:10.3390/ijerph14101200
Received: 4 July 2017 / Revised: 23 September 2017 / Accepted: 6 October 2017 / Published: 11 October 2017
PDF Full-text (318 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Studies have examined the characteristics of individuals who use e-cigarettes, including sociodemographic and smoking characteristics, and the relationship of e-cigarette use to tobacco control policies. While most studies consider a subset of these characteristics with weak measures of regular e-cigarette use, this study
[...] Read more.
Studies have examined the characteristics of individuals who use e-cigarettes, including sociodemographic and smoking characteristics, and the relationship of e-cigarette use to tobacco control policies. While most studies consider a subset of these characteristics with weak measures of regular e-cigarette use, this study uses a large, recent U.S. survey to simultaneously consider the association of each of these factors with different use measures. Data from the May 2014 Tobacco Use Supplement-Current Population Survey is supplemented with information on tobacco control policies. The prevalence of ever, current (at least 1 of the last 30 days), and regular (at least 20 of the last 30 days) e-cigarette use were 7.7%, 2.1% and 0.9%, implying that 27.0% of ever users were current users of which 45.3% were regular users. E-cigarette use varied by socio-demographic characteristics and by smoking status, and depended on the measure of use adopted. However, regardless of measures, e-cigarette use was higher among those smokers who smoked more cigarettes. The association with policies was generally weak, but we found more regular use by smokers in low tax and low tobacco control spending states. The results indicate that the user characteristics differ depending on the e-cigarette use measure. The measure of use should be carefully considered in analyzing how e-cigarette use affects cigarette use. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
Open AccessArticle Young People’s Use of E-Cigarettes across the United Kingdom: Findings from Five Surveys 2015–2017
Int. J. Environ. Res. Public Health 2017, 14(9), 973; doi:10.3390/ijerph14090973
Received: 2 August 2017 / Revised: 18 August 2017 / Accepted: 23 August 2017 / Published: 29 August 2017
Cited by 1 | PDF Full-text (935 KB) | HTML Full-text | XML Full-text
Abstract
Concern has been expressed about the use of e-cigarettes among young people. Our study reported e-cigarette and tobacco cigarette ever and regular use among 11–16 year olds across the UK. Data came from five large scale surveys with different designs and sampling strategies
[...] Read more.
Concern has been expressed about the use of e-cigarettes among young people. Our study reported e-cigarette and tobacco cigarette ever and regular use among 11–16 year olds across the UK. Data came from five large scale surveys with different designs and sampling strategies conducted between 2015 and 2017: The Youth Tobacco Policy Survey; the Schools Health Research Network Wales survey; two Action on Smoking and Health (ASH) Smokefree Great Britain-Youth Surveys; and the Scottish Schools Adolescent Lifestyle and Substance Use Survey. Cumulatively these surveys collected data from over 60,000 young people. For 2015/16 data for 11–16 year olds: ever smoking ranged from 11% to 20%; regular (at least weekly) smoking between 1% and 4%; ever use of e-cigarettes 7% to 18%; regular (at least weekly) use 1% to 3%; among never smokers, ever e-cigarette use ranged from 4% to 10% with regular use between 0.1% and 0.5%; among regular smokers, ever e-cigarette use ranged from 67% to 92% and regular use 7% to 38%. ASH surveys showed a rise in the prevalence of ever use of e-cigarettes from 7% (2016) to 11% (2017) but prevalence of regular use did not change remaining at 1%. In summary, surveys across the UK show a consistent pattern: most e-cigarette experimentation does not turn into regular use, and levels of regular use in young people who have never smoked remain very low. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
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Open AccessArticle Online Vape Shop Customers Who Use E-Cigarettes Report Abstinence from Smoking and Improved Quality of Life, But a Substantial Minority Still Have Vaping-Related Health Concerns
Int. J. Environ. Res. Public Health 2017, 14(7), 798; doi:10.3390/ijerph14070798
Received: 8 May 2017 / Revised: 28 June 2017 / Accepted: 12 July 2017 / Published: 17 July 2017
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Abstract
(1) Background: Characteristics and usage patterns of vapers (e-cigarette users) have mainly been studied in web-based convenience samples or in visitors of brick-and-mortar vape shops. We extended this by targeting customers of one particular online vape shop in the Netherlands; (2) Methods: Customers
[...] Read more.
(1) Background: Characteristics and usage patterns of vapers (e-cigarette users) have mainly been studied in web-based convenience samples or in visitors of brick-and-mortar vape shops. We extended this by targeting customers of one particular online vape shop in the Netherlands; (2) Methods: Customers were questioned on their smoking history, current smoking and vaping status, reasons for vaping, perceived harmfulness, and potential health changes due to vaping; (3) Results: Almost everyone (99%, 95% CI 0.96, 1.00) smoked before they started vaping. A great majority agreed that unlike with other smoking-cessation aids, they could quit smoking (81%, 95% CI 0.79, 0.90) due to vaping. Almost all customers were regular vapers (93.6%, 95% CI 0.89, 0.96) who used state-of-the-art open system devices without modifications and e-liquid with 10 mg/mL nicotine on average. Vapers reported using e-cigs to quit smoking, because e-cigs are healthier, and for financial reasons. The majority (52.6%, 95% CI 0.46, 0.60) perceived vaping as not that harmful to not harmful at all, but one fifth (21.8%, 95% CI 0.16, 0.28) believed vaping to be harmful. More than half (57.8%, 95% CI 0.50, 0.65) reported gaining more pleasure from vaping than from smoking. A substantial majority (84.2%, 95% CI 0.78, 0.89) agreed that their health had improved since they started vaping; (4) Conclusions: Findings are similar to those obtained in other vape shop studies, but also to the results of convenience samples of less-well-defined populations. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
Open AccessArticle Why Don’t More Smokers Switch to Using E-Cigarettes: The Views of Confirmed Smokers
Int. J. Environ. Res. Public Health 2017, 14(6), 647; doi:10.3390/ijerph14060647
Received: 21 April 2017 / Revised: 8 June 2017 / Accepted: 13 June 2017 / Published: 16 June 2017
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Abstract
Whilst e-cigarettes have been characterised by Public Health England as being around 95% less harmful than combustible tobacco products, only a minority of current smokers (around 16% within the UK) are using these devices. In this paper we report the results of an
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Whilst e-cigarettes have been characterised by Public Health England as being around 95% less harmful than combustible tobacco products, only a minority of current smokers (around 16% within the UK) are using these devices. In this paper we report the results of an online survey of 650 smokers in contact with a smokers’ rights group in the UK. A total of 91% of the smokers surveyed were smoking on a daily basis. Fifty nine percent reported having used electronic nicotine delivery systems, the majority of whom reported having used e-cigarettes. Those smokers that had not used these devices principally explained this in terms of the pleasure they derived from smoking. The features smokers’ liked most about e-cigarette had to do with the range of settings in which they could be used, the lack of an offensive smell associated with their use, the available flavours and the reduced level of harm. The elements which smokers liked least about e-cigarettes had to do with the vaping experience, the technology, the chemical nature of e-liquids and the complex technology that was associated with these devices. If a greater number of smokers are to be encouraged to take up e-cigarettes, it will be necessary not only to convey accurate information on the relative harm of these devices (compared to combustible tobacco products), but to ensure that they are able to be used in a wider range of settings than those within which smoking can currently occur and that the vaping experience more closely resembles the smoking experience. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)

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Open AccessBrief Report Generally Recognized as Safe: Uncertainty Surrounding E-Cigarette Flavoring Safety
Int. J. Environ. Res. Public Health 2017, 14(10), 1274; doi:10.3390/ijerph14101274
Received: 22 September 2017 / Revised: 17 October 2017 / Accepted: 21 October 2017 / Published: 23 October 2017
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Abstract
Despite scientific uncertainty regarding the relative safety of inhaling e-cigarette aerosol and flavorings, some consumers regard the U.S. Food and Drug Administration’s “generally recognized as safe” (GRAS) designation as evidence of flavoring safety. In this study, we assessed how college students’ perceptions of
[...] Read more.
Despite scientific uncertainty regarding the relative safety of inhaling e-cigarette aerosol and flavorings, some consumers regard the U.S. Food and Drug Administration’s “generally recognized as safe” (GRAS) designation as evidence of flavoring safety. In this study, we assessed how college students’ perceptions of e-cigarette flavoring safety are related to understanding of the GRAS designation. During spring 2017, an online questionnaire was administered to college students. Chi-square p-values and multivariable logistic regression were employed to compare perceptions among participants considering e-cigarette flavorings as safe and those considering e-cigarette flavorings to be unsafe. The total sample size was 567 participants. Only 22% knew that GRAS designation meant that a product is safe to ingest, not inhale, inject, or use topically. Of participants who considered flavorings to be GRAS, the majority recognized that the designation meant a product is safe to ingest but also considered it safe to inhale. Although scientific uncertainty on the overall safety of flavorings in e-cigarettes remains, health messaging can educate the public about the GRAS designation and its irrelevance to e-cigarette safety. Full article
(This article belongs to the Special Issue Electronic Cigarette Use and Public Health)
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