Search Results (943)

Adolescent vaping has become a persistent health and behavioural challenge in schools, yet many institutions lack reliable tools to detect and respond to concealed e-cigarette use. This study addresses this problem by evaluating the real-world performance of a low-cost “Internet of Things” (IoT) vape detection system deployed across 37 high-risk restroom and change-room locations at a large Australian Independent school. The aim was to determine whether an IoT-based environmental monitoring platform could accurately identify vaping events, support timely staff intervention, and provide actionable insights into student behaviour patterns. A longitudinal case study design was used, collecting continuous particulate matter (PM_2.5 and PM₁₀) data at one-minute intervals over an 18-month period, where PM₂.₅ and PM₁₀ refer to particulate matter with aerodynamic diameters ≤ 2.5 µm and ≤ 10 µm, respectively, reported in micrograms per cubic metre (µg/m³). Threshold-based alerting, cloud-based data processing, and school-led Closed-circuit television (CCTV) verification were combined to assess detection accuracy, temporal trends, and operational responses. The system recorded more than 300 vaping-related incidents, with clusters aligned to predictable times of day and higher prevalence among senior students. Operational detection performance was high, with alert events characterised by rapid, concurrent PM_2.5 and PM₁₀ excursions consistent with vaping-related aerosol profiles, although staff responsiveness declined over time due to alert fatigue and competing priorities. A major environmental smoke event demonstrated the need for context-aware logic to reduce false positives. The findings demonstrate that real-time aerosol monitoring is not only technically reliable but also highly effective in detecting vaping within school environments. These perspectives help explain why user engagement, alert fatigue, and institutional follow-through are as critical as sensor accuracy itself. Ultimately, the effectiveness of vape detection relies on strong organisational commitment, well-defined response workflows, and alignment with broader wellbeing and policy strategies. When these elements are in place, such systems can evolve from simple detection tools into intelligent, integrated components of school health governance. Full article

Atrial septal defect (ASD) has become increasingly common in the USA and now affects 1 in 11.3 children in some places, but space–time analysis has not been applied to this emerging trend. ASD rate (ASDR) data were obtained from the National Birth Defects Prevention Network 2003–2020. Substance (cigarettes, alcohol, cannabis, analgesics, cocaine) use data were obtained from the National Survey of Drug Use and Health. Income data were obtained from the US Census. Analysis was limited to the Non-Hispanic White population by technical factors. Time-sequential univariate and bivariate maps were prepared for both covariates and outcomes and their combinations. Spatial regression of the ASDR was performed using the R package splm. A total of 7.6% of data was interpolated by linear regression. A total of 110,107 ASD cases were identified amongst 17,751,437 live births in 27 US states across 10 reporting periods. Time series maps showed that ASDR showed concordant patterns with indices of cannabis use rather than other substances. This was confirmed by multivariate spatial regression where cannabis and cannabinoids alone were found to significantly relate to ASDR, with p = 0.00002 for cannabidiol. Cannabis legal status similarly tracked with ASDR. Compared to states where cannabis was not legal, ASDR was more prevalent in cannabis-legal states (OR = 2.73 (2.66, 2.80); E-Value 4.90 (lower C.I. 4.76)). Twenty-seven of 34 (79.4%) E-values were >9 (high range) and 34/34 were > 1.25 (causal threshold). Data show that cannabis, including cannabis legalization, is driving the US ASD epidemic. While most high-ASDR states have high rates of cannabis use, Midwestern states where cannabis is farmed, such as Kentucky, Tennessee and Missouri, do not, suggesting other routes of exposure, potentially implicating environmental contamination. ASD is a bellwether marker for cannabinoid teratogenicity, indicating that communities should carefully control cannabinoid exposure and limit transgenerational cannabinoid genotoxicity more generally. Full article

Background: E-cigarette use has risen sharply among young never-smokers, largely driven by the availability of several thousand appealing flavours. This narrative review synthesises evidence on the health effects of vaping, flavour toxicology and attractiveness, designs and outcomes of flavour bans, and complementary measures. Methods: Peer-reviewed publications and institutional reports (up to January 2026) were retrieved from PubMed, Web of Science, Google Scholar, and reference lists of included articles. Evidence from about 200 references was synthesised by a multidisciplinary working group. Results: Although flavouring substances are generally considered safe for ingestion, their inhalation toxicity remains uncertain. In vitro and in vivo studies have reported oxidative stress, inflammation, cytotoxicity, impaired ciliary function, transcriptomic changes, genotoxicity, and DNA damage. These findings—along with the strong youth appeal of fruit/sweet flavours, the inconclusive effects of flavours on smoking cessation, and persisting uncertainties—support banning non-tobacco e-cigarette flavours under the precautionary principle. Flavour bans can reduce e-cigarette use and initiation, especially among young adults, although partial substitution towards combustible cigarettes has been reported in some U.S. states. Policy success requires effective enforcement, prevention of industry circumvention, curbing cross-border sales, and closing regulatory loopholes—ideally at the international level (e.g., EU-wide). Conclusions: E-cigarette flavours may increase vaping toxicity and strongly appeal to youth, justifying flavour bans to prioritise youth protection. To maximise effectiveness, accompanying measures and sustained investment in tobacco prevention, youth education, and accessible evidence-based smoking cessation support are essential. Full article

Extracellular vesicles (EVs) are lipid-enclosed particles secreted from a wide variety of cells, with the ability to transfer biologically active content from parent to recipient cells. Lung epithelial-derived EVs (LE-EVs) play an important role in the progression of pulmonary disease, but there is limited evidence regarding the impact of cigarette smoke (CS) and electronic cigarette aerosol (ECA) on epithelial-derived EVs. The aim of this systematic review was to evaluate the current published literature on the impact of cigarette smoke and electronic cigarette aerosol on LE-EVs. Original research studies and clinical data were included, but research involving microparticles or non-epithelial-derived EVs was excluded. A total of 29 articles were identified from three databases (EMBASE, Web of Science and PubMed), of which nine demonstrated that CS exposure leads to molecular changes in epithelial-derived EVs, whereas 21 reported that CS-induced LE-EVs can deliver their cargo to neighbouring cells. The results highlighted that LE-EVs secreted in response to cigarette or e-cigarette exposure presented altered EV cargo, associated with increased cellular damage, inflammation and disease development. The current literature suggests that conventional and electronic cigarettes can influence the secretion of EVs from lung epithelial cells, with these EVs potentially playing a role in the development of lung inflammation. Nonetheless, there is limited research studying the impact of ECA on LE-EVS. Further research examining the impact of electronic cigarettes on lung epithelial-derived EVs, using robust human in vitro models coupled with clinical studies, is required. Full article

Type 2 Diabetes Mellitus (T2DM) is a widespread metabolic disorder that can affect brain health, primarily through the damaging effects of prolonged hyperglycemia. This condition increases oxidative stress (OS), neuroinflammation, and neuroapoptosis, ultimately impairing cognitive function. Acrylamide (ACY), a neurotoxicant formed during high-temperature food processing and present in cigarette smoke, may further aggravate these neurological disturbances. The present experiment examined the exacerbating effects of T2DM and ACY exposure on cognitive function, neurodegeneration, OS, neuroinflammation, and neuroapoptosis in diabetic rats. T2DM was induced via intraperitoneal injections of nicotinamide and streptozotocin, followed by daily oral doses of ACY for a month. Behavioral assessments (EPM, NOR, and Y-maze) evaluated cognitive performance. Brain tissues were analyzed for biochemical markers of neurodegeneration (GSK-3β, AChE, BACE1), OS (MDA, GSH, Catalase), neuroinflammation (NF-κB, TNF-α, PGE2, COX-2), and neuroapoptosis (Bcl-2, Bax, Caspase-3). Immunohistochemistry of Bcl-2, Bcl-6, CD138, and NF assessed structural brain changes. Results indicated that T2DM and ACY exposure significantly increased the incidence of neurological disturbances. Notably, through increased COX-2, PGE2, MDA, Bax, Bcl-6, Caspase-3, and cognitive decline deficits. This study highlights the harmful neurotoxic amplification of T2DM and ACY exposure, emphasizing the importance of public health measures to reduce ACY exposure through dietary and lifestyle changes, particularly among T2DM populations. Further research into neuroprotective strategies and underlying mechanisms is necessary. Full article

Background: The increasing use of electronic cigarettes (ECIGs), especially among youth, has raised concerns about the impact of vaping on oral health. While ECIGs are often marketed as a safer alternative, the existing literature suggests that their use may have detrimental effects on the pulmonary and cardiovascular systems. The oral cavity is the first point of contact for ECIG aerosol, and new reports link vaping to the onset of periodontal disease. It is critical to understand the potential effects of vaping on the oral microbiome, which affects systemic health. This study investigates how flavored E-liquids and commensal bacteria influence the growth of Porphyromonas gingivalis, a periodontal pathobiont, under planktonic and biofilm conditions. Methods: P. gingivalis was grown planktonically in the presence of the supernatants of four streptococcal species (Streptococcus gordonii, Streptococcus intermedius, Streptococcus mitis, and Streptococcus oralis) and flavored E-liquids (tobacco, menthol, cinnamon, strawberry, and blueberry) under anaerobic conditions. Multispecies biofilms, including all the species mentioned above and Fusobacterium nucleatum, were also grown anaerobically and quantified by crystal violet assays, qPCR, and CFU counts. Results: Although E-liquids inhibit P. gingivalis growth under planktonic conditions, the presence of commensal supernatants partially mitigates this effect. However, P. gingivalis growth in multispecies biofilms is increased by E-liquid treatments. Conclusions: This study highlights the enhanced growth of P. gingivalis as part of an oral microbial community in the presence of E-liquids. These results suggest that E-liquid-induced alterations in multispecies biofilms may contribute to the observed dysbiosis in vapers and the associated risk of oral diseases. Full article

Background/Objectives: Lung cancer remains a major global health burden, largely driven by cigarette use. Although electronic cigarettes (e-cigarettes) are viewed as safer alternatives due to their reduced chemical load, growing evidence shows their vapor can disrupt cellular transcriptomes, including long noncoding RNAs (lncRNAs). In this study, we examined the regulation and function of vape-associated lncRNA transcript 1 (VALT1), a novel transcript upregulated in the oral transcriptomes of e-cigarette users and similarly elevated in non-small-cell lung cancer (NSCLC) tumors. Methods: Publicly available RNA-seq datasets were analyzed, and VALT1 was identified as an e-cigarette-responsive lncRNA. Its dose-dependent induction by e-cigarette smoke extract (eCSE) and cytoplasmic localization were confirmed via RT-qPCR. Its effects on cancer-associated phenotypes including proliferation, ROS detoxification, resistance to apoptosis, migration, cytoskeletal disorganization, and nuclear remodeling were assessed through overexpression and siRNA-mediated knockdown in A549 and BEAS-2B cells. Results: Acute eCSE exposure induced a biphasic, dose-dependent increase in VALT1 expression, accompanied by enhanced proliferation, ROS detoxification, apoptosis resistance, migration, cytoskeletal disorganization, and nuclear remodeling in A549 cells. VALT1 overexpression reproduced these phenotypes in both cell lines without eCSE treatment, whereas knockdown attenuated them. VALT1 promoted survival under cytotoxic stress in A549 but not BEAS-2B cells. Conclusions: These findings support an active role for VALT1 as an e-cigarette vapor-upregulated transcript that contributes to its phenotypic readout and enhances cellular survival under extracellular chemical stress—thereby aggravating tumorigenic phenotypes even in the absence of mutations that contribute to malignant transformation. Full article

The growing popularity of electronic cigarettes (e-cigarettes) necessitates a better understanding of their biological effects. In this study, we aimed to evaluate the effects of e-cigarette aerosol condensates generated from either e-cigarette carrier liquid alone or with e-cigarette liquid with nicotine and flavor on bronchial epithelial cells. BEAS-2B cells were exposed to e-cigarettes for 24 h, and transcriptional and proteomic profiling, including assessment of protein modifications, was performed. Additionally, cell-based assays were used to evaluate mitochondrial function, rate of protein synthesis, lysosomal signal, lipid droplet quantity and actin formation. Our findings reveal that short-term exposure to both types of aerosol condensates altered transcriptome and proteome profiles, disrupting cellular homeostasis in BEAS-2B cells through impaired proteostasis and mitochondrial function in response to both types of condensates. Changes in lipid and lysosome content, as well as a reduction in polymerized actin, were observed with nicotine- and flavor-containing condensate. E-cigarette exposure also induced irreversible protein modifications, including different chemical derivatives (25 out of 49 in nicotine/flavor condensate; 20 out of 48 in nicotine/flavor-free condensate; 4 out of 35 in control), suggesting their particularly harmful effect. Together, these findings point to early-onset cellular stress and impaired lung epithelial fitness caused by acute e-cigarette exposure. Full article

The electronic cigarette has divided the medical community. While promoted as a tool for smoking cessation, its use has opened a Pandora’s box. Evidence from studies on both cardiovascular and pulmonary health demonstrates that e-cigarettes are associated with multiple adverse effects. In this review, we specifically examine their consequences and associations with coronary artery disease, myocardial infarction, arrhythmias, arterial hypertension, and related conditions. Finally, we highlight approaches to counter the spread of these so-called harm-reduction alternatives, drawing on data from the European Respiratory Society, the European Society of Cardiology, and the Cochrane Collaboration. Full article

The influence of gaseous components of tobacco smoke, e-cigarettes, and air pollutants on the development of glomerulonephritis has been the subject of numerous studies in recent years. Glomerulonephritis (GN) often leads to progressive kidney damage and chronic kidney disease (CKD), which is a global health problem. Genetic and autoimmune factors have been shown to contribute to their development. Yet, increasing attention is being given to environmental and lifestyle-related risk factors. This paper summarizes how specific substances found in tobacco smoke, e-cigarette smoke, and air pollutants contribute to the development and progression of GN. Particular emphasis is placed on substances such as formaldehyde, heavy metals, and particulate matter, which have been shown to trigger oxidative stress, immune dysregulation, and endothelial dysfunction. A clear understanding of the contributions of those agents to kidney inflammation is crucial for developing preventive strategies and improving public health awareness. We also highlight gaps in current research and suggest directions for future investigation. Understanding consequences of cigarette smoking should be promoted to encourage people to reduce their exposure to cigarette smoke, which could prevent many diseases. Full article

Background/Objective: Heart disease is the leading cause of death for men and women across most racial and ethnic groups. Effective self-care improves patient outcomes. This study aimed to examine self-care and its associated variables in men and women with coronary heart disease. Methods: This cross-sectional survey enrolled patients with coronary heart disease through convenience sampling. Data were collected via in-person interview, including sociodemographic variables (e.g., age and sex) and clinical variables (e.g., comorbidities). We also used the Charlson Comorbidity Index to measure comorbidity; the Patient Health Questionnaire-9 to measure depression; and Generalized Anxiety Disorder-7 to measure anxiety. Self-care was evaluated with the Self-care Coronary Heart Disease Inventory and Self-Care Self-Efficacy Scale. Descriptive and multivariate analyses were performed. This study adhered to the CROSS guidelines. Results: The sample comprised 354 patients (57.6% men and 42.4% women). Self-care monitoring and management scores were inadequate with women. Self-care self-efficacy scores were marginally adequate. Men had worse depression, comorbidities, and smoking, while women had higher anxiety and a sedentary lifestyle. Older age, low education, public transportation use, sedentary lifestyle, comorbidity, anxiety, and depression were associated with worse self-care, whereas being single and ambulance accessibility improved self-care. Conclusions: Self-care monitoring and self-care management scores were inadequate for both sexes. Depression and public transportation use were inversely associated with all self-care domains. Depression and anxiety screening should be included in routine practice. Healthcare providers should enhance self-care education for CHD patients. Interventions must address sedentary lifestyles in women and cigarette smoking in men. Full article

Atrial septal defect (ASD) affects 1:11.3 children in some US states; however, the antecedents of these trends are yet to be identified. A total of 1882 ASD rates (ASDRs) for 2003–2020 were sourced from the National Birth Defects Prevention Network reports. A total of 406,893 ASDs are reported. Substance (cigarettes, binge alcohol, cannabis, cannabinoids, analgesics, cocaine) exposure data were taken from the National Survey of Drug Use and Health. Income and ethnicity data were derived from the US Census. Adjustment was performed by mixed effects, survey and generalized additive regression. Causal analysis was by inverse probability weighting and E-values. Data were analyzed in RStudio. The highest ASDR of 884/10,000 live births was amongst Non-Hispanic Asians and Pacific Islanders in Nevada in 2016–2020. The 2005–2018 median ASDR rose >12-fold in Nevada and New Mexico, >6-fold in New York, and 4.2-fold nationally 1989–2020; it doubled in NY from 2012–2016 to 2016–2020. The average state ASDR rose supra-exponentially (p = 0.0075) and was associated with higher cannabis use states (p = Zero, Cohen’s D = 1.24), apparently driven by cannabis legalization (p = Zero). Estimated exposures to Δ9THC, cannabidiol and cannabigerol were implicated (from p = 2.67 × 10^–68). Cannabis-legal states were compared with others (mean ASDR (C.I.) 178.15 (131.68, 224.62) vs. 74.28 (70.60, 77.96), p = Zero; O.R. 1.82 (1.81, 1.84), E-values 3.04 (lower C.I. 3.02), Cohen’s D 1.29 (0.96, 1.62)). Overall, 29/39 (74.4%) E-value estimates were >4; 39/39 (100%) were >1.25. Cannabis, cannabinoids and cannabis legalization are strong candidates for driving the US ASDR supra-exponentially. Estimates of many cannabinoids, including cannabidiol, Δ9THC, and cannabigerol, are implicated. The results are consistent with other large epidemiological studies. The importance of the results is magnified by the increasing legalization and penetration of cannabinoids into the US population. Since therapeutic abortion is not practiced for ASD, it may be used as a bellwether index of heritable transgenerational cannabinoid genotoxicity and epigenotoxicity associated with cannabinoid exposure. Full article

Nicotine exposure from e-cigarette use remains a growing public health concern, necessitating reliable biomarkers and analytical approaches for long-term exposure assessment. This study aimed to investigate the feasibility of detecting and classifying cotinine, the primary metabolite of nicotine, in fingernails of e-cigarette users using Fourier transform infrared (FTIR) spectroscopy coupled with chemometric analysis. Fingernail samples were collected and extracted from 30 e-cigarette users and 30 non-smokers. Infrared spectra were acquired in attenuated total reflectance mode and analysed using principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) for classification and prediction. Distinct spectral features associated with cotinine were observed in smoker samples, particularly an absorption band near 1277 cm⁻¹ corresponding to C–N stretching vibrations. Quantitative analysis revealed significantly higher cotinine concentrations in smokers compared with non-smokers (p < 0.05, Mann–Whitney U test). Chemometric modelling achieved complete discrimination between groups, with the PLS-DA model demonstrating excellent predictive performance and an area under the receiver operating characteristic (ROC) curve of 1.0. These findings indicate that FTIR spectroscopy combined with chemometric tools provides a rapid and effective approach for cotinine detection in fingernails, supporting its potential application in nicotine exposure assessment. Full article

Social determinants of health (SDoH) comprise a broad array of social conditions, such as access to food and housing, that facilitate or impede individual behavior. The aim of this study was to assess the association between SDoH and cigarette smoking-related outcomes among U.S. adults (aged ≥18 years) by using data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS). Cross-sectional data were obtained from the Social Determinants and Health Equity (SD/HE) module, conducted in 33 states, the District of Columbia, and Puerto Rico as part of the 2023 BRFSS. We examined four indicators of adverse SDoH (i.e., food insecurity, housing insecurity, utility insecurity, and lack of reliable transportation) and three cigarette smoking-related outcomes (i.e., cigarette smoking status, menthol cigarette smoking, and past-year quit attempt). All analyses were conducted with SAS 9.4 and used BRFSS sampling weights to adjust for the complex sampling design. Among 45,160 respondents, 2991 (7.8%) were adults who smoked cigarettes in the past month, of whom 570 (16.5%) reported making a quit attempt in the past 12 months. Menthol cigarette use was reported by 634 (22.0%) adults who smoked cigarettes in the past month. In adjusted analyses, each SDoH measure (i.e., food insecurity (aOR = 1.70, 95% CI: 1.19–2.41, p < 0.01), housing insecurity (aOR = 1.66, 95% CI: 1.06–2.59, p < 0.05), utility insecurity (aOR = 1.92, 95% CI: 1.01–3.65, p < 0.05), and lack of reliable transportation (aOR = 1.67, 95% CI: 1.03–2.73, p < 0.05)) was significantly associated with making a quit attempt in the past 12 months. Food insecurity was significantly associated with the odds of current cigarette smoking. Food insecurity and utility insecurity were independent risk factors for using menthol cigarettes. U.S. adults experiencing adverse SDoH are trying to stop smoking at higher rates than adults not experiencing adverse SDoH. Findings demonstrate that SDoH is a strong predictor of cigarette smoking status, menthol cigarette smoking, and past-year quit attempts among U.S. adults. Full article

Introduction: cigarette smoking is a major source of systemic oxidative stress and a well-established risk factor for cardiovascular disease. Heated tobacco products (HTPs) are increasingly promoted as reduced-risk alternatives, yet their cellular effects remain incompletely understood. Methods: this study compared the oxidative stress-mediated effects of conventional cigarette smoking and HTP use on human erythrocytes. Erythrocytes from healthy non-smokers, conventional smokers, and HTP users were analyzed using biochemical, functional, and cytological approaches to assess redox status, membrane and cytoskeletal organization, anion exchanger 1 (AE1) function, antioxidant response, and redox-sensitive signaling pathways. Results: conventional smokers exhibited higher intracellular reactive oxygen species (ROS) levels, thiol depletion, methemoglobin and hemichrome formation, whereas HTP users showed marked lipid peroxidation despite lower ROS availability. Both groups instead displayed altered expression and distribution of key membrane and cytoskeletal proteins, including glycophorin A, AE1, spectrin, ankyrin, and band 4.1, indicating impaired membrane–cytoskeleton interactions. Functional analyses revealed an accelerated AE1-mediated anion exchange in erythrocytes from conventional smokers, whereas cells from HTP users exhibited a reduced sulfate accumulation, indicating altered transport capacity. In both groups, G6PDH activity was significantly increased, and redox-sensitive signaling pathways involving ERK, AKT, and eNOS were activated, accompanied by sex-dependent alterations in estrogen receptor expression and distribution. Conclusions: collectively, these findings identify erythrocytes as sensitive biomarkers of tobacco-related systemic damage and indicate that smoking-induced erythrocyte dysfunction, including that associated with HTP use, may actively contribute to vascular impairment. This evidence challenges the assumption that heated tobacco products confer a substantially reduced cardiovascular risk compared with conventional cigarettes. Full article