Search Results (75)

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

The prevalence of e-cigarette use (vaping) in young adults is concerning, particularly because the initiation of combustible tobacco use is higher in e-cigarette vapers. It is unclear why young, never-smoker vapers decide to start smoking cigarettes, but they may be influenced by perceptions of health risks and accessibility. We designed a social media questionnaire to assess factors driving the initiation of combustible tobacco use by e-cigarette vapers (multi-inhalant use) and switches between inhalant types. Respondents reported an earlier initiation of combustible tobacco versus vaping (18 vs. 19, respectively, p < 0.0001), greater ease of obtaining combustibles versus vaping products (p < 0.01), and pleasure of vaping being equivalent to that of smoking. The majority of subjects (57%) reported smoking first prior to adding vaping devices, 32% reported initiating both smoking and vaping within 12 months of one another, and 11% reported initiating vaping first. Among respondents (n = 864) who switched from vaping to smoking (n = 104), the primary reasons included 1. the perception that smoking was healthier (44%) and 2. greater accessibility of cigarettes (40%). For those who switched from smoking to vaping (n = 178), the predominant motivations included 1. having friends or family who vape (40%) and 2. the perception that vaping was healthier (36%). Among multi-inhalant users (n = 223), key factors driving this behavior included 1. increased enjoyment (47%) and 2. greater variety (42%). Our findings imply that there is no single, dominant reason driving the initiation of combustible use or switching from one inhalant to another. Further, tobacco users are receiving mixed messaging, leading many to believe that combustible tobacco is the healthier option. Public health interventions are needed to prevent the initiation of e-cigarette vaping by youth and to educate the public about the health effects of tobacco products. Full article

Background: Acute and chronic sinusitis significantly impact patients’ quality of life. Effective drug delivery to paranasal sinuses is crucial for treating these conditions. However, medications from conventional devices like nasal drops, sprays, and nebulized mists often fail to penetrate the small ostia and reach the sinuses. This study aims to assess the effectiveness of e-vape-generated aerosols entering and filling paranasal sinus cavities, particularly the maxillary sinus. Methods: The aerosol droplets were generated using an electronic vaporizer (e-vape) and were composed solely of vegetable glycerin (VG) and propylene glycol (PG). Patient-specific, transparent nose-sinus models, including one with post-uncinectomy surgery, were used to evaluate the effectiveness of these e-vape-generated VG-PG aerosols in entering the sinuses under unidirectional and bidirectional airflow conditions. Visualizations from various nasal model views and lighting conditions were recorded. Particle size distribution measurements of the e-vape aerosol were conducted using a laser diffraction particle size analyzer. Results: E-vape-generated VG-PG droplets effectively enter paranasal sinuses under specific administration conditions. E-vape aerosol droplet size measurements revealed a mean particle size ranging from 2.895 to 3.359 μm, with a median particle size (D50) averaging 2.963 μm. The speed of aerosol entering the paranasal sinuses is directly proportional to the ostia size; larger ostia result in faster sinus entry. A continuous moderate flow is necessary to gradually fill the paranasal sinus cavities. The aerosol entry into sinuses was observed at 2 L/min and decreased with increasing flow rate. The mechanisms of aerosol entry involve maintaining a positive pressure gradient across the ostial canal, a non-equilibrium transverse pressure distribution, and a two-way flow through the ostium. Gravitational forces and recirculation currents further enhance the deposition of e-vape aerosols. Comparative tests showed that traditional delivery devices exhibited limited penetration into paranasal sinuses. Conclusions: This study demonstrated that e-vape-generated aerosols could serve as a vehicle for delivering active pharmaceutical ingredients (APIs) directly to the paranasal sinuses, improving treatment outcomes. Full article

Background/Objectives: This study focuses on the ability of vaping technology to deliver beclomethasone dipropionate compared to nebulization. Methods: An in vitro comparison of aerosol properties in terms of respirable dose with the Glass Twin Impinger and the mass median aerodynamic diameter using the Next Generation Impactor was performed. The respirable dose delivered in a vaping drug delivery system (VDDS) puff as a function of concentration was quantified by high-pressure liquid chromatography coupled with an ultraviolet detector. Results: The mass of drug contained in a single puff of 55 mL of aerosol varied between 0.94 and 1.95 µg for a refill liquid concentration range of 400 to 1600 µg/mL. The analysis of the particle size distribution shows an advantage for a VDDS in producing smaller particles compared to nebulization (1.56 ± 0.05 µm vs. 2.30 ± 0.19 µm). In total, 81 puffs are needed to reach the dose equivalent to nebulized beclomethasone dipropionate under these specific experimental conditions, which corresponds to an aerosol duration of about 4 min (i.e., four times lower than the jet nebulizer) and a patient administration time of about 45 min (i.e., three times higher than the jet nebulizer). Conclusions: The results show the potential of vaping devices as an alternative to nebulizers for the administration of beclomethasone dipropionate in an equivalent respirable dose. Full article

New-generation disposable e-cigarettes have become increasingly popular among young adults in the USA since the FDA’s partial flavor ban. This study aims to examine longitudinal changes in health risks among young adults who adopted these novel products, as well as the health effects of device types beyond the effects of other important e-cigarette characteristics. This study recruited e-cigarette users via voluntary response sampling from three college campuses in the USA to respond to four-wave online surveys conducted in four consecutive semesters. Among the participants who adopted disposables during the study, their health risks (dependence symptoms, respiratory symptoms, combustible tobacco use) and e-cigarette consumption characteristics (use frequency, nicotine concentration and flavors) before and after the adoption were compared using paired-sample t- or McNemar’s tests. Generalized linear mixed models with a random intercept were conducted on data from the entire sample to investigate the effects of device type (tank, cartridge/pod, disposable) on health risks, controlling for other e-cigarette consumption characteristics. The study sample of 650 e-cigarette users were, on average, 20 years old, with 49% being male, 70% being White, and 13% being Hispanic. Adopting disposables may increase secondary dependence motives (t = 2.42, p < 0.05) and the use of higher levels of nicotine concentration (t = 2.09, p < 0.05) and sweet flavors (x² = 22.53, p < 0.05) but decrease the number of times of vaping per day (t = −2.18, p < 0.05) and the use of menthol flavors (x² = 4.57, p < 0.05). Tank use is associated with a higher level of primary dependence motives (b = 0.1998, p < 0.05) and a greater odds of using combustible tobacco (b = 0.4772, p < 0.05). Although disposable use is not associated with the likelihood of using combustible tobacco, it is associated with higher levels of both primary (b = 0.2158, p < 0.05) and secondary (b = 0.2533, p < 0.05) dependence motives. It is not the device type, but rather the frequency of vaping, that affects respiratory symptoms (b = 0.0602, p < 0.05). The findings indicate that when young adults switch to disposables, their e-cigarette dependence and use of sweet-flavored e-liquids increase. Even after controlling for use frequency, nicotine concentration and flavors, using disposables is related to not only instrumental motives that are influenced by psychological and environmental contexts but also heavy, automatic use that can operate without environmental cues. Given the health risks associated with disposable e-cigarettes, more comprehensive tobacco product regulations that consider the impact of device types may be needed. Full article

The chemical components of the e-liquids and aerosols contained in electronic nicotine delivery systems (ENDSs), better known as vapes, were evaluated. The analytical technique used was gas chromatography–mass spectrometry, where the extraction and injection methods were established in this study. The work consisted of the analysis of twenty samples of disposable electronic cigarettes prefilled with new e-liquid, of a known brand, flavor, volume, and, in some of them, the percentage of nicotine and the number of puffs per device were indicated on the label. We detected the presence of many substances (at a qualitative and semi-quantitative level), and we achieved the quantification of benzene, toluene, and xylenes (BTX), dangerous substances that cause severe damage to health. Several of the e-liquids and aerosols present BTX concentrations above the permissible exposure limit (PEL), recommended by the Occupational Safety and Health Administration (OSHA): benzene in aerosol samples 80% > PEL, and toluene in aerosol samples 45% > PEL. The number of chemical compounds found in the samples increases from 13 to 167, the average being 52 compounds for the water extraction method, 42 compounds for the methanol extraction method of e-liquids, and 107 compounds for the direct aerosol analysis. It is a fact that many of those compounds, especially BTX, can cause serious effects on human health, affecting the respiratory, digestive, cardiovascular, pulmonary, and immune systems, as well as the brain. Therefore, the use of these devices should be considered with caution, since the substances and their chemical nature may pose significant health risks to both users and those exposed to secondhand emissions. Full article

Heated tobacco products (HTPs) are newly developed nicotine delivery systems via the inhalation of mainstream aerosols generated during the heating of tobacco leaf materials. Previous studies have shown that the amount of chemicals generated is much lower than that generated by conventional combustible cigarettes. However, little attention has been paid to formate, a conjugated base of formic acid with potentially toxic effects on human health. This study aims to understand the actual emission levels and behaviour of formate in mainstream aerosols produced by commercially available HTP devices in Japan. Aerosols were generated from four types of devices with regular and menthol-type flavours using a vaping machine following the CRM 81 puffing protocol. Formate was tapped in 5 mM sodium carbonate solution and subsequently analysed using ion chromatography. The results showed that the total emission amount of formate ranged from 0.0027 ± 0.0031 to 0.27 ± 0.055 mg L⁻¹, varying with heating temperature and flavour type. Moreover, the majority of formate existed in a particulate form due to the weak-basic property of the aerosol, and the formate emission level was much greater than the workplace exposure limit for the direct inhalation of mainstream aerosols. The formate in the mainstream aerosol can be considered a health concern, when using “high-temperature type” HTPs over a long period. Full article

Because of the increasing popularity of e-cigarettes, monitoring the e-cigarette market has become important for national health authorities to guarantee safety and quality. In the EU, the Tobacco Products Directive requires emission studies for e-cigarette products. The absence of industry guidelines for studying these emissions and the lack of proper validation in the literature led us to develop and validate a method using the total error approach for the determination of nicotine in e-cigarette aerosols. A commercial vaping device was used to generate aerosols, which were then collected on Cambridge filter pads and measured for nicotine concentration by UHPLC-DAD after extraction. The method was successfully validated by generating accuracy profiles, which show that the β-expectation tolerance intervals remained below the acceptance limits of ±20%. Within-run repeatability and intermediate precision were considered acceptable since the highest RSD value obtained was below 5%. The method was applied to 15 commercial e-liquids. A complete validation of a method for the analysis of e-cigarette emissions is presented, including several parameters that impact the accuracy and reproducibility. Similar systematic approaches for method development and validation could be used for other e-cigarette emission analysis methods to ensure the reliability of the measurements. Full article

Background: Electronic cigarettes or vapes are battery-operated devices that heat a liquid, often containing nicotine and flavouring substances, to produce an inhalable aerosol. Despite being used as an alternative to traditional smoking, many studies have reported their health risks and ineffectiveness in smoking cessation. The impact of e-cigarettes on weight control behaviours, a known effect of traditional cigarette smoking, is unclear. Herein, a systematic review was conducted to explore the relationship between e-cigarette use and body weight changes in adolescents and young adults. Methods: The existing literature from databases such as PubMed, Cochrane Library, Embase, Science Direct, Web of Science, Scopus, and Google Scholar until October 2023 was searched and included in the review. The methodological quality of all selected studies was assessed using the Joanna Briggs Institute’s (JBI) Critical Appraisal Checklists for Studies. Results: Out of 5117 citations, 20 publications featuring cross-sectional studies with adolescent participants were qualitatively analysed. The high rates of e-cigarette usage seemed to correlate with increased weight concerns, particularly among females. Regular e-cigarette users who reported being overweight and used calorie restriction for weight reduction were more likely to view vaping as a weight loss or control strategy. Young adults (<24 years) may consume more flavoured e-cigarettes than older users (>25 years). Conclusions: This study revealed a significant use of e-cigarettes among high school students, driven by taste preferences, weight management, and perceived harm reduction. Particularly among girls facing body image pressures, vaping serves as a weight control method. This highlights the need to assess cardiovascular risks and advocate for further research, including longitudinal studies, to inform public health strategies effectively. Full article

This work aims to investigate bronchodilator delivery with the use of different vaping drug delivery systems (VDDS) by determining the dose equivalence delivered in relation to different references: a clinical jet nebulizer, a pMDI (pressurized metered dose inhaler) and a DPI (dry powder inhaler). Three different bronchodilators were used (terbutaline, salbutamol hemisulfate, ipratropium bromide). The e-liquids contained the active pharmaceutical ingredient (API) in powder form. Two different VDDS were tested (JUUL and a GS AIR 2 atomizer paired with a variable lithium-ion battery (i-stick TC 40 W), 1.5 ohm resistance, and 15 W power). Samples were collected using a glass twin impinger (GTI). High-performance liquid chromatography (HPLC) was used to quantify the drugs. A next-generation impactor (NGI) was used to measure the particle size distribution. Terbutaline emerged as the optimal API for bronchodilator delivery in both VDDS devices. It achieved the delivery of a respirable dose of 20.05 ± 4.2 µg/puff for GS AIR 2 and 2.98 ± 0.52 µg/puff for JUUL. With these delivered doses, it is possible to achieve a dose equivalence similar to that of a jet nebulizer and DPI, all while maintaining a reasonable duration, particularly with the GS AIR 2. This study is the first to provide evidence that vaping bronchodilators work only with appropriate formulation, vaping technology, and specific drugs, depending on their thermal degradation properties. Full article

Despite growing interest in the use of cannabis for the treatment of cancer-related symptoms, there are limited studies that have assessed the use pattern, type, and mode of delivery of cannabis products used by cancer survivors. This study describes the current state of the use pattern, product type, and mode of delivery of cannabis used by cancer survivors. This was a cross-sectional study of cancer survivors from 41 U.S. states who received treatment at the largest NCI-designated comprehensive cancer center. The weighted prevalence of the use patterns, product types, and modes of delivery of cannabis used by cancer survivors was estimated. A total of 1886 cancer survivors were included in the study, with 915 (48% [95% CI: 45–51]) reporting ever using cannabis. Of survivors who had ever used cannabis, 36% (95% CI: 33–40) were current users. Among survivors who reported cannabis use after diagnosis, 40% used cannabis during and after cancer treatment, 35% used cannabis during treatment, and 25% used cannabis after completing their cancer treatment. Additionally, 48% of survivors reported an increase in cannabis use since cancer diagnosis. The commonest types of cannabis products used by cancer survivors were dry leaf cannabis (71%), cannabidiol (CBD) oil (46%), and cannabis candy (40%). Moreover, cancer survivors frequently used baked goods (32%), creams and gels (21%), and tinctures (18%). Furthermore, among ever users, the predominant mode of use was cannabis inhalation/smoking (69%) compared to eating/drinking (59%). More so, the common mode of inhalation/smoking of cannabis products were rolled cannabis cigarettes (79%), pipes (36%), water pipes (34%), vaporizers or vapes (14%), and e-cigarette devices (14%). A substantial number of cancer survivors use cannabis during cancer treatment, with increased use following cancer diagnosis. The forms and modes of delivery of cannabis varied among survivors, with most survivors inhaling or smoking cannabis. There is a need to educate healthcare providers (HCPs) and survivors on current evidence of cannabis use and strengthen cannabis regulatory frameworks to optimize benefits and minimize adverse events from cannabis use during cancer treatment. Full article

E-cigarette use has been reported to affect cell viability, induce DNA damage, and modulate an inflammatory response resulting in negative health consequences. Most studies focus on oral and lung disease associated with e-cigarette use. However, tissue damage can be found in the cardio-vascular system and even the bladder. While the levels of carcinogenic compounds found in e-cigarette aerosols are lower than those in conventional cigarette smoke, the toxicants generated by the heat of the vaping device may include probable human carcinogens. Furthermore, nicotine, although not a carcinogen, can be metabolized to nitrosamines. Nitrosamines are known carcinogens and have been shown to be present in the saliva of e-cig users, demonstrating the health risk of e-cigarette vaping. E-cig vape can induce DNA adducts, promoting oxidative stress and DNA damage and NF-kB-driven inflammation. Together, these processes increase the transcription of pro-inflammatory cytokines. This creates a microenvironment thought to play a key role in tumorigenesis, although it is too early to know the long-term effects of vaping. This review considers different aspects of e-cigarette-induced cellular changes, including the generation of reactive oxygen species, DNA damage, DNA repair, inflammation, and the possible tumorigenic effects. Full article

To study and monitor the adverse health consequences of using electronic cigarettes, a user’s puff topography, which are quantification parameters of the user’s vaping habits, plays a central role. In this work, we introduce a topography sensor to measure the mass of total particulate matter generated in every puff and to estimate the nicotine yield. The sensor is compact and low-cost, and is integrated into the electronic cigarette device to promptly and conveniently monitor the user’s daily puff topography. The topography sensor is comprised of a photometric sensor and a pressure sensor. The photometric sensor measures the mass concentration of the aerosol, based on scattering of near-infrared light from airborne particles, while the pressure sensor measures the flow rate. The topography sensor was tested under various conditions including a wide range of atomizer power, puff duration, and inhalation pressure. The sensor’s accuracy was validated by comparing the sensor’s readings with reference measurements, and the results matched closely with the trends reported by existing studies on electronic cigarettes. An example application for tracking a user’s puff topography was also demonstrated. Our topography sensor holds great promise in mitigating the health risks of vaping, and in promoting quality control of electronic cigarette products. Full article

Despite claims of safety or harm reduction for electronic cigarettes (E-cig) use (also known as vaping), emerging evidence indicates that E-cigs are not likely safe, or necessarily safer than traditional cigarettes, when considering the user’s risk of developing vascular dysfunction/disease. E-cigs are different from regular cigarettes in that E-cig devices are highly customizable, and users can change the e-liquid composition (such as the base solution, flavors, and nicotine level). Since the effects of E-cigs on the microvascular responses in skeletal muscle are poorly understood, we used intravital microscopy with an acute (one-time 10 puff) exposure paradigm to evaluate the individual components of e-liquid on vascular tone and endothelial function in the arterioles of the gluteus maximus muscle of anesthetized C57Bl/6 mice. Consistent with the molecular responses seen with endothelial cells, we found that the peripheral vasoconstriction response was similar between mice exposed to E-cig aerosol or cigarette smoke (i.e., 3R4F reference cigarette); this response was not nicotine dependent, and endothelial cell-mediated vasodilation was not altered within this acute exposure paradigm. We also report that, regardless of the base solution component [i.e., vegetable glycerin (VG)-only or propylene glycol (PG)-only], the vasoconstriction responses were the same in mice with inhalation exposure to 3R4F cigarette smoke or E-cig aerosol. Key findings from this work reveal that some component other than nicotine, in inhaled smoke or aerosol, is responsible for triggering peripheral vasoconstriction in skeletal muscle, and that regardless of one’s preference for an E-cig base solution composition (i.e., ratio of VG-to-PG), the acute physiological response to blood vessels appears to be the same. The data suggest that vaping is not likely to be ‘safer’ than smoking towards blood vessels and can be expected to produce and/or result in the same adverse vascular health outcomes associated with smoking cigarettes. Full article

The use of vaping or electronic cigarette devices (ECDs) has recently increased as an alternative to conventional tobacco smoking products. By recording the CIELAB coordinates (L*a*b*) and computing the total color difference (ΔE) values using a spectrophotometer, the effect of ECDs on contemporary aesthetic dental ceramics was investigated in this in-vitro study. A total of seventy-five (N = 75) specimens from five different (n = 15) dental ceramic materials (Pressable ceramics (PEmax); Pressed and layered ceramics (LEmax); Layered zirconia (LZr); Monolithic zirconia (MZr) and Porcelain fused to metal (PFM)) were prepared and exposed to aerosols produced by the ECDs. The color assessment was performed using a spectrophotometer at six time intervals (0 = baseline; 250-puff exposures; 500-puff exposures; 750-puff exposures; 1000-puff exposures; 1250-puff exposures; and 1500-puff exposures). By recording L*a*b* and computing total color difference (ΔE) values, the data were processed. A one-way ANOVA and Tukey procedure for pairwise comparisons were used to assess color differences between tested ceramics (p < 0.05). All test materials demonstrated significant color differences (ΔE) after exposure to vaping (p < 0.05). The LZr group displayed noticeably high ΔE values at all the distinct puff exposure intervals, with the highest ΔE value of (13.67) after 1500 puffs. The lowest (ΔE) values were observed in the PFM group after 250 and 500 puffs (0.85 and 0.97, respectively). With the exception of the group PEmax (p = 0.999), all groups produced readings of “ΔE” that indicated significant differences (p < 0.05) at various degrees of puff exposures. ECDs can noticeably alter the color of the dental ceramics affecting the esthetics of the patients. All the materials tested demonstrated significant color changes (ΔE > 3.33) above the clinically acceptable threshold, except for the PFM and PEmax group (ΔE < 3.33) which showed color stability after exposure to the ECDs. Full article