Special Issue "Passive Exposure to Conventional, Heat-Not-Burn and Electronic Smoking Products and Related Health Effects"

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: 29 February 2020.

Special Issue Editors

Prof. Dr. Matteo Vitali
E-Mail Website1 Website2
Guest Editor
Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy
Interests: environmental pollution; environmental chemistry; environmental tobacco smoke (ETS); public health; human biomonitoring; risk assessment; hospital hygiene
Special Issues and Collections in MDPI journals
Dr. Carmela Protano
E-Mail Website
Guest Editor
Department of Public Health and Infectious Diseases, Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy
Interests: environmental pollution; environmental chemistry; environmental tobacco smoke (ETS); public health; environmental epidemiology; human biomonitoring; risk assessment
Special Issues and Collections in MDPI journals

Special Issue Information

Dear colleagues,

The exposure to passive smoking, also called environmental tobacco smoke (ETS), continues to pose devastating health, social, environmental, and economic consequences. Despite a great amount of studies performed on this issue, many critical research agendas on ETS exposure and effects remain, and new scientific evidence is needed.

For example, ETS has been recently demonstrated to result from the combination of two phenomena: second-hand Smoke (SHS) and third-hand smoke (THS), which are, respectively, the environmental smoke near people who are smoking or just finished smoking, and the environmental smoke that persists long after the clearing of second-hand smoke. Studies performed to evaluate ETS chemistry, human exposure, and health effects should assess the independent contributions of both SHS and THS.

To further complicate this scenario, in the last years a great number of “alternative” cigarettes (electronic cigarettes or heat-not-burn tobacco products) were introduced into several markets worldwide. Previous studies already demonstrated that passive exposure to “cold” smoke generated by e-devices and heat-not-burn tobacco products does occur, but additional investigation is needed to better characterize these new exposure scenarios.

The focus of this Special Issue is aimed at filling the gap currently existing in “hot and cold” smoke chemistry, exposure and effects, both for conventional combustion smoking products and for electronic and heat-not-burn tobacco products. Authors are invited to submit original articles, systematic reviews and meta-analysis, critical reviews and short communications addressing all the issues relevant to report any recent advance in hot and cold smoke exposure and their impact on individual and public health.

Prof. Dr. Matteo Vitali
Dr. Carmela Protano
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 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 2000 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

  • Environmental tobacco smoke (ETS)
  • Secondhand smoke (SHS) and thirdhand smoke (THS)
  • Environmental electronic vape exposure
  • Human exposure
  • Adverse health effects
  • ETS chemistry
  • Aerosol characterization
  • Human biomonitoring
  • Environmental monitoring
  • Traditional smoking devices
  • Electronic cigarette (e-cig)
  • Heat-not-burn products
  • Risk assessment

Published Papers (7 papers)

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Research

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Open AccessArticle
Comparison of Liquid Chromatography Mass Spectrometry and Enzyme-Linked Immunosorbent Assay Methods to Measure Salivary Cotinine Levels in Ill Children
Int. J. Environ. Res. Public Health 2020, 17(4), 1157; https://doi.org/10.3390/ijerph17041157 - 12 Feb 2020
Abstract
Objective: Cotinine is the preferred biomarker to validate levels of tobacco smoke exposure (TSE) in children. Compared to enzyme-linked immunosorbent assay methods (ELISA) for quantifying cotinine in saliva, the use of liquid chromatography tandem mass spectrometry (LC-MS/MS) has higher sensitivity and specificity [...] Read more.
Objective: Cotinine is the preferred biomarker to validate levels of tobacco smoke exposure (TSE) in children. Compared to enzyme-linked immunosorbent assay methods (ELISA) for quantifying cotinine in saliva, the use of liquid chromatography tandem mass spectrometry (LC-MS/MS) has higher sensitivity and specificity to measure very low levels of TSE. We sought to compare LC-MS/MS and ELISA measures of cotinine in saliva samples from children overall and the associations of these measures with demographics and TSE patterns. Method: Participants were nonsmoking children (N = 218; age mean (SD) = 6.1 (5.1) years) presenting to a pediatric emergency department. Saliva samples were analyzed for cotinine using both LC-MS/MS and ELISA. Limit of quantitation (LOQ) for LC-MS/MS and ELISA was 0.1 ng/mL and 0.15 ng/mL, respectively. Results: Intraclass correlations (ICC) across methods = 0.884 and was consistent in sex and age subgroups. The geometric mean (GeoM) of LC-MS/MS = 4.1 (range: < LOQ to 382 ng/mL; 3% < LOQ) which was lower (p < 0.0001) than the ELISA GeoM = 5.7 (range: < LOQ to 364 ng/mL; 5% < LOQ). Similar associations of cotinine concentrations with age ( β ^ < −0.10, p < 0.0001), demographic characteristics (e.g., income), and number of cigarettes smoked by caregiver ( β ^ > 0.07, p < 0.0001) were found regardless of cotinine detection method; however, cotinine associations with sex and race/ethnicity were only found to be significant in models using LC-MS/MS-derived cotinine. Conclusions: Utilizing LC-MS/MS-based cotinine, associations of cotinine with sex and race/ethnicity of child were revealed that were not detectable using ELISA-based cotinine, demonstrating the benefits of utilizing the more sensitive LC-MS/MS assay for cotinine measurement when detecting low levels of TSE in children. Full article
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Open AccessArticle
Diet, Secondhand Smoke, and Glycated Hemoglobin (HbA1c) Levels among Singapore Chinese Adults
Int. J. Environ. Res. Public Health 2019, 16(24), 5148; https://doi.org/10.3390/ijerph16245148 - 17 Dec 2019
Abstract
The combination of poor diet and exposure to secondhand smoke may increase hemoglobin A1c (HbA1c) levels, but few studies have explored this interaction. We explored an interaction among 574 never-smoking adults from the Singapore Chinese Health Study. At baseline (age 59 ± 8 [...] Read more.
The combination of poor diet and exposure to secondhand smoke may increase hemoglobin A1c (HbA1c) levels, but few studies have explored this interaction. We explored an interaction among 574 never-smoking adults from the Singapore Chinese Health Study. At baseline (age 59 ± 8 years), intakes of omega-3 polyunsaturated fatty acids, vitamin C, vitamin E and fiber were estimated using a modified food frequency questionnaire. At follow-up (age 64 ± 9 years), HbA1c and cotinine were measured. A product term between cotinine (above or below the median value) and each nutrient (high or low intake) was included in separate linear regression models with HbA1c as the outcome. HbA1c among those with high cotinine and low omega-3 polyunsaturated fatty acids intakes were higher than would be expected due to the individual effects alone (p-for-interaction = 0.05). Among those with lower intakes of omega-3 polyunsaturated fatty acids, high cotinine levels were associated with 0.54% higher HbA1c levels (95% confidence interval [CI]: 0.02, 1.06). Conversely, among those with higher intakes of omega-3 polyunsaturated fatty acids, HbA1c differ not differ by exposure (−0.09%; 95% CI: −0.45, 0.30). No evidence of interaction was observed for other nutrients. Diets high in omega-3 polyunsaturated fatty acids may ameliorate secondhand smoke-induced increases in HbA1c. Full article
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Open AccessArticle
The Association of Environmental Tobacco Smoke Exposure and Inflammatory Markers in Hospitalized Children
Int. J. Environ. Res. Public Health 2019, 16(23), 4625; https://doi.org/10.3390/ijerph16234625 - 21 Nov 2019
Abstract
Background: Environmental tobacco smoke (ETS) exposure is associated with altered cytokine levels in children. We sought to examine ETS exposure prevalence and the relationship between ETS exposure and cytokine levels in a sample of hospitalized children. (2) Methods: Inflammatory markers (IL-8, IL-1β, IL-10, [...] Read more.
Background: Environmental tobacco smoke (ETS) exposure is associated with altered cytokine levels in children. We sought to examine ETS exposure prevalence and the relationship between ETS exposure and cytokine levels in a sample of hospitalized children. (2) Methods: Inflammatory markers (IL-8, IL-1β, IL-10, and TNF-α) and cotinine were measured in saliva of hospitalized, nonsmoking children (N = 112). To assess the association between ETS exposure and immune system response, we built a multivariate regression model including the four inflammatory markers as the response variables and cotinine, age, sex, and discharge diagnosis as explanatory variables while assessing possible interaction effects. (3) Results: Mean age (SD) was 5.8(5.0) years; Geometric Mean (GeoM) cotinine = 1.8 [95% CI = 1.4–2.2]. Children with non-inflammatory other diagnoses had lower IL-10 (p = 0.003) and TNF-α (p = 0.009) levels than children with inflammatory other diagnoses. Children with asthma (p = 0.01) and bacterial illnesses and/or pneumonia (p = 0.002) had higher IL-8 levels. Independent of diagnosis, there was a significant curvilinear association between cotinine and IL-1β (p = 0.002) reflecting no association for cotinine levels <5 ng/mL and a positive association for >5 ng/mL. (4) Conclusions: Children with higher ETS exposure levels have higher IL-1β levels regardless of age, sex, and diagnosis. ETS exposure may increase pro-inflammatory immune responses in children and may interfere with native immune responses and the ability to heal and fight infection. Full article
Open AccessArticle
Environmental Tobacco Smoke Exposure in Relation to Family Characteristics, Stressors and Chemical Co-Exposures in California Girls
Int. J. Environ. Res. Public Health 2019, 16(21), 4208; https://doi.org/10.3390/ijerph16214208 - 30 Oct 2019
Abstract
Childhood environmental tobacco smoke (ETS) exposure is a risk factor for adverse health outcomes and may disproportionately burden lower socioeconomic status groups, exacerbating health disparities. We explored associations of demographic factors, stressful life events, and chemical co-exposures, with cotinine levels, among girls in [...] Read more.
Childhood environmental tobacco smoke (ETS) exposure is a risk factor for adverse health outcomes and may disproportionately burden lower socioeconomic status groups, exacerbating health disparities. We explored associations of demographic factors, stressful life events, and chemical co-exposures, with cotinine levels, among girls in the CYGNET Study. Data were collected from families of girls aged 6–8 years old in Northern California, through clinic exams, questionnaires and biospecimens (n = 421). Linear regression and factor analysis were conducted to explore predictors of urinary cotinine and co-exposure body burdens, respectively. In unadjusted models, geometric mean cotinine concentrations were higher among Black (0.59 ug/g creatinine) than non-Hispanic white (0.27), Asian (0.32), or Hispanic (0.34) participants. Following adjustment, living in a rented home, lower primary caregiver education, and lack of two biologic parents in the home were associated with higher cotinine concentrations. Girls who experienced parental separation or unemployment in the family had higher unadjusted cotinine concentrations. Higher cotinine was also associated with higher polybrominated diphenyl ether and metals concentrations. Our findings have environmental justice implications as Black and socio-economically disadvantaged young girls experienced higher ETS exposure, also associated with higher exposure to other chemicals. Efforts to reduce ETS and co-exposures should account for other disparity-related factors. Full article
Open AccessArticle
Further Insights on Predictors of Environmental Tobacco Smoke Exposure during the Pediatric Age
Int. J. Environ. Res. Public Health 2019, 16(21), 4062; https://doi.org/10.3390/ijerph16214062 - 23 Oct 2019
Cited by 1
Abstract
Background: The smoking ban in public places has reduced Environmental Tobacco Smoke (ETS) exposure for non-smokers, but despite this, domestic environments still remain places at high risk of exposure, and, today, about 40% of children worldwide are exposed to ETS at home. The [...] Read more.
Background: The smoking ban in public places has reduced Environmental Tobacco Smoke (ETS) exposure for non-smokers, but despite this, domestic environments still remain places at high risk of exposure, and, today, about 40% of children worldwide are exposed to ETS at home. The aims of the study are to investigate the contribution of several factors on ETS exposure among a group of Italian children and to evaluate the changes in smoking precautions adopted at home when the smoker is the mother, the father, or both parents, respectively. Methods: A cross-sectional study was performed on a sample of 519 Italian schoolchildren. Information was collected via a questionnaire. Results: 41.4% of the participants lived with at least one smoker. Almost half of the children exposed to ETS lived with one or more smokers who do not observe any home smoking ban. Lower maternal or paternal educational levels significantly increase the risk of ETS exposure at home and the “worst case” is represented by both parents who smoke. Conclusions: More effective preventive interventions are needed to protect children from ETS exposure. Some interventions should be specifically dedicated to smokers with a low educational level and to mothers that smoke. Full article
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Review

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Open AccessReview
Heat Not Burn Tobacco Product—A New Global Trend: Impact of Heat-Not-Burn Tobacco Products on Public Health, a Systematic Review
Int. J. Environ. Res. Public Health 2020, 17(2), 409; https://doi.org/10.3390/ijerph17020409 - 08 Jan 2020
Abstract
Introduction: The use of heat-not-burn tobacco products (HnB) is being adopted increasingly as an alternative to smoking combusted products, primarily cigarettes. Substantial controversy has accompanied their marketing and use in the public health context. In this study, we aimed to consider the probable [...] Read more.
Introduction: The use of heat-not-burn tobacco products (HnB) is being adopted increasingly as an alternative to smoking combusted products, primarily cigarettes. Substantial controversy has accompanied their marketing and use in the public health context. In this study, we aimed to consider the probable impacts of HnB tobacco products use on public health. Methods: In May 2019, we conducted a systematic review of 15 studies concerning awareness and use of IQOS (abbrv. I Quit Ordinary Smoking) selected from three databases: Cochrane, PubMed, and Embase regarding public health. Results: All key outcomes varied by smoking status: more young adults who were currently smoking reported being aware of, interested in trying, and prone to trying heat-not-burn tobacco products. Interest in trying HnB products was also present among non-smokers, which raises concerns regarding new smokers. Interestingly, susceptibility to trying IQOS (25.1%) was higher than for traditional cigarettes (19.3%), but lower than for e-cigarettes (29.1%). Conclusions: Present studies suggest that HnB tobacco products have the potential to be a reduced risk product for public health compared to conventional cigarettes, considering indirectly the potential effects on the chronic diseases which are traditionally linked to traditional cigarette use as well as second hand exposure, but further studies are needed to determine whether this potential is likely to be realized. The process of HnB tobacco products becoming increasingly popular is of a global scale. Only small differences between countries on different continents regarding popularity and use of HnB tobacco products have been reported. Full article
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Open AccessReview
Impact of Nicotine Replacement and Electronic Nicotine Delivery Systems on Fetal Brain Development
Int. J. Environ. Res. Public Health 2019, 16(24), 5113; https://doi.org/10.3390/ijerph16245113 - 14 Dec 2019
Abstract
Maternal tobacco smoking during pregnancy remains a major public health issue. The neurotoxic properties of nicotine are associated with fetal neurodevelopmental disorders and perinatal morbimortality. Recent research has demonstrated the effects of nicotine toxicity on genetic and epigenetic alterations. Smoking cessation strategies including [...] Read more.
Maternal tobacco smoking during pregnancy remains a major public health issue. The neurotoxic properties of nicotine are associated with fetal neurodevelopmental disorders and perinatal morbimortality. Recent research has demonstrated the effects of nicotine toxicity on genetic and epigenetic alterations. Smoking cessation strategies including nicotine replacement therapy (NRT) and electronic nicotine delivery systems (ENDS) show lack of clear evidence of effectiveness and safety in pregnant women. Limited trials using randomized controls concluded that the intermittent use formulation of NRT (gum, sprays, inhaler) in pregnant women is safe because the total dose of nicotine delivered to the fetus is less than continuous-use formulations (transdermal patch). Electronic nicotine delivery systems (ENDS) were hyped as a safer alternative during pregnancy. However, refill liquids of ENDS are suspected to be cytotoxic for the fetus. Animal studies revealed the impact of ENDS on neural stem cells, showing a similar risk of pre- and postnatal neurobiological and neurobehavioral disorders to that associated with the exposure to traditional tobacco smoking during early life. There is currently no clear evidence of impact on fetal brain development, but recent research suggests that the current guidelines should be reconsidered. The safety of NRT and ENDS is increasingly being called into question. In this review, we discuss the special features (pharmacodynamics, pharmacokinetics, and metabolism) of nicotine, NRT, and ENDS during pregnancy and postnatal environmental exposure. Further, we assess their impact on pre- and postnatal neurodevelopment. Full article

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Association of Environmental Tobacco Smoke Exposure with Carotid Intima Media Thickness in Healthy Children and Adolescents: A Systematic Review
Authors: Siyu Dai and Kate Ching Ching Chan
Affiliation: Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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