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Special Issue "Tobacco Harm Reduction"

Special Issue Editors

Guest Editor
Assoc. Prof. Coral Gartner

School of Public Health, University of Queensland, Cnr Wyndham Street and Herston Road, Herston, QLD 4006, Australia
Website | E-Mail
Interests: tobacco control; tobacco harm reduction; alternative nicotine products; priority populations and health disparities; environmental health
Guest Editor
Dr. Ratika Sharma-Kumar

School of Public Health, University of Queensland, Cnr Wyndham Street and Herston Road, Herston, QLD 4006, Australia
Website | E-Mail
Interests: tobacco cessation; tobacco harm reduction; priority populations and health disparities; health communication; online social media; dental public health
Guest Editor
Dr. Kylie Morphett

School of Public Health, University of Queensland, Cnr Wyndham Street and Herston Road, Herston, QLD 4006, Australia
Website | E-Mail
Interests: tobacco control; health communication; smoking cessation; addiction beliefs; lay understandings of health and illness

Special Issue Information

Dear Colleagues,

Tobacco Harm Reduction has been a controversial area in public health, largely due to the promotion by the tobacco industry of cigarette modifications that gave the appearance of reduced harm, without reducing health risk. This may have increased overall harm by discouraging smokers from quitting. However, there is now good evidence that switching from cigarettes to some alternate nicotine and tobacco products can reduce exposure to harmful constituents and reduce health risk. The Swedish experience with snus, a form of oral snuff manufactured to limit the formation of carcinogenic nitrosamines, is an example of an alternate tobacco product with long-term epidemiological evidence to support its much lower risk profile. Newer products, such as e-cigarettes and other vaping devices and heated tobacco products are generating substantial interest. While this is a rapidly advancing research field, the recent National Academies of Science, Engineering and Medicine Report on the Public Health Consequences of E-cigarettes has identified a number of priority areas for research to help fill some of the gaps in evidence on these alternate nicotine and tobacco products. This Special Issue of IJERPH on Tobacco Harm Reduction welcomes submissions on these priority research areas and other research that advances our understanding of the potential place of tobacco harm reduction within a comprehensive strategy to reduce the burden of smoking related disease and assists policy makers to determine what level of regulation is most appropriate.

Assoc. Prof. Coral Gartner
Dr. Ratika Sharma-Kumar
Dr. Kylie Morphett
Guest Editors

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

  • tobacco harm reduction
  • e-cigarettes
  • vaporized nicotine products
  • nicotine
  • smokeless tobacco
  • snus
  • heated tobacco
  • biomarkers
  • secondhand exposure
  • substitution
  • harmful and potentially harmful constituents
  • emissions
  • relative risk
  • dual use

Published Papers (5 papers)

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Research

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Open AccessArticle The Value of Providing Smokers with Free E-Cigarettes: Smoking Reduction and Cessation Associated with the Three-Month Provision to Smokers of a Refillable Tank-Style E-Cigarette
Int. J. Environ. Res. Public Health 2018, 15(9), 1914; https://doi.org/10.3390/ijerph15091914
Received: 18 June 2018 / Revised: 25 August 2018 / Accepted: 29 August 2018 / Published: 3 September 2018
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Abstract
Despite the uptake of tobacco smoking declining in the United Kingdom (UK), smoking is still the leading cause of preventable poor health and premature death. While improved approaches to smoking cessation are necessary, encouraging and assisting smokers to switch by using substantially less
[...] Read more.
Despite the uptake of tobacco smoking declining in the United Kingdom (UK), smoking is still the leading cause of preventable poor health and premature death. While improved approaches to smoking cessation are necessary, encouraging and assisting smokers to switch by using substantially less toxic non-tobacco nicotine products may be a possible option. To date, few studies have investigated the rates of smoking cessation and smoking reduction that are associated with the provision of free electronic-cigarettes (e-cigarettes) to smokers. In this exploratory study, the Blu Pro e-cigarette was given to a convenience sample of adult smokers (n = 72) to assist them in reducing and quitting over a 90-day period. The rates of smoking abstinence and daily smoking patterns were assessed at baseline, 30 days, 60 days, and 90 days. The response rate was 87%. After 90 days, the complete abstinence rate was 36.5%, up from 0% at baseline. The frequency of daily smoking reduced from 88.7% to 17.5% (p < 0.001), and the median consumption of cigarettes/day reduced from 15 to five (p < 0.001). The median number of days per month that participants smoked also reduced from 30 to 13 after 90 days (p < 0.001). On the basis of these results, there may be value in smoking cessation services and other services ensuring that smokers are provided with e-cigarettes at zero or minimal costs for at least a short period of time. Full article
(This article belongs to the Special Issue Tobacco Harm Reduction)
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Open AccessArticle About One in Five Novice Vapers Buying Their First E-Cigarette in a Vape Shop Are Smoking Abstinent after Six Months
Int. J. Environ. Res. Public Health 2018, 15(9), 1886; https://doi.org/10.3390/ijerph15091886
Received: 16 July 2018 / Revised: 23 August 2018 / Accepted: 29 August 2018 / Published: 31 August 2018
PDF Full-text (1706 KB) | HTML Full-text | XML Full-text
Abstract
Background: E-cigarette use is rising with the majority of vapers purchasing their e-cigarettes in vape shops. We investigated the smoking/vaping trajectories and quit-smoking success rates of smokers deciding to start vaping for the first time and buying their e-cigarette in brick-and-mortar vape
[...] Read more.
Background: E-cigarette use is rising with the majority of vapers purchasing their e-cigarettes in vape shops. We investigated the smoking/vaping trajectories and quit-smoking success rates of smokers deciding to start vaping for the first time and buying their e-cigarette in brick-and-mortar vape shops in Flanders. Methods: Participants filled out questionnaires assessing smoking/vaping behaviour at three moments (intake, after three and six months) and smoking status was biochemically verified using eCO measurements. Results: Participants (n = 71) were regular smokers (MeCO-intake = 22 ppm), half of whom reported a motivation to quit smoking in the near future. Participants bought 3rd/4th generation e-cigarettes and e-liquid with a nicotine concentration averaging 7 mg/mL. A smoking reduction of 53% (17 cigarettes per day (CPD) at intake to 8 CPD after six months) was observed, whereas eCO decreased to 15 ppm. Eighteen percent of participants had quit smoking completely (eCO = 2 ppm), another 25% had at least halved CPD, whereas 57% had failed to reduce CPD by at least 50% (including 13% lost to follow-up). Quitters consumed more e-liquid than reducers and those who continued to smoke. Conclusions: Around one in five smoking customers buying their first e-cigarette in a brick-and-mortar vape shop had quit smoking completely after six months. Full article
(This article belongs to the Special Issue Tobacco Harm Reduction)
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Open AccessArticle Influence of Coil Power Ranges on the E-Liquid Consumption in Vaping Devices
Int. J. Environ. Res. Public Health 2018, 15(9), 1853; https://doi.org/10.3390/ijerph15091853
Received: 25 July 2018 / Revised: 20 August 2018 / Accepted: 21 August 2018 / Published: 28 August 2018
PDF Full-text (1589 KB) | HTML Full-text | XML Full-text
Abstract
As electronic cigarettes (e-cigarettes) represent a new constantly evolving product category, the systematic analysis of the developed devices and the e-liquid vaporization is challenging. Indeed, understanding how e-cigarettes work and the role of key parameters in the process are major issues. This work
[...] Read more.
As electronic cigarettes (e-cigarettes) represent a new constantly evolving product category, the systematic analysis of the developed devices and the e-liquid vaporization is challenging. Indeed, understanding how e-cigarettes work and the role of key parameters in the process are major issues. This work focuses on an experimental study of how the power supplied by the battery to the atomizer coil influences e-liquid consumption. The reproducibility and the repeatability of e-liquid consumption were investigated over 20 series of 20 puffs for one of the tested atomizers. Then, the reproducibility and the repeatability of the e-liquid consumption was investigated over five series of 20 puffs for each tested atomizer. The wire behavior according to the supplied power could be separated into three regimes: under-heating (insufficient power to generate an aerosol), optimal vaporization characterized by a linear trend (vaporization of the e-liquid proportional to the supplied energy) and over-heating (dry-burn occurs). Using a controllable and repeatable energy supply, the reproducibility of the quantity of vaporized e-liquid was verified for each of the five series of 20 puffs programed for all the atomizers except one. Finally, the influence of the supplied power on the vaporization and the consumption of the e-liquid as well as the optimal power ranges were investigated and discussed. The results showed that atomizers with resistance ranging from 1 Ω to 1.8 Ω are efficient using all the energy supplied by the battery to vaporize the e-liquid and reducing the energy lost in the cotton or in the metal part of atomizer coil. Full article
(This article belongs to the Special Issue Tobacco Harm Reduction)
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Open AccessArticle A Comparison of Dependence across Different Types of Nicotine Containing Products and Coffee
Int. J. Environ. Res. Public Health 2018, 15(8), 1609; https://doi.org/10.3390/ijerph15081609
Received: 6 July 2018 / Revised: 28 July 2018 / Accepted: 30 July 2018 / Published: 30 July 2018
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Abstract
Introduction: Few studies have compared the dependence to different tobacco and nicotine products. Even less is known about how it relates to dependence on other common drugs, e.g., caffeine. In this study degree of dependence was compared between snus, cigarettes, nicotine replacement (NR),
[...] Read more.
Introduction: Few studies have compared the dependence to different tobacco and nicotine products. Even less is known about how it relates to dependence on other common drugs, e.g., caffeine. In this study degree of dependence was compared between snus, cigarettes, nicotine replacement (NR), electronic cigarettes and coffee. Methods: A random sample of Swedish citizens belonging to an internet panel were contacted from September to October 2017. The responders were asked among other related things about their use of snus, NR, traditional cigarette or e-cigarette use and coffee consumption. The indicators of dependence used were: (A) the Heavy Smoking Index, (B) The proportions that used within 30 min after raising in the morning, (C) rating the first use in the morning as the most important and (D) Stating that it would be very hard to give up entirely. Results: Significantly fewer coffee drinkers started use within 30 min of awakening compared with all other products. The first use of the day was found to be more important for snus users compared with other products. On HSI there was no difference between snus and cigarettes. Snus and cigarettes were rated as being more difficult to give up than NR and coffee. Conclusion: Dependence to traditional cigarettes and snus seem to be relatively similar while NR was rated lower and coffee lowest. Since the prevalence of caffeine use in all forms is so much more prevalent than nicotine there might be more persons in the society heavily dependent on caffeine. Implication: Tobacco products are likely more dependence forming than NR products and coffee although there might be more people dependent on caffeine. The addiction to coffee or caffeine is seldom discussed in the society probably because of the little or no harm it causes. Funding: The Snus Commission in Sweden (snuskommissionen) funded the data collection. No funding used for the analysis and writing of manuscript. Full article
(This article belongs to the Special Issue Tobacco Harm Reduction)

Other

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Open AccessFeature PaperConcept Paper Vape Club: Exploring Non-Profit Regulatory Models for the Supply of Vaporised Nicotine Products
Int. J. Environ. Res. Public Health 2018, 15(8), 1744; https://doi.org/10.3390/ijerph15081744
Received: 18 July 2018 / Revised: 4 August 2018 / Accepted: 7 August 2018 / Published: 14 August 2018
PDF Full-text (302 KB) | HTML Full-text | XML Full-text
Abstract
Vaporised nicotine products (VNPs) that are not approved as therapeutic goods are banned in some countries, including Australia, Singapore, and Thailand. We reviewed two non-profit regulatory options, private clubs and the Australian Therapeutic Goods Administration Special Access Scheme (SAS) that have been applied
[...] Read more.
Vaporised nicotine products (VNPs) that are not approved as therapeutic goods are banned in some countries, including Australia, Singapore, and Thailand. We reviewed two non-profit regulatory options, private clubs and the Australian Therapeutic Goods Administration Special Access Scheme (SAS) that have been applied to other controlled substances (such as cannabis) as a potential model for regulating VNPs as an alternative to prohibition. The legal status of private cannabis clubs varies between the United States, Canada, Belgium, Spain, and Uruguay. Legal frameworks exist for cannabis clubs in some countries, but most operate in a legal grey area. Kava social clubs existed in the Northern Territory, Australia, until the federal government banned importation of kava. Access to medical cannabis in Australia is allowed as an unapproved therapeutic good via the SAS. In Australia, the SAS Category C appears to be the most feasible option to widen access to VNPs, but it may have limited acceptability to vapers and smokers. The private club model would require new legislation but could be potentially more acceptable if clubs were permitted to operate outside a medical framework. Consumer and regulator support for these models is currently unknown. Without similar restrictions applied to smoked tobacco products, these models may have only a limited impact on smoking prevalence. Further research could explore whether these models could be options for regulating smoked tobacco products. Full article
(This article belongs to the Special Issue Tobacco Harm Reduction)
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