The electronic cigarette (e-cig) has gained popularity as an aid in smoking cessation programs mainly because it maintains the gestures and rituals of tobacco smoking. However, it has been shown in inexperienced e-cig users that ineffective nicotine delivery can cause tobacco craving that could be responsible for unsuccessful smoking reduction/cessation. Moreover, the incorrect use of an e-cig could also led to potential nicotine overdosage and intoxication. Medically assisted training on the proper use of an e-cig plus behavioral support for tobacco dependence could be a pivotal step in avoiding both issues. We performed an eight-month pilot study of adult smokers who started e-cig use after receiving a multi-component medically assisted training program with monitoring of nicotine intake as a biomarker of correct e-cig use. Participants were tested during follow-up for breath carbon monoxide (CO), plasma cotinine and trans-3’-hydroxycotinine, and number of tobacco cigarettes smoked. At the end of the first, fourth, and eighth month of follow-up, 91.1, 73.5, and 76.5% of participants respectively were e-cig users (‘only e-cig’ and ‘dual users’). They showed no significant variation in plasma cotinine and trans-3’-hydroxycotinine with respect to the start of the study when they smoked only tobacco cigarettes, but a significant reduction in breath CO. The proposed medically assisted training program of e-cig use led to a successful nicotine intake, lack of typical cigarette craving and overdosage symptoms and a significant decrease in the biomarker of cigarette combustion products. Full article

A fast and sensitive ultra-performance liquid chromatography tandem mass spectrometry method was developed for the measurement of caffeine in caffeine-laced pants and in urine and skin of a pants user. The substance and its internal standard (N-ethylnorcotinine) were separated by reversed phase chromatography with 5 mM ammonium formate pH 3.0 and 0.3% formic acid in acetonitrile mobile phase (83:17 v/v) by isocratic elution and detected by tandem mass spectrometry operated in multiple reaction monitoring mode via positive electrospray ionization. Linearity was studied from 1.4 to100 ng/mL range for urine, from 5 to 100 ng/cotton swab for skin caffeine and from 1.3 to 100 µg/samples for 4 cm² textile samples. Good determination coefficients (r² = 0.99) were found in all cases. At three concentrations spanning the linear dynamic ranges of different samples mean recoveries of caffeine were always higher than 80% and intra-assay and inter-assay imprecision and inaccuracy were always better than 105%. For the first time, caffeine content in this cosmetotextile was determined together with the measurement of caffeine released on the user skin, the absorbed amount with resulting urinary concentrations. Full article

Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and 10 years of age attending the emergency room of Hospital del Mar in Barcelona, Spain. Hair samples from the accompanying parent were also collected. The samples were analyzed for the presence of opiates, cocaine, amphetamines, and cannabinoids by ultra-performance liquid chromatography-tandem mass spectrometry. Parental sociodemographics and possible drug of abuse history were recorded. Hair samples from twenty-three children (20.1%) were positive for cocaine (concentration range 0.15–3.81 ng/mg hair), those of thirteen children (11.4%) to cannabinoids (D9-THC concentration range 0.05–0.54 ng/mg hair), with four samples positive to codeine (0.1–0.25 ng/mg hair), one positive for 2.09 ng methadone per mg hair and one to 6-MAM (0.42 ng/mg hair) and morphine (0. 15 ng/mg hair) . In 69.5 and 69.2% of the positive cocaine and cannabinoids cases respectively, drugs was also found in the hair of accompanying parent. Parental sociodemographics were not associated with children exposure to drugs of abuse. However, the behavioural patterns with potential harmful effects for the child’s health (e.g., tobacco smoking, cannabis, benzodiazepines and/or antidepressants use) were significantly higher in the parents of exposed children. In the light of the obtained results (28% overall children exposure to drugs of abuse) and in agreement with 2009 unsuspected 23% cocaine exposure in pre-school children from the same hospital, we support general hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions. Full article