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Special Issue "Electronic Cigarettes: Good and Bad Impacts"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: 30 November 2019

Special Issue Editor

Guest Editor
Dr. Maciej Goniewicz

Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Website | E-Mail
Interests: Dr. Goniewicz is a pharmacologist and toxicologist with a research interest in the population health impact of emerging nicotine-containing products and alternative forms of tobacco. He examined the safety and efficacy of electronic nicotine delivery devices, commonly called e-cigarettes. These studies include the laboratory evaluation of the products, pharmacological and toxicological assessment, surveys among their users, and their potential application in harm reduction and smoking cessation.

Special Issue Information

Dear Colleagues,

As highlighted in a consensus report by the National Academies of Sciences, Engineering, and Medicine (NASEM) titled “Public Health Consequences of E-Cigarettes”, the net public health outcome of e-cigarette use depends on the balance between positive and negative consequences. E‑cigarettes appear to pose less risk to an individual than combustible tobacco cigarettes but these products are not without biological effects in humans. Although e‑cigarette aerosol contains fewer numbers and lower levels of toxicants than smoke from combustible tobacco cigarettes, it does contain high levels of nicotine, toxic metals, flavorings, and cancer-causing chemicals, like formaldehyde and acetaldehyde. The implications for the long-term effects on morbidity and mortality are not yet clear. Overall, the current evidence suggests that while e‑cigarettes might cause youth who use them to transition to use of combustible tobacco products, they might also increase adult cessation of combustible tobacco cigarettes. The NASEM report has called for more and better research to help clarify whether e-cigarettes will prove to reduce or induce harm at the individual and the population levels. To address this knowledge gap, we invite manuscripts on a wide range of topics related to the public health impact of e-cigarettes, including, but not limited to, analysis of key constituents in e-cigarettes, human health effects (including in-vitro and in-vivo studies), initiation and cessation of combustible tobacco cigarette use, and harm reduction.

Dr. Maciej Goniewicz
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 semimonthly 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 1800 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

  • E-cigarettes
  • Vaporized nicotine
  • In-vitro and In-vivo testing of e-cigarettes
  • Health consequences of vaping
  • Vaping and smoking initiation among youth
  • Smoking cessation
  • Harm reduction
  • Tobacco-related morbidity and mortality
  • Marketing and regulation of nicotine-containing products

Published Papers (7 papers)

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Research

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Open AccessArticle
Influence of Electronic Cigarette Characteristics on Susceptibility, Perceptions, and Abuse Liability Indices among Combustible Tobacco Cigarette Smokers and Non-Smokers
Int. J. Environ. Res. Public Health 2019, 16(10), 1825; https://doi.org/10.3390/ijerph16101825
Received: 13 April 2019 / Revised: 16 May 2019 / Accepted: 20 May 2019 / Published: 23 May 2019
PDF Full-text (324 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
This study assessed how electronic cigarette (ECIG) characteristics amenable to regulation—namely nicotine content, flavor, and modified risk messages—impact ECIG use susceptibility, harm/addiction perceptions, and abuse liability indices among combustible tobacco cigarette (CTC) smokers and non-smokers. CTC smokers and non-smokers varying in ECIG use [...] Read more.
This study assessed how electronic cigarette (ECIG) characteristics amenable to regulation—namely nicotine content, flavor, and modified risk messages—impact ECIG use susceptibility, harm/addiction perceptions, and abuse liability indices among combustible tobacco cigarette (CTC) smokers and non-smokers. CTC smokers and non-smokers varying in ECIG use recruited via Amazon Mechanical Turk (MTurk) completed an online survey in 2016 (analytic n = 706). Participants were randomly assigned to one of eight conditions differing in ECIG characteristics: nicotine content (no, low, high), flavor (menthol, tobacco, fruit), or modified risk message (reduced harm, reduced carcinogen exposure). Regressions assessed ECIG susceptibility, harm/addiction perceptions, and abuse liability indices (purchase task measures of breakpoint/intensity) within each regulatory domain (nicotine content, flavor, message) and their interactions with CTC/ECIG status. Differential effects on ECIG susceptibility, harm/addiction perceptions, and abuse liability indices were observed by regulatory domain with many effects moderated by CTC/ECIG status. ECIG nicotine content and flavor conditions were the most influential across outcomes. Greater nicotine content, tobacco-flavored and reduced carcinogen exposure ECIGs were more highly preferred by CTC smokers with some differing preferences for non-users. Findings reinforce consideration of discrete ECIG preferences across tobacco use status to improve regulatory efficacy. Full article
(This article belongs to the Special Issue Electronic Cigarettes: Good and Bad Impacts)
Open AccessArticle
The Health Risks of Electronic Cigarette Use to Bystanders
Int. J. Environ. Res. Public Health 2019, 16(9), 1525; https://doi.org/10.3390/ijerph16091525
Received: 15 March 2019 / Revised: 15 April 2019 / Accepted: 19 April 2019 / Published: 30 April 2019
PDF Full-text (598 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
This works aimed to assess the health risks of e-cigarette use to bystanders. The exhaled breath of 17 volunteers was collected while they were vaping, and the levels of nicotine, propylene glycol, glycerol, formaldehyde, acetaldehyde, acrolein, tobacco-specific nitrosamines (TSNAs), and heavy metals were [...] Read more.
This works aimed to assess the health risks of e-cigarette use to bystanders. The exhaled breath of 17 volunteers was collected while they were vaping, and the levels of nicotine, propylene glycol, glycerol, formaldehyde, acetaldehyde, acrolein, tobacco-specific nitrosamines (TSNAs), and heavy metals were analyzed. Increased levels of nicotine, propylene glycol, TSNAs and copper were found in the exhaled breath of the volunteers. From these measurements, bystander exposure was estimated for two different scenarios: (1) A non-ventilated car with two e-cigarette users and (2) a ventilated office with one e-cigarette user. Our results show that bystanders may experience irritation of the respiratory tract as a result of exposure to propylene glycol and glycerol. Systemic effects of nicotine should also be expected if nicotine-containing e-liquid is used, including palpitations, and an increase of the systolic blood pressure. Furthermore, due to the presence of TSNAs in some e-liquids, an increased risk of tumors could not be excluded for the ‘car’ scenario. While e-cigarette use can clearly have effects on the health of bystanders, the risks depend on the rate of ventilation, dimensions of the room, and vaping behavior of the e-cigarette user. The presence of TSNAs in e-liquids can be avoided, which will prevent the most serious effect identified (increased risk of tumors). Full article
(This article belongs to the Special Issue Electronic Cigarettes: Good and Bad Impacts)
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Open AccessArticle
Association between Regular Electronic Nicotine Product Use and Self-Reported Periodontal Disease Status: Population Assessment of Tobacco and Health Survey
Int. J. Environ. Res. Public Health 2019, 16(7), 1263; https://doi.org/10.3390/ijerph16071263
Received: 21 March 2019 / Revised: 4 April 2019 / Accepted: 5 April 2019 / Published: 9 April 2019
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Abstract
Electronic nicotine product use is increasing in the U.S., but few studies have addressed its effects on oral health. The goal of this work was to determine the association between electronic nicotine product use and periodontal disease. Population Assessment of Tobacco and Health [...] Read more.
Electronic nicotine product use is increasing in the U.S., but few studies have addressed its effects on oral health. The goal of this work was to determine the association between electronic nicotine product use and periodontal disease. Population Assessment of Tobacco and Health adult survey data from 2013–2016 (waves 1, 2 and 3) was used for the analysis. Longitudinal electronic nicotine product users used electronic nicotine products regularly every day or somedays in all three waves. Participants with new cases of gum disease reported no history of gum disease in wave 1 but reported being diagnosed with gum disease in waves 2 or 3. Odds ratios (OR) were calculated to determine the association between electronic nicotine product use and new cases of gum disease after controlling for potential confounders. Compared to never users, longitudinal electronic nicotine product users had increased odds of being diagnosed with gum disease (OR 1.76, 95% Confidence Interval (CI) 1.12–2.76) and bone loss around teeth (OR 1.67, 95% CI 1.06–2.63). These odds were higher for participants with a history of marijuana and a history of illicit or non-prescribed drug use. Our findings show that e-cigarettes may be harmful to oral health. Full article
(This article belongs to the Special Issue Electronic Cigarettes: Good and Bad Impacts)
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Open AccessArticle
Electronic Cigarette Use and Smoking Initiation in Taiwan: Evidence from the First Prospective Study in Asia
Int. J. Environ. Res. Public Health 2019, 16(7), 1145; https://doi.org/10.3390/ijerph16071145
Received: 14 January 2019 / Revised: 21 March 2019 / Accepted: 22 March 2019 / Published: 30 March 2019
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Abstract
A growing literature indicates that electronic cigarette use increases the risk of subsequent initiation of conventional smoking among cigarette-naïve adolescents in several Western countries. This research assesses the same relationship in an Asian country, Taiwan. The Taiwan Adolescent to Adult Longitudinal Study is [...] Read more.
A growing literature indicates that electronic cigarette use increases the risk of subsequent initiation of conventional smoking among cigarette-naïve adolescents in several Western countries. This research assesses the same relationship in an Asian country, Taiwan. The Taiwan Adolescent to Adult Longitudinal Study is a school-based survey that was carried out in two waves in 2014 (baseline) and in 2016 (follow-up). It employs probability sampling to create nationally representative samples of students in junior high school (mean age 13, 7th grade at baseline) and in senior high school (mean age 16, 10th grade at baseline). Data from this survey were analyzed via logistic regression to estimate the association between ever use of e-cigarettes at baseline and smoking initiation at follow-up, accounting for susceptibility to smoking, socio-demographic profile, depression status, and peer support. Among the 12,954 cigarette-naïve students surveyed, those with e-cigarette experience at baseline exhibited higher odds of smoking initiation at follow-up (Odds Ratio = 2.14, 95% CI (1.66, 2.75), p < 0.001). For the first time, we confirmed, through a longitudinal survey, a prospective association between ever use of e-cigarettes and smoking initiation in an Asian adolescent population. The restrictive policy on e-cigarettes currently in force in Taiwan is justified to prevent both e-cigarette and cigarette use among adolescents. Full article
(This article belongs to the Special Issue Electronic Cigarettes: Good and Bad Impacts)
Open AccessArticle
A Comparison of E-Cigarette Use Patterns and Smoking Cessation Behavior among Vapers by Primary Place of Purchase
Int. J. Environ. Res. Public Health 2019, 16(5), 724; https://doi.org/10.3390/ijerph16050724
Received: 12 January 2019 / Revised: 22 February 2019 / Accepted: 25 February 2019 / Published: 28 February 2019
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Abstract
Background: E-cigarettes are purchased through multiple channels, including general retail, online, and specialty smoke and vape shops. We examine how e-cigarette users’ primary purchase place relates to e-cigarette use and smoking cessation behaviors. Methods: Probability-based samples of the U.S. population who were current [...] Read more.
Background: E-cigarettes are purchased through multiple channels, including general retail, online, and specialty smoke and vape shops. We examine how e-cigarette users’ primary purchase place relates to e-cigarette use and smoking cessation behaviors. Methods: Probability-based samples of the U.S. population who were current e-cigarette users were surveyed in 2014 (N = 879) and 2016 (N = 743), with responses combined for most analyses. E-cigarette use and smoking cessation behaviors were compared across users’ primary purchase place. Results: Higher percentages of vape shop (59.1%) and internet (42.9%) customers were current daily users of e-cigarettes compared to retail (19.7%) and smoke shop (23.2%) customers (p-values < 0.001). Higher percentages of vape shop (40.2%) and internet (35.1%) customers were also former smokers, compared to 17.7% of retail and 19.3% of smoke shop customers (p’s < 0.001). Among those smoking 12 months prior to survey, smoking cessation rates were higher for vape shop (22.2%) and internet customers (22.5%) than for retail customers (10.7%, p = 0.010 and p = 0.022, respectively), even though retail customers were more likely to use FDA-approved smoking cessation aids. The percentage of customers purchasing from vape shops increased from 20.4% in 2014 to 37.6% in 2016, surpassing general retail (27.7%) as the most likely channel in 2016. Conclusions: E-cigarette customers differed in significant ways by channels of purchase, most notably in their smoking cessation behaviors. Previous population studies have relied mostly on retail channel data, which accounted for less than 30% of all products sold by 2016. Future studies of e-cigarette use should consider a broader set of channels. Full article
(This article belongs to the Special Issue Electronic Cigarettes: Good and Bad Impacts)
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Open AccessArticle
Where Do Vapers Buy Their Vaping Supplies? Findings from the International Tobacco Control (ITC) 4 Country Smoking and Vaping Survey
Int. J. Environ. Res. Public Health 2019, 16(3), 338; https://doi.org/10.3390/ijerph16030338
Received: 19 December 2018 / Revised: 18 January 2019 / Accepted: 19 January 2019 / Published: 26 January 2019
Cited by 2 | PDF Full-text (282 KB) | HTML Full-text | XML Full-text
Abstract
Aim: This study examines where vapers purchase their vaping refills in countries having different regulations over such devices, Canada (CA), the United States (US), England (EN), and Australia (AU). Methods: Data were available from 1899 current adult daily and weekly vapers who participated [...] Read more.
Aim: This study examines where vapers purchase their vaping refills in countries having different regulations over such devices, Canada (CA), the United States (US), England (EN), and Australia (AU). Methods: Data were available from 1899 current adult daily and weekly vapers who participated in the 2016 (Wave 1) International Tobacco Control Four Country Smoking and Vaping. The outcome was purchase location of vaping supplies (online, vape shop, other). Adjusted odds ratios and 95% confidence intervals were reported for between country comparisons. Results: Overall, 41.4% of current vapers bought their vaping products from vape shops, 27.5% bought them online, and 31.1% from other retail locations. The vast majority of vapers (91.1%) reported using nicotine-containing e-liquids. In AU, vapers were more likely to buy online vs other locations compared to CA (OR = 6.4, 2.3–17.9), the US (OR = 4.1, 1.54–10.7), and EN (OR = 7.9, 2.9–21.8). In the US, they were more likely to buy from vape shops (OR = 3.3, 1.8–6.2) or online (OR = 1.9, 1.0–3.8) vs other retail locations when compared to those in EN. In CA, vapers were more likely to purchase at vape shops than at other retail locations when compared to vapers in EN (5.9, 3.2–10.9) and the US (1.87, 1.0–3.1). Conclusions: The regulatory environment and enforcement of such regulations appear to influence the location where vapers buy their vaping products. In AU, banning the retail sale of nicotine vaping products has led vapers to rely mainly on online purchasing sources, whereas the lack of enforcement of the same regulation in CA has allowed specialty vape shops to flourish. Full article
(This article belongs to the Special Issue Electronic Cigarettes: Good and Bad Impacts)

Other

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Open AccessBrief Report
A Comparison of Flavorless Electronic Cigarette-Generated Aerosol and Conventional Cigarette Smoke on the Survival and Growth of Common Oral Commensal Streptococci
Int. J. Environ. Res. Public Health 2019, 16(10), 1669; https://doi.org/10.3390/ijerph16101669
Received: 21 March 2019 / Revised: 26 April 2019 / Accepted: 8 May 2019 / Published: 14 May 2019
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Abstract
Background: The use of electronic cigarettes (ECIG) has become very common. Consequently, critical analysis of the biological effects of ECIG aerosol deserves attention. Flavorless ECIG aerosol is known to comprise fewer harmful constituents than cigarette smoke. Therefore, we hypothesize that aerosol has less [...] Read more.
Background: The use of electronic cigarettes (ECIG) has become very common. Consequently, critical analysis of the biological effects of ECIG aerosol deserves attention. Flavorless ECIG aerosol is known to comprise fewer harmful constituents than cigarette smoke. Therefore, we hypothesize that aerosol has less immediate effect on the viability of oral commensal streptococci than smoke. Methods: Survival and growth of four strains of commensal streptococci were measured after exposure to flavorless ECIG aerosol ± nicotine and smoke. Peristaltic pumps were used to transport aerosol or smoke into chambers containing recently seeded colony-forming units (CFUs) of the oral commensal streptococci on agar plates. Bacterial survival and growth, based on colony counts and sizes, were determined 24 h post-exposure. Additionally, aerosol or smoke were delivered into chambers containing pre-adhered streptococci to plastic coverslips and biofilm formation was determined 24 h post-exposure via scanning electron microscopy. Results: The results suggest that flavorless aerosol ± nicotine has a modest effect on bacterial growth both as colonies on agar and as biofilms. In contrast, smoke dramatically decreased bacterial survival and growth in all parameters measured. Conclusion: Unlike cigarette smoke, flavorless ECIG aerosol has only a small effect on the survival and growth of oral commensal streptococci. Full article
(This article belongs to the Special Issue Electronic Cigarettes: Good and Bad Impacts)
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