Search Results (296)

Although electronic cigarettes have been banned in Brazil since 2009, their use is increasing, particularly among youth. We conducted a biomarker-based study to profile exclusive e-cigarette users in São Paulo and to examine the associations of e-cigarette use with salivary nicotine and cotinine levels. A population-based, cross-sectional study was conducted between April and September 2024 in six municipalities in São Paulo, Brazil. Randomly selected participants who reported exclusive use of electronic cigarettes completed a questionnaire and provided oral fluid samples for the determination of their nicotine and cotinine concentrations using LC-MS/MS. The cohort consisted of N = 417 participants. Significant associations were found between nicotine and cotinine concentrations and variables such as knowledge of nicotine content and product type. Addiction status significantly influenced the nicotine and cotinine concentrations, as well as smoking history, last consumption, recharge/purchase frequency, and consumption duration (all p < 0.001). Participants who perceived themselves to have a moderate or severe addiction exhibited higher nicotine and cotinine concentrations compared with those who did not perceive that they had an addiction (p < 0.001). Most participants were young, predominantly White, and highly educated and earned higher incomes. The findings reveal a correlation between perceived nicotine dependence and salivary nicotine and cotinine concentrations, underscoring the physiological and behavioral markers of electronic cigarette addiction. High salivary concentrations of nicotine appear to be independent of duration of e-cigarette use, smoking history, and age. These findings underscore the urgent need for surveillance and public health interventions, even in jurisdictions where these products remain illegal. The study limitations include its cross-sectional design and potential selection bias due to convenience sampling. Full article

The term ‘vaping’ refers to the use of electronic cigarettes or other devices to inhale a variety of heated and aerosolized substances. Vaping has been promoted as a less harmful and potentially oncogenic alternative to nicotine cigarettes, particularly to help heavy smokers quit. While vaping products do not produce the same carcinogenic substances—such as polycyclic aromatic hydrocarbons—generated by the combustion of tobacco, and while their fluids lack tobacco-related carcinogens like nitrosamines, it is now well established that they still generate harmful and potentially oncogenic byproducts. Several mechanisms have been proposed to explain the potential oncogenic effects of vaping fluids, including direct chemical action, epithelial–mesenchymal transition induction, redox stress, mitochondrial toxicity, and DNA damage. In addition to cancer risk, there have been reports of adverse effects on cardiovascular health, reproductive function, and non-oncologic lung injuries. These include exogenous lipoid pneumonia, diffuse alveolar hemorrhage with proven alveolar injury, and vaping-associated bronchiolitis obliterans. The aim of this review is to examine vaping devices, their potential role in lung carcinogenesis, vaping-associated lung injury, and other clinical implications, including impacts on cardiovascular, cerebrovascular, and respiratory diseases, and also pregnancy and fetus health. Full article

Tobacco use remains a critical global health issue, with extensive research focusing on its impact on public health, particularly its strong association with oral cavity cancer. It is a leading cause of preventable disease and death worldwide, affecting millions each year. Despite increased awareness and regulatory measures, tobacco continues to pose significant challenges, prompting ongoing investigations into its health effects and related behaviors. Objective: This study aims to conduct a bibliometric analysis of smoking and smokeless tobacco research from 2014 to 2024, focusing on identifying key research trends, influential contributors, emerging topics, and collaborative networks on a global scale. Methods: A dataset of 2694 research papers from PubMed was analyzed using bibliometric tools. Keyword co-occurrence, authorship patterns, and institutional collaborations were mapped to reveal dominant themes and trends. Additionally, country-specific publications were examined to assess geographical contributions and emerging research frontiers. Results: The analysis indicates a 7.3% annual increase in publications, with a peak in 2021 likely influenced by COVID-19. Research topics have shifted from traditional tobacco-related health impacts, such as lung cancer and cardiovascular diseases, to newer areas like e-cigarettes and social determinants of health. Strong international collaborations were noted, with the U.S., China, and Europe as dominant contributors. Emerging research frontiers include electronic nicotine delivery systems and strategies aimed at controlling tobacco-related health risks. Conclusion: This bibliometric study highlights significant growth in tobacco-related research over the past decade. Evolving trends reflect a shift toward newer tobacco products and public health challenges. These findings provide valuable insights for shaping future research agendas and informing global tobacco control policies. Full article

Background/Objectives: Obstructive sleep apnea (OSA) is known to be closely associated with obesity, cardiovascular diseases, stroke, and mortality, and is a growing public health concern in South Korea. While conventional cigarette smoking is an established risk factor for OSA, the impact of electronic cigarette use on OSA remains poorly understood. This cross-sectional study aimed to investigate the association between electronic cigarette use and the risk of OSA among Korean adults. Methods: This study utilized data from the 2019–2023 Korea National Health and Nutrition Examination Survey (KNHANES). Smoking behavior was categorized into four groups: electronic cigarette users (dual users of electronic and conventional cigarettes), conventional cigarette smokers, non-smokers, and ex-smokers. The risk of OSA was assessed using the STOP-Bang questionnaire (score ≥ 5), and multivariable logistic regression was used to examine associations between smoking behaviors and OSA risk, with full adjustment for potential confounders. Results: Of the total participants, 3.3% were electronic cigarette users, 15.0% conventional cigarette smokers, 26.6% ex-smokers, and 55.1% non-smokers. Compared to non-smokers, the odds of being at high risk for OSA were significantly elevated among electronic cigarette users (OR = 2.01, 95% CI: 1.21–3.33), conventional cigarette smokers (OR = 1.84, 95% CI: 1.32–2.57), and ex-smokers (OR = 1.70, 95% CI: 1.25–2.30). This association remained significant even when the analysis was restricted to male participants. Conclusions: The significant association between electronic cigarette use and increased OSA risk highlights the need for targeted smoking cessation strategies and public health interventions that address the underestimated harms of vaping. Full article

Low back pain is a widespread condition that significantly impacts quality of life, with intervertebral disc degeneration (IDD) being a major contributing factor. However, the underlying mechanisms of IDD remain poorly understood, necessitating further investigation. Environmental risk factors, such as mechanical stress and cigarette smoke, elevate reactive oxygen species levels from both endogenous and exogenous sources, leading to redox imbalance and oxidative stress. The endoplasmic reticulum (ER) and mitochondria, two key organelles responsible for protein folding and energy production, respectively, are particularly vulnerable to oxidative stress. Under oxidative stress conditions, ER stress and mitochondrial dysfunction occur, resulting in unfolded protein response activation, impaired biosynthetic processes, and disruptions in the tricarboxylic acid cycle and electron transport chain, ultimately compromising energy metabolism. Prolonged and excessive ER stress can further trigger apoptosis through ER–mitochondrial crosstalk. Given the unique microenvironment of the intervertebral disc (IVD)—characterized by hypoxia, glucose starvation, and region-specific cellular heterogeneity—the differential effects of environmental stressors on distinct IVD cell populations require further investigation. This review explores the potential mechanisms through which environmental risk factors alter IVD cell activities, contributing to IDD progression, and discusses future therapeutic strategies aimed at mitigating disc degeneration. Full article

Smoking behavior, encompassing both traditional tobacco and electronic cigarette use, is influenced by a range of demographic, familial, and social factors. This study examines the relationship between smoking habits and family dynamics through a cross-sectional survey of 100 participants, using an anonymous questionnaire to collect demographic data, smoking patterns, and familial interactions. Validated instruments, including the Penn State Electronic Cigarette Dependence Index and the Family Relationship Assessment Scale, were employed to assess smoking dependence and family dynamics. The analysis identified key patterns, such as increased smoking frequency among individuals experiencing higher family tension and variations in smoking habits across age and gender groups. Nocturnal smoking was linked to higher cigarette consumption, whereas early-day smokers exhibited a lower desire to quit. Machine learning models were applied to predict and classify smoking behaviors based on socio-demographic and familial variables, with an ensemble learning model achieving the highest accuracy (93.33%), outperforming k-nearest neighbors (90.00%), support vector machines (80.00%), and decision trees (83.33%). These findings underscore the complex interplay between family relationships and smoking behavior, providing insights for public health interventions. Additionally, this study highlights the potential of machine learning in behavioral research, demonstrating its utility in identifying and predicting smoking-related patterns. Full article

The use of electronic cigarettes (e-cigarettes), or vaping, has risen significantly over the past decade as an alternative to traditional smoking. Despite growing evidence of vaping’s adverse health effects, limited data exist on medical students’ knowledge, attitudes, and behaviors regarding vaping, as well as the extent of education they receive on this topic. This study aimed to assess medical students’ perceptions of vaping-related harms and their evaluation of vaping education in medical school. A cross-sectional online survey was conducted among currently enrolled students at St. George’s University’s School of Medicine (n = 5794) over a five-week period from February to March 2024. The survey focused on students’ experiences, behaviors, attitudes, and perceptions toward e-cigarettes and vaping and their assessment of vaping-related education. Of 5794 invited students, 1400 (24%) responded, with 1193 (94%) completing the survey. While 82% had never used conventional tobacco cigarettes, 29% reported having vaped at least once. Nearly all respondents (97%) recognized vaping as a health risk; however, 75% reported receiving no formal education on vaping in their curriculum, and 68% rated their education on the topic as poor or very poor. Despite awareness of vaping’s risks, a notable proportion of medical students have engaged in the practice. The findings highlight a gap in medical education, underscoring the need for improved curriculum coverage to equip future physicians with the knowledge necessary to address vaping-related health concerns. Full article

Electronic cigarettes (e-cigarettes) are devices designed to vaporize a liquid solution, offering an alternative to traditional tobacco consumption. The identification, detection, and analysis of the compounds present in these devices are crucial for understanding their impacts on health and the environment. Numerous studies have identified a diverse range of compounds emitted by e-cigarettes, including well-known substances such as nicotine, thermal degradation products, and other toxicants that may be harmful or carcinogenic. Although e-cigarettes are often considered an alternative to conventional smoking, they are not without risks. Recent research has increasingly focused on assessing the health impacts of e-cigarettes, integrating findings from various scientific disciplines. Two primary analytical approaches are used for the sample preparation, identification, and quantification of these compounds. The first approach focuses on aerosol analysis, utilizing techniques such as headspace static extraction and gas chromatography coupled with mass spectrometry (GC-MS). The second approach is directed towards liquid analysis, employing liquid–liquid extraction techniques and liquid chromatography (LC) systems. Given the constant publication of new research in this area, a comprehensive review that consolidates information on identified compounds, sample preparation methods, and extraction and analysis techniques is necessary to integrate current knowledge and address emerging findings. Full article

Cannabis use among young adults in the U.S. has nearly doubled in recent years, driven by diverse methods of consumption and evolving cannabis legalization. Multi-modal cannabis use among young adults is an emerging public health issue that remains underexplored. This study examines the prevalence, patterns, and predictors of multi-modal cannabis use, defined as the use of two or more administration methods of cannabis use (e.g., smoking, vaping, edibles, dabbing, other forms) in the past month, among U.S. young adults aged 18–34 years. Data from the 2022–2023 Behavioral Risk Factor Surveillance System (BRFSS) across 23 states (n = 7635; weighted n = 7,482,134) show that 57% of young adults reporting current cannabis use engaged in multi-modal use, with dual- and triple-mode use being the most common. Factors associated with higher odds of multi-modal use include sexual minority status, poor physical health, frequent cannabis use, and co-use of electronic cigarettes and alcohol. Recreational cannabis legalization (RCL) is significantly linked to higher odds of multi-modal use. These findings underscore the interplay between individual risk factors and cannabis policy environments in shaping multi-modal cannabis use behaviors. To mitigate potential harms, targeted prevention strategies should prioritize young adults at risk for cannabis use, addressing both personal and policy-related factors influencing multi-modal cannabis use. Full article

Current lifestyles bring about an increasing prevalence of unhealthy habits that can negatively affect male fertility. Cigarette smoking, alcohol intake, stress, inadequate physical activity, an unequilibrated diet leading to obesity, and use of mobile telephones and portable electronic devices can affect the male reproductive system through multiple mechanisms. Moreover, the modern man is often exposed to environmental factors independent of his will, such as air pollution, exposure to heat or toxicants in his workplace, or the presence of harmful chemicals in food, beverages, agricultural and industrial products, etc. The susceptibility to these factors depends on genetic and epigenetic predisposition, potentially present systemic disease and medication, and local affections of the genitourinary system. The multifaceted nature of both the causative factors and the susceptibility background makes the resulting fertility disturbance highly individual and variable among different men exposed to the same conditions. This paper critically reviews the current knowledge of different causative and susceptibility factors with a special attention to the molecular mechanisms of their action. Finally, strategies for the prevention of abnormalities due to lifestyle and environmental factors and available treatment modalities for already-present abnormalities are exposed. Full article

Background and Objectives: Pneumothorax is a medical condition characterized by the accumulation of air in the pleural cavity, leading to lung collapse. While cigarette smoking is a well-known risk factor, the role of electronic cigarettes is less understood. This systematic review aimed to evaluate the outcomes of vaping-associated pneumothorax, in addition to its clinical features and management strategies, by compiling published case reports and case series. Materials and Methods: The choice to use case reports and case series was due to the limited availability of other types of studies on this emerging condition, as vaping-associated pneumothorax is relatively rare and primarily reported in isolated cases. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic search of six databases for case reports and case series. Data extraction and quality assessment were performed independently by multiple reviewers. Results: Seven case reports and four case series with a total number of 16 patients were included. Most patients were young, underweight men who presented with chest pain and shortness of breath. Conventional cigarette and cannabis use were commonly reported alongside vaping. The main treatment was the insertion of a chest tube, with surgical interventions reserved for severe cases. Patients who were treated non-surgically exhibited a higher recurrence rate. Additionally, specific symptoms such as chest pain radiating to the ipsilateral shoulder were associated with a higher recurrence rate. Conclusions: Clinicians should be vigilant for pneumothorax in at-risk individuals, consider targeted screening for symptomatic vapers, and prioritize early surgical intervention in recurrent cases to reduce complications. Further research is needed to understand the pathophysiology of vaping-associated spontaneous pneumothorax and optimal management strategies. Full article

Tobacco smoking and electronic cigarette (EC) use are associated with elevated levels of particulate matter (PM) and nicotine in indoor environments. This study assessed filtration and nicotine capture efficiency of untreated and citric acid-treated high efficiency particulate air (HEPA) filters from two manufacturers, “on-brand” (original) and “off-brand” (replacement). When challenged with salt aerosol, the filtration efficiency (FE) (Mean ± RSD) of original HEPA filters (99.9% ± 0.1) was significantly higher than replacements (94.4% ± 1.7), but both were significantly below the HEPA designation of 99.97%. No significant differences in FE were observed between treated and untreated HEPA filters. All filters had lower FE for EC aerosol compared to salt aerosol, especially among replacement filters. Nicotine capture efficiency was significantly higher in citric acid-treated HEPA filters for originals (99.4% ± 0.22) and replacements (99.0% ± 1.07) compared to untreated originals (57.4% ± 2.33) and replacements (42.0% ± 14.20). This study demonstrated that our citric acid treatment of HEPA filters was effective and efficient at capturing airborne nicotine and did not affect the FE for PM. Use of citric acid-treated HEPA filters would be an effective exposure reduction strategy for both nicotine and PM in indoor settings. Full article

The current study began with the following question: Is smoking a balanced factor between human body systems? One of the particular features of the oral cavity is its localization at the gateway of respiratory and digestive. Morphologically, the oral cavity encompasses a complex association of soft tissues, hard tissues, salivary glands, and taste receptors. The main purpose of this study was to analyze the tobacco residues (TAR) deposited on dental materials and the alterations of artificial saliva that comes into contact with tobacco smoke, by obtaining a solution of cigarette smoke extracts (CSE) after 5, 10, 15, and 20 tobacco cigarettes. According to LC-MS analysis and FT-IR spectra, carbonyl compounds, phenols, and carboxylic acids are present in CSE, which could explain the pH decrease and acid characteristic. Moreover, the CSE solution was added to the culture medium of Mesenchymal Stem Cells (MSCs) to evaluate the cytotoxicity. The MTT study revealed decreased MSC viability; morphological changes and cell death were more intense at higher doses of CSE added to the culture medium. Scanning Electron Microscopy (SEM) indicated cellular ruffling and irregular cell surface under higher concentrations of CSE-15 and CSE-20 in culture media, which is a characteristic feature demonstrating the membrane stress. In conclusion, the present study, with its limitations, showed the negative cellular effects of tobacco cigarette smoking and the impact of this habit on the oral cavity homeostasis. Full article

Electronic cigarettes (e-cigs) recently increased their popularity as “safer” alternatives to traditional tobacco smoking, including among pregnant women. However, the effect of e-cig exposure on fetal and neonatal developing lungs remains poorly investigated. In this review, we analysed the impact of e-cig aerosol components (e.g., nicotine, solvents, and flavouring agents) on respiratory system development. We particularly emphasized the role of e-cig-related oxidative stress and inflammation on lung impairment. Nicotine contained in e-cigs can impair lung development at anatomical and molecular levels. Solvents and flavours induce inflammation and oxidative stress and contribute to compromising neonatal lung function. Studies suggest that prenatal e-cig aerosol exposure may increase the risk of future development of respiratory diseases in offspring, such as asthma and chronic obstructive pulmonary disease (COPD). Preventive strategies, such as smoking cessation programs and antioxidant supplementation, may be essential for safeguarding respiratory health. There is an urgent need to explore the safety profile and potential risks of e-cigs, especially considering the limited studies in humans. This review highlights the necessity of regulating e-cig use during pregnancy and promoting awareness of its potential consequences on fetal and neonatal development. Full article

The habit of smoking in its various forms represents a significant public health concern due to its wide range of pathological effects, included the oral cavity. In recent years, alternatives to traditional cigarettes, such as heated tobacco products and electronic cigarettes, have gained popularity and are often marketed as potentially less harmful options. This study seeks to evaluate and compare the morphometric characteristics of oral mucosal capillaries in individuals who consume combusted tobacco, heated tobacco, vaporized liquid, and non-smokers. Using videocapillaroscopy, we assessed both parametric and non-parametric data from 60 patients, divided into four groups according to their smoking habits. The analysis revealed significant differences in capillary morphology among the groups. Users of combusted tobacco exhibited pronounced reductions in capillary diameter, alongside increased tortuosity and the presence of microaneurysms. These alterations are indicative of chronic inflammation and vasoconstriction, likely driven by exposure to nicotine and the high temperatures associated with combustion. Conversely, users of heated tobacco and vaporized liquid exhibited comparatively fewer vascular abnormalities, although angiogenic effects attributable to nicotine were still observable. These findings suggest that alternative tobacco products may have a comparatively lesser impact on the oral microcirculation when compared to traditional smoking. However, the potential long-term effects of these products remain unclear. Further longitudinal research is required to fully understand the risks associated with prolonged use of heated tobacco and electronic cigarettes. Full article