Search Results (983)

Electronic cigarette use among adolescents is an emerging public health concern, yet evidence from specific rural communities in Thailand remains limited. This cross-sectional study estimated the prevalence of e-cigarette use, described perceptions of e-cigarettes and attitudes toward e-cigarette use, and examined factors associated with overall attitude scores among 512 participants recruited from selected rural communities in Samut Songkhram Province, Thailand. The mean age was 18.46 years (SD = 1.37). Data were collected from December 2024 to August 2025 using a structured questionnaire and analyzed using descriptive statistics and multiple linear regression. Current e-cigarette use, defined as use within the previous 30 days, was reported by 5.86% of participants, while 18.36% reported lifetime use. Overall perceptions of e-cigarettes were classified as high (M = 2.52, SD = 0.34), whereas overall attitudes toward e-cigarette use were classified as good (M = 2.73, SD = 0.40). Sex was positively associated with overall attitude scores (B = 0.109, β = 0.097, p = 0.023), whereas perceptions of e-cigarettes were negatively associated with attitude scores (B = −0.473, β = −0.343, p < 0.001). The model explained 12.3% of the variance in overall attitudes. Among adolescents participating in this study from selected rural communities in Samut Songkhram Province, the findings indicate ongoing e-cigarette experimentation and highlight the potential importance of coordinated prevention strategies addressing peer influence, misconceptions, affective attitudes, and access through informal and online channels. These findings should be interpreted within the specific study setting and sampling design and should not be generalized to adolescents in rural Thailand as a whole. Full article

Background/Objectives: Tobacco involvement and depression frequently co-occur among young people, but Chinese campus studies rarely examine mental health across tobacco susceptibility and use categories. We examined cross-sectional associations of three mutually exclusive categories (firmly non-susceptible ‘never users’, susceptible never users, and ‘ever users’) with depressive symptoms and life satisfaction. Methods: A cross-sectional survey of 415 undergraduates (75.4% female) was conducted in southeastern China in December 2025. Primary analyses used trend tests and adjusted regression for depressive symptoms; secondary analyses examined susceptibility components and a descriptive bootstrap decomposition of the life-satisfaction association; sensitivity analyses evaluated alternative specifications, model diagnostics, and response quality. Results: Mean CES-D-10 scores were 9.29, 11.55, and 13.06 across the three categories (trend p < 0.001), and probable depression prevalence was at 46.5%, 60.7%, and 68.1% (p = 0.002). Each one-category increase was associated with a 1.74-point-higher adjusted CES-D-10 score (HC3 95% CI: 0.76 to 2.73) and 65% higher adjusted odds of probable depression (95% CI: 1.17 to 2.33). In a descriptive cross-sectional decomposition, the indirect association with lower life satisfaction through concurrent depressive symptoms was −0.071 (bootstrap 95% CI: −0.124 to −0.027); this does not establish causal mediation. Ever users who remained susceptible scored 4.82 points (HC3 95% CI: 2.63 to 7.00) above firmly non-susceptible never users, whereas the 12 non-susceptible ever users did not differ detectably. Conclusions: The findings identify a cross-sectional mental-health gradient across tobacco susceptibility/use categories, without establishing temporal direction. Replication in longitudinal, multi-site samples is required before reciprocal screening and referral are implemented at scale. Full article

Cigarette smokers have different levels of nicotine dependence, which affect their daily cigarette consumption and ability to quit. Genetic factors play a role, and there is interest in tailored nicotine therapy based on an individual’s rate of nicotine metabolism, which can be measured by the ratio of 3′hydroxycotinine [3HC]-to-cotinine, e.g., the nicotine metabolite ratio [NMR]. However, many other behavioral factors or symptoms are considered important indicators of nicotine dependence. The current study uses machine learning (ML) and traditional statistical methods to rank the importance of NMR and non-NMR factors that contribute to nicotine addiction. Using data from the Pennsylvania Adult Smoking Study (PASS), we found that salivary NMR is a predictor of nicotine dependence in the most commonly used nicotine dependence scales, including the Fagerstrom Test for Nicotine Dependence, Heaviness of Smoking Index, and the Hooked On Nicotine Checklist. However, other predictor variables, such as waking urges, showed higher rankings than NMR, with findings dependent on the modeling approach. These results indicate that other factors besides NMR may be clinically useful for understanding the extent of dependence and approaches to quitting. Full article

Background/Objectives: Periodontal and peri-implant diseases are influenced by several risk factors, including smoking. While cigarette smoking (CS) is a well-established risk factor, the impact of heated tobacco products (HTPs), electronic cigarettes (E-Cigs), and waterpipe (WS) remains less clear. This systematic review aimed to update the current evidence evaluating the clinical, radiographical, and inflammatory biomarkers of periodontal and peri-implant status among different untreated adult users of inhaled tobacco and nicotine products. Methods: A systematic search of PubMed/MEDLINE, Scopus, and Cochrane Library was performed for studies published between April 2022 and December 2025. Data were extracted and synthesized qualitatively according to the study protocol (PROSPERO: CRD420261284851). Studies were qualitatively assessed using the Risk-of-Bias in Nonrandomized-I. Results: Thirty-one studies including 3106 subjects were analyzed. CS consistently showed the worst periodontal and peri-implant status, with higher plaque indices, probing depth (PD), clinical attachment level (CAL), marginal bone loss (MBL) and more missing teeth. WS showed parameters comparable to CS and worse than non-smokers, with particularly high plaque accumulation and probing depth, as well as a pro-inflammatory biomarker profile. E-Cigs and HTPs generally exhibited intermediate status; E-Cigs showed increased PD and CAL compared with non-smokers, with elevated bleeding on probing despite a lower gingival index, whereas MBL was notably higher, showing the highest overall values among all smoking categories, exceeding CS. HTPs presented slightly less harmful outcomes than other smokers, but the evidence was limited. Biomarker analysis indicated elevated pro-inflammatory and tissue-destructive markers, particularly in CS and WS. Conclusions: Smoking negatively affects periodontal and peri-implant status, with CS exhibiting the worst impact. E-Cigs and HTPs appear less harmful but are not risk-free. Longitudinal studies are warranted to define long-term effects, particularly on peri-implant status, for which robust evidence was restricted to CS. Full article

Background: Nicotine exposure is increasingly occurring through non-combustible products such as electronic cigarettes and nicotine pouches. Although sport participation is often considered protective against substance use, nicotine use appears to be increasingly normalised within performance-oriented sporting environments. Methods: This scoping review synthesised evidence on non-combustible nicotine use among amateur and university athletes. Following Joanna Briggs Institute (JBI) methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, the searches were conducted in Ovid MEDLINE, Web of Science, Embase, Scopus, SPORTDiscus, and CINAHL for peer-reviewed studies published from 2019 onwards that examined non-combustible nicotine use in these populations. Results: Eleven studies, predominantly cross-sectional and conducted in high-income Western countries, met the inclusion criteria. Nicotine use was more common among male athletes, younger athletes, and those participating in team and contact sports, particularly for e-cigarette use. Across studies, nicotine use was frequently characterised as socially normative and compatible with sport, influenced by peer networks, social identity, perceived harm reduction, and beliefs regarding performance enhancement, coping, and recovery. The evidence base was limited by inconsistent measurement approaches and a predominance of studies examining demographic correlates rather than behavioural drivers. Conclusions: Non-combustible nicotine use appears embedded within sport-specific social norms and performance-related beliefs, highlighting the need for theoretically informed research and sport-specific prevention strategies. Full article

Background/Objectives: Tobacco use among young adults remains a public health concern. Understanding trends in tobacco and e-cigarette use may help inform future education and intervention strategies. This survey aims to assess tobacco and e-cigarette use and related perceptions over a 5-year period. Methods: A validated 33-item questionnaire was sent to students at a Midwestern university in Fall 2018, 2020, and 2023. The survey assessed tobacco use, e-cigarette use, and perceptions. Results: A total of 8143 student responses were collected over the 5-year period. A total of 3850 students participated in 2018, 1743 in 2020, and 2550 in 2023. Current traditional cigarette use declined over time (6.1%, 3.2%, 4.2%, respectively), while e-cigarette use decreased but remained the most common product (22.9%, 23.1%, 18.8%, respectively). Disagreement with the statements that imply e-cigarettes are a safe or effective option to quit smoking, and agreement with the stance that e-cigarettes are addictive, all increased during the 5-year period. Conclusions: These survey findings suggest a decrease in self-reported tobacco and e-cigarette consumption over the 5-year study period. Continued surveillance of local alongside national and global systems remains essential to determine whether specific sub-populations mirror the broader use patterns. Full article

Adult hematopoietic stem cells (HSCs) and bone marrow (BM) mesenchymal stem/stromal cells (MSCs) are essential for lifelong hematopoiesis, skeletal homeostasis, immune competence, and tissue regeneration. The use of electronic cigarettes (E-cigs) among women of reproductive age continues to rise, raising concerns about potential adverse developmental effects; however, the long-term consequences of maternal E-cig vaping on offspring BM stem cell function and hematopoietic homeostasis remain incompletely understood. Here, using a rat model of maternal E-cig exposure (containing nicotine) during gestation, combined with longitudinal in vivo analyses and complementary ex vivo studies of human cells, we show that prenatal E-cig exposure is associated with persistent alterations in offspring BM stem cell function and lineage commitment. Gestational E-cig exposure was associated with expansion of the CD11b/c⁺ myeloid-enriched compartment, increased CD90⁺ stromal cells, and impaired osteogenic differentiation in rat offspring. Complementary experiments using primary human cells showed that nicotine exposure was associated with reduced T-cell proliferation and impaired cytotoxic activity in a proof-of-principle co-culture assay. Mechanistically, transcriptomic profiling followed by Gene Ontology and pathway enrichment analyses identified alterations in molecular programs associated with KLF4–Notch1 signaling, mitochondrial biogenesis, inflammation, and stem cell regulation in the BM of E-cig-exposed rat offspring. Changes in CCL11, FTO, and RUNX2 were additionally associated with an inflammatory and aging-related molecular phenotype that persisted from early life into adulthood, although these findings do not establish a causal CCL11–FTO–RUNX2 signaling axis or direct cellular senescence. Collectively, our study provides a phenotypic and mechanistic framework for understanding how maternal E-cig exposure may influence long-term offspring hematopoietic, skeletal, and immune health while highlighting the need for further studies to establish causal molecular mechanisms and determine their relevance to maternal E-cig use in humans. Full article

This study seeks to understand the effects of electronic cigarettes on the oral microenvironment. Macrophages are paramount in the oral innate immune response against pathogens. Porphyromonas gingivalis is a Gram-negative bacterium that invades oral epithelial cells, escapes phagocytosis and is associated with the progression of periodontitis. We hypothesize that e-liquid treatments enhance P. gingivalis’s escape from post-macrophage phagocytosis and subsequent invasion into oral epithelial cells. THP-1-derived macrophages were polarized to M1 ± 1% e-liquids (±menthol or cinnamon). The M1 cellular morphology and surface area were determined after e-liquid treatments. Escherichia coli or P. gingivalis were added to M1 macrophages ± e-liquids. Phagocytosis and escape were determined by multiple assays. After e-liquid treatments and phagocytosis, OKF6/TERT-2 cells (oral epithelial cells) were exposed to M1 macrophages with intracellular P. gingivalis to evaluate escape and invasion. The results show that cinnamon e-liquids alter M1 morphology by diminishing pseudopodia extensions and actin stress fibers, which persist after a second polarization attempt. Phagocytosis of P. gingivalis by e-liquid-treated macrophages also decreases. Furthermore, P. gingivalis absolute escape and OKF6/TERT-2 cell invasion increase after menthol and cinnamon e-liquid treatments, respectively. Thus, following e-liquid exposure, phagocytosis and retention of P. gingivalis deteriorate. Full article

Background and Objectives: Cigarette smoking is a recognized risk factor for periodontal disease and subgingival dysbiosis; however, the impact of electronic cigarettes on the subgingival microbiome in young adults is still not sufficiently investigated. This study aimed to characterize and compare the carriage and bacterial load of 20 subgingival species among young adult cigarette smokers, e-cigarette users, and non-smokers, and to evaluate whether e-cigarette use is linked to a periodontopathogen-enriched profile similar to that of smoking. Materials and Methods: In this exploratory cross-sectional study, fifty young adults were divided into three groups: cigarette smokers (n = 18), e-cigarette users (n = 16), and non-smokers (n = 16). Subgingival specimens were examined using real-time Polymerase Chain Reaction (PCR) (Perio panel; ADD Laboral B.V., Malden, The Netherlands) for 20 bacterial species. Carriage was analyzed across groups utilizing Fisher’s exact test with Cramér’s V as the effect size, while bacterial load was assessed using the Kruskal–Wallis test accompanied by Dwass–Steel–Critchlow–Fligner post hoc comparisons (jamovi; significance threshold established at p < 0.05). Results: Red-complex pathogens were more prevalent and present in greater quantities in smokers and e-cigarette groups compared to non-smokers. Porphyromonas gingivalis prevalence was seen in smokers (94.4%), vapers (75.0%), and non-smokers (56.2%; p = 0.028), whereas Tannerella forsythia was found in 100% of smokers, 87.5% of vape users, and 68.8% of the non-smokers (p = 0.022). Aggregatibacter actinomycetemcomitans was not present in non-smokers but was identified in 37.5% of vapers and 16.7% of smokers (p = 0.018), whereas Eubacterium nodatum was significantly elevated in tobacco users (p = 0.012; Cramér’s V = 0.449). In contrast, Prevotella nigrescens was predominant among non-smokers (87.5%; p = 0.022). Conclusions: In young adults, the red-complex bacteria—Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola—were found more frequently and in larger quantities among smokers and vapers as compared to non-smokers. Full article

Despite their introduction two decades ago as cessation tools, vaping devices and electronic cigarettes (ECs) have surged dramatically among adolescents and adults worldwide. The widespread misconception that ECs are harmless has raised substantial concern about their potential contribution to chronic diseases associated with oxidative stress (OS) pathways. To map this rapidly growing field, we combined a bibliometric analysis of human research on vaping-associated OS over the past decade with a narrative review of EC component toxicology and regulatory updates. The bibliometric analysis of 189 human studies identified four keyword clusters reflecting clinico-epidemiological, biological/mechanistic, methodological, and acute-event research themes. The results of this bibliometric analysis structure the narrative synthesis, which evaluates the chemical constituents of ECs, including e-liquid constituents, device-derived contaminants, and their aerosol by-products, and links them to pathways associated with OS development. Oxidative stress was the most frequent bridging keyword, reflecting predominant academic trends as research shifted from acute-focused investigations toward mechanistic chronic disease research. No prior review has integrated EC component toxicology with bibliometric evidence to map this landscape. This combined approach provides researchers, clinicians, and policymakers with an integrated evidence base and identifies priority areas for future investigation, including long-term exposure thresholds, age- and sex-specific outcomes, and the urgent need for harmonized global regulation. Full article

Background: The recent rise in worldwide e-cigarette use has sparked concerns about its effects on oral health, especially regarding the increased risk of periodontal disease. Measuring pro-inflammatory cytokines in crevicular fluid can help detect early subclinical inflammation before symptoms appear. Aim: To quantify the levels of inflammatory biomarkers (IL-1β, IL-6, TNF-α, and MCP-1) in the gingival crevicular fluid of vaping and non-vaping patients. Methods: An observational, cross-sectional study was conducted with vaper and non-vaper patients. Participants were selected through convenience sampling based on specific inclusion and exclusion criteria. The study collected demographic and clinical data and measured cytokines such as IL-1β, IL-6, TNF-α, and MCP-1 in crevicular fluid using flow cytometry. Data analysis was conducted in SPSS^®, including descriptive statistics, Shapiro–Wilk normality tests, and correlation analyses (Spearman rank). The Ethics Committee approved the study (Act No. 6-2025). Results: Sixteen vapers and sixteen non-vapers participated, paired by age. Vapers showed higher levels of all markers, especially TNF-α (1451.55 pg/mL, SD = 428.5, p = 0.036) and IL-6 (55.01 pg/mL, SD = 46.48, p = 0.050), compared to non-vapers. No significant differences were found in IL-1β and MCP-1. Conclusions: Vaping is associated with increased pro-inflammatory cytokines, notably TNF-α and IL-6, and clinical signs of periodontal inflammation, specifically a higher plaque index (p = 0.027); bleeding on probing showed only a non-significant upward trend (p = 0.19). These findings suggest vaping may enhance periodontal–inflammatory responses and should be considered in the assessment of periodontitis progression. Full article

Vanilla and vanillin are the most popular flavorings added to processed foods, medications, cosmetics, and e-cigarette liquids. Vanilla owes its unique aroma to vanillin. Both vanilla and vanillin can cause hypersensitivity reactions, probably type IV. Clinically, hypersensitivity to vanilla and/or vanillin most often manifests as a limited rash (of various types) accompanied by itching and/or swelling. Long-term exposure to vanillin or its intermediates may be a factor in occupational sensitization. Although hypersensitivity to vanilla/vanillin appears to be rare, it is worth considering in the diagnostic process, especially in non-obvious situations when identifying the triggering allergen is difficult. Regardless of the likely allergic hypersensitivity to vanilla and vanillin, there are also hypotheses suggesting that vanillin and other flavorings and aromas found in e-cigarette liquids may have cytotoxic effects in people who use electronic cigarettes (vaping). Toxic reactions caused by inhaling vapors of these additives may affect the bronchial tree and other distant organs. This hypothesis, although new and relatively poorly researched, may have significant implications for public health, including for future generations, especially considering that vaping is a popular form of nicotine delivery, particularly among adolescents and young adults. Full article

Electronic cigarettes (e-cigarettes) have gained widespread diffusion as a perceived safer alternative to conventional smoking, particularly among women of reproductive age. The present systematic review provides an overview of the current literature on the effects of e-cigarette exposure on female reproductive function, embryonic development, and pregnancy outcomes, with a focus on underlying molecular mechanisms. A systematic literature search was conducted in PubMed, Web of Science, and Google Scholar, and the review was conducted in accordance with the PRISMA 2020 guidelines. A total of 11 studies met the eligibility criteria and were included in the qualitative synthesis, comprising six experimental and five clinical studies. Experimental studies suggest that e-cigarette exposure may impair ovarian function, leading to morphological alterations, disrupted folliculogenesis, and altered steroidogenesis, mainly through oxidative stress, apoptosis, mitochondrial dysfunction, and dysregulation of pathways such as Hippo signaling. Non-nicotine components, including propylene glycol (PG), vegetable glycerin (VG), and flavoring agents, appear to be key contributors. Adverse effects on implantation, embryo development, and placental growth have also been reported in experimental models, although further studies are needed. Clinical evidence remains scarce, suggesting possible associations between e-cigarette smoking and reduced ovarian reserve and fecundability in naturally conceiving women. No conclusive associations have been identified with in vitro fertilization outcomes. Overall, e-cigarette exposure may negatively affect female reproductive function, although the predominance of experimental data and the limited clinical evidence preclude definitive conclusions. Full article

Background/Objectives: The increasing prevalence of electronic nicotine delivery systems (ENDS) has prompted questions regarding their effects on periodontal health. While the detrimental impacts of cigarette smoking are well-established, the periodontal implications of ENDS use remain poorly understood. This narrative review aimed to evaluate current evidence comparing periodontal parameters, inflammatory markers, and oral microbiome composition among ENDS users, cigarette smokers, and non-smokers. Methods: A structured literature search was conducted in PubMed (January 2009–May 2026) following a PICO question: “What is the impact of ENDS, compared to cigarette smoking and non-smoking, on periodontal health?” Clinical studies reporting on periodontal health parameters (plaque index, bleeding on probing, probing depth, and clinical attachment loss), inflammatory markers (e.g., IL-1β, IL-6, TNF-α), and microbial composition were included. Due to methodological heterogeneity across studies, meta-analysis was not feasible, necessitating narrative synthesis. Results: Across studies, clinical periodontal findings in ENDS users were heterogeneous and did not consistently resemble those of either cigarette smokers or non-smokers. In contrast, ENDS use was consistently associated with alterations in inflammatory profiles and oral microbiome composition, characterized by selective changes in specific inflammatory cytokines rather than uniform inflammatory upregulation, as well as shifts towards microbial communities linked to periodontal inflammation. Notably, these biological alterations were not uniformly reflected in traditional clinical periodontal indices. Conclusions: ENDS use is associated with heterogeneous clinical findings and inflammatory and microbial alterations that suggest ENDS is a distinct exposure rather than a predictable intermediate between smoking and non-use. This review, to our knowledge, is the first to integrate clinical, inflammatory, and microbiome outcomes and highlights the limitations of relying solely on clinical parameters to assess the impact of ENDS on periodontal health. It also underscores the need for well-designed longitudinal studies to clarify the periodontal implications of ENDS use. Full article