Should Nicotine Content of Cigarettes Be Reduced Gradually or Suddenly?

MedicalResearch.com Interview with:

Dorothy K. Hatsukami, Ph.D. Forster Family Professor in Cancer Prevention Professor of Psychiatry Associate, Director Masonic Cancer Center University of Minnesota

Dr. Hatsukami

Dorothy K. Hatsukami, Ph.D.
Forster Family Professor in Cancer Prevention
Professor of Psychiatry
Associate, Director Masonic Cancer Center
University of Minnesota 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The U.S. Food and Drug Administration is considering a rule that would reduce nicotine in all cigarettes and possibly other burned tobacco products sold in the U.S. to minimally addictive levels.   Reducing nicotine in cigarettes does not make the cigarette safer, but because nicotine is the addictive chemical in tobacco, nicotine reduction would reduce the progression towards tobacco dependence and make it easier for smokers to quit smoking.  We recently published a study in JAMA that adds to the accumulating evidence to support reducing nicotine in cigarettes and addresses if a gradual reduction or a targeted immediate reduction in nicotine in cigarettes is the best approach.

In a large clinical trial involving 1,250 smokers across 10 academic institutions, immediate reduction of nicotine was compared to a gradual nicotine reduction approach. These two groups were also compared to smokers who continued to smoke usual nicotine content cigarettes.

Key findings showed that immediate nicotine reduction is likely to result in more rapid positive public health effects.  That is, smokers in the immediate reduction group experienced significantly less exposure to toxic cigarette smoke chemicals and reported smoking fewer cigarettes per day, less dependence on cigarettes and greater number of days that they were smoke-free compared to the other two groups. On the other hand, smokers in the immediate nicotine reduction group experienced more severe but transient withdrawal symptoms and greater drop-outs.  Continue reading

Which Group Is at Highest Risk for Tobacco Use Onset? Youth or Young Adults?

MedicalResearch.com Interview with:
“hookah” by Ksenia M is licensed under CC BY 2.0Cheryl L. Perry, Ph.D.
Professor of Health Promotion and Behavioral Sciences
The Rockwell Distinguished Chair in Society and Health
University of Texas Health Science Center at Houston (UTHealth)
School of Public Health, Austin, Texas

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There have been large changes in the social environment over the past 10 years that have affected tobacco use among youth and young adults. These include social media, e-cigarettes, and new regulations aimed at preventing use among youth.

Historically, nearly all onset of tobacco use, particularly cigarettes, occurred prior to high school graduation by age 18. Some recent national cross-sectional data suggested that onset might be occurring among young adults.

We decided to explore, with national and Texas data, whether onset of tobacco use was more likely to occur among young adults.

We did this by analyzing data from 3 studies over one year. Continue reading

Thousands of Students Sneak JUUL To Use School Hours

MedicalResearch.com Interview with:

Jon-Patrick Allem, Ph.D., M.A. Research Scientist Keck School of Medicine of USC

Dr. Allem

Jon-Patrick Allem, Ph.D., M.A.
Research Scientist
Keck School of Medicine of USC

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by JUUL? 

Response: The JUUL vaporizer is the latest advancement in electronic cigarette technology, delivering nicotine to the user from a device about the size and shape of a thumb drive.

JUUL has taken the electronic cigarette market by storm experiencing a year-over-year growth of about 700 percent.

In our most recent study, we wanted to document and describe the public’s initial experiences with JUUL. We collected posts to Twitter containing the term “Juul” from April 1, 2017 to December 14, 2017. We analyzed over 80,000 posts representing tweets from 52,098 unique users during this period and used text classifiers (automated processes that find specified words and phrases) to identify topics in posts.

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Could Restricting Nicotine in E-Cigarettes Do More Harm Than Good?

MedicalResearch.com Interview with:
e-cigarette CDC imageDr Lynne Dawkins, PhD

Associate Professor
London South Bank University

MedicalResearch.com: What is the background for this study?

Response: Many people think that it’s the nicotine that’s harmful so they opt for using a low strength in their e-liquid. We know from tobacco smoking that when people switch to using a lower nicotine yield cigarette, they compensate in order to maintain a steady blood nicotine level by taking longer, harder drags and this can increase exposure to toxins in the smoke. We also know from some of our other work with vapers (e-cigarette users) that they tend to reduce the nicotine strength of their e-liquid over time. We therefore wanted to explore whether vapers also engage in this compensatory puffing and whether this has any effect on exposure to potentially harmful chemicals.

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Does Preloading With a Nicotine Patch Help Smokers Quit?

MedicalResearch.com Interview with:
“Day 1 of nicotine patch, just stuffed my face with lunch at work and do NOT even want a cigarette” by David Bruce Jr. is licensed under CC BY 2.0Paul Aveyard
Professor of Behavioural Medicine
Nuffield Department of Primary Care Health Sciences
University of Oxford
Radcliffe Primary Care Building
Radcliffe Observatory Quarter
Oxford

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Tobacco addiction occurs because of repeated pairings of the act and sensation of smoking with binding of nicotine in the midbrain leading to release of dopamine in the nucleus accumbens. These repeated pairings create associative learning and, when brain nicotine concentrations fall, this produces a compulsion to keep using tobacco. In theory, blocking the actions of nicotine released while smoking ought to reverse this learning. One way to do this is to use a nicotine patch which provides a steady state high concentration of nicotine that desensitises the nicotinic receptors in the midbrain, making them unresponsive to nicotine from a smoked cigarette. This is the theory behind nicotine preloading.

The clinical trial evidence that preloading works is equivocal, with some trials suggesting a very large therapeutic effect and others no benefit at all. In the light of both the promise and the uncertainty, we aimed to complete the largest trial to date of nicotine preloading to examine its effectiveness, safety, and tolerability.

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Tobacco Flavorings On Their Own May Cause Heart Disease

MedicalResearch.com Interview with:
“fathers day” by James Simkins is licensed under CC BY 2.0Jessica L. Fetterman, PhD

Assistant Professor of Medicine
Boston University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: In our study, we studied endothelial cells, the cells that line the inside of the blood vessels. We collected endothelial cells from smokers both who use menthol and non-menthol cigarettes are impaired compared to non-smokers and we could make the non-smoker cells look like the endothelial cells of smokers by treating with menthol or eugenol (provides a clove spice-flavoring).

To test a wider variety of commonly used flavoring additives, we treated cultured (outside of the body in a dish) endothelial cells with some of the most commonly used flavoring additives in tobacco products and at different concentrations/doses. We then evaluated the effects of flavoring additives by looking at measures of cell death, oxidative stress, inflammation, and the ability of the cells to produce nitric oxide, a cardio-protective chemical made by endothelial cells that is lost when the cells become damaged.

We found that the flavoring additives used in tobacco products like e-cigarettes are toxic to the cells that line the blood vessels (endothelial cells). Our works suggests that the flavoring additives used in tobacco products may be harmful to the cardiovascular system.

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More Young Women Than Men Now Get Lung Cancer

MedicalResearch.com Interview with:
“Woman smoking” by Pedro Ribeiro Simões is licensed under CC BY 2.0Ahmedin Jemal, DVM, PHD
Scientific Vice President, Surveillance & Health Services Rsch
American Cancer Society, Inc.
Atlanta, GA 30303

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Historically, lung cancer rates have been higher in men than women at all ages because of the substantially higher cigarette smoking prevalence in men.

However, cigarette smoking prevalences over the past few decades have become similar between young men and women. Consistent with this pattern, we previously reported the convergence of lung cancer rates between young men and young women. In this paper, we examined the lung cancer incidence rates in young women versus young men in the contemporary cohorts.

We found that the historically higher lung cancer incidence rates in young men than in young women have reversed in whites and Hispanics born since the mid-1960s. However, this emerging incidence patterns were not fully explained by sex difference in smoking prevalence as cigarette smoking prevalences among whites and Hispanics were not higher in young women than young men.

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Consumers Trying But Not Continuing E-Cigarettes

MedicalResearch.com Interview with:
“E-Cigarette/Electronic Cigarette/E-Cigs/E-Liquid/Vaping” by Vaping360 is licensed under CC BY 2.0
Wei Bao, MD, PhD
Assistant Professor
Department of Epidemiology,
College of Public Health,
University of Iowa,
Iowa City, IA 52242 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Although the health effects of e-cigarettes remains unclear, e-cigarettes have been marketed as an approach for smoking cessation. Previous studies have reported an increase in e-cigarette use in US people since 2010. The current study showed that from 2014 to 2016, there was an increase in ever use of e-cigarettes but decline in current use of e-cigarettes.  Continue reading

Smoking: The Great Brain Drain

MedicalResearch.com Interview with:
“Stop smoking!” by Emil_95 is licensed under CC BY 2.0Janina Markidan MS III, MD Student

University of Maryland School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In a study of 1,145 young men, we found a strong dose-response relationship between the number of cigarettes smoked daily and the risk of ischemic stroke.

We categorized the participants as never smokers, former smokers and current smokers. Current smokers were divided into groups based on the number of cigarettes smoked daily, 1 to 10, 11 to 20, 21 to 39, or 40 or more.

We found that men who smoked were 88 percent more likely to have a stroke than men who never smoked. Among current smokers, men who smoked fewer than 11 cigarettes daily were 46 percent more likely to have a stroke than those who never smoked. But the heavier smokers, smoking at least two packs a day, were nearly 5 times (466%) more likely to have a stroke than those who never smoked.  Continue reading

Non-Cigarette Tobacco Products Double Chances of Youth Smoking Within a Year

MedicalResearch.com Interview with:
“hookah” by Ksenia M is licensed under CC BY 2.0Benjamin Chaffee, DDS MPH PhD

UCSF School of Dentistry
San Francisco, CA 94118

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Non-cigarette tobacco products, which include electronic cigarettes, hookah (tobacco waterpipe), smokeless tobacco, and non-cigarette combustibles, like cigars, are increasingly popular among young people. Considerable debate surrounds whether use of these non-cigarette products encourages youth to begin smoking conventional cigarettes.

Several previous studies have shown associations between non-cigarette tobacco use and youth smoking. These studies had largely looked at only one type of tobacco product at a time. This study included more than 10,000 adolescents from all over the United States, surveyed at two time points one year apart. Therefore, this study featured enough participants and detailed information about tobacco behaviors to consider all types of tobacco products in a comprehensive way.

We found that each type of non-cigarette tobacco product (i.e., e-cigarettes, hookah, combustibles, or smokeless tobacco) added to smoking risk. Among youth who had never smoked a cigarette at the start of the survey, use of any of the non-cigarette products approximately doubled the odds of cigarette smoking within a year, after adjusting for multiple smoking-related risk factors. Each product independently increased risk. The adolescents most susceptible to future smoking to were those who had tried two or more types of non-cigarette tobacco.

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Fewer Cigarettes But More Vaping Among Today’s Adolescents

MedicalResearch.com Interview with:
“Checking your phone and vaping as you do” by Alper Çuğun is licensed under CC BY 2.0
Richard Allen Miech, PhD
Research Professor, Survey Research Center
Institute for Social Research
University of Michigan 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Monitoring the Future conducts annual, nationally-representative surveys of ~45,000 adolescents every year to assess trends in substance use.  We track which drugs are gaining traction among adolescents and which are falling out of favor.  The survey draws separate, nationally-representative samples of 8th, 10th, and 12th grade students from about 400 total schools every year.  Once a recruited school agrees to participate, a field interviewer travels to the school to administer the paper-and-pencil survey, typically in classrooms.  The project is funded by the National Institute of Drug Abuse and is carried out by the University of Michigan.  More details on the project’s survey design and survey procedures can be found in chapter 3 here: http://monitoringthefutu re.org/pubs/monographs/mtf- vol1_2016.pdf

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Married Head/Neck Cancer Patients Less Likely To Smoke, More Likely To Live Longer

MedicalResearch.com Interview with:

Nosayaba Osazuwa-Peters, BDS, MPH, CHES Instructor, Department of Otolaryngology-Head and Neck Surgery Saint Louis University School of Medicine Member, Saint Louis University Cancer Center St Louis, Missouri

Nosayaba Osazuwa-Peters

Nosayaba Osazuwa-Peters, BDS, MPH, CHES
Instructor, Department of Otolaryngology-Head and Neck Surgery
Saint Louis University School of Medicine
Member, Saint Louis University Cancer Center
St Louis, Missouri 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Several studies have shown that there is an adverse effect of smoking on head and neck cancer survival; however, there are studies that show no effect between smoking and head and neck cancer. We wanted to investigate this problem using a single institution’s cancer dataset. Additionally, we wanted to understand the role of marital status in the smoking behavior of head and neck cancer patients, and to understand if smoking played any role in head and neck cancer survival.

Our study confirmed that head and neck cancer patients who were smokers at the time of diagnosis had lower survival rates than nonsmokers. We also found that married head and neck cancer patients were less likely to be smokers and more likely to survive longer than those unmarried.

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Trained Volunteers Can Deliver Effective Brief Smoking Cessation Advice

MedicalResearch.com Interview with:
“Stop smoking!” by Emil_95 is licensed under CC BY 2.0
Dr. Man Ping Wang, PhD
School of Nursing
University of Hong Kong
Hong Kong

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Smoking cessation (SC) services can effectively increase the chance of abstinence, but few smokers proactively seek help from these services worldwide. Smoking cessation guidelines recommend referring smokers to SC services, but such referrals were usually conducted in a passive way (e.g. providing contacts of these services and asking smokers to use them). Actively referring smokers may increase use of smoking cessation services and abstinence rates.

Previous studies were mostly conducted in clinical settings. We investigated the efficacy of using trained volunteers to actively refer smokers recruited in the community to smoking cessation services in this cluster randomized control trial. We found that smokers who received a brief cessation advice and active referral had significantly higher abstinence rate and smoking cessation service use rate at 6-month follow-up, compared with smokers who received a minimal advice and a self-help booklet.

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Cheap Cigarettes in Europe Associated With Increased Infant Mortality

MedicalResearch.com Interview with:

Filippos Filippidis MD MPH PhD Lecturer in Public Health School of Public Health Imperial College London London

Dr. Filippidis

Filippos Filippidis MD MPH PhD
Lecturer in Public Health
School of Public Health
Imperial College London
London

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Smoking kills millions of people every year. It is well established that increasing tobacco prices is the most effective way to reduce tobacco consumption and hence mitigate the devastating effects of tobacco on health. Taxation on tobacco products is high in the European Union, which makes cigarettes less affordable. However, transnational tobacco companies are known to manipulate prices, ensuring that cheap or ‘budget’ cigarettes are still available. This is particularly important for younger smokers and those of low socioeconomic status who are more sensitive in price increases.

Smoking during pregnancy, as well as exposure of pregnant women and babies to cigarette smoke increase infant mortality. There is also evidence that increasing tobacco prices is associated with lower infant mortality. However, researchers typically use average or premium cigarette prices. We analysed 54 million births from 23 European Union countries to see if the differential between average priced and budget cigarettes (i.e. the availability of cigarettes much cheaper than average priced ones) is associated with infant mortality.

We found that increasing average cigarette prices by 1 Euro per pack was associated with 0.23 fewer deaths per 1,000 live births in the same year and an additional 0.16 fewer deaths per 1,000 live births in the following year. A 10% increase in the price differential between budget and average priced cigarettes was associated with 0.07 more deaths per 1,000 live births the following year. This means that 3,195 infant deaths could potentially have been avoided in these 23 countries if there was no price difference between cigarette products over the 10-year study period.

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Smoking Cessation Meds Underprescribed To Hospitalized Cardiac Patients

MedicalResearch.com Interview with:

Dr Quinn Pack

Dr. Quinn Pack

Dr.  Quinn R Pack MD
Assistant Professor of Medicine at Tufts University School of Medicine
Baystate Northern Region Cardiology
Baystate Health
Springfield, MA  

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Smoking is the leading cause of preventable death and is very common among patients with heart disease.  Several smoking cessation medications are available and recommended in clinical guidelines to help smokers quite. However, it was unknown how often these were used and what factors make the use of pharmacotherapy more common.

The main finding is that, across of broad range of hospitals, smoking cessation medications are infrequently used and the hospital where the patient was treated was the most important factor in determining if the patient was treated.

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Holes in Cigarette Filters Linked To Increase in Lung Adenocarcinomas

MedicalResearch.com Interview with:
Peter G. Shields, M.D.
Deputy Director, Comprehensive Cancer Center
James Cancer Hospital
Professor, College of Medicine
Julius F. Stone Chair in Cancer Research
The Ohio State University Columbus, OH

MedicalResearch.com: What do we know about the health effects of cigarette filters? 
Response:  The issue is that the design of the filters makes a cigarette even more dangerous, which can be regulated by the FDA. The issue is not about having a filter, but how they are made. And now we are changing the dialogue to the design of virtually all cigarettes. The holes on the filter are likely one reason the cigarettes of today are more dangerous.

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E-cigarette Smoke Increases Bladder Cancer Risk

MedicalResearch.com Interview with:

Moon-shong Tang, Ph</strong>D Professor of Environmental Medicine, Pathology and Medicine New York University School of Medicine Tuxedo Park, New York 10987

Dr. Moon-shong Tang

Moon-shong Tang, PhD
Professor of Environmental Medicine, Pathology and Medicine
New York University Langone School of Medicine
Tuxedo Park, New York 10987

MedicalResearch.com: What is the background for this study?

Response: E-cigarettes (E-cigs) are designed to deliver the stimulant nicotine through aerosols, commonly referred as vapors. Nicotine is dissolved in organic solvents such as glycerin and propylene glycol. The nicotine is then aerosolized by controlled electric heating. E-cigs do not use tobacco leaves and E-cig smoke does not involve the burning process. Hence, E-cig smoke (ECS) contains only nicotine and the gas phase of the solvent. Because ECS contains neither carcinogens nor allergens or odors from the tobacco burning process, E-cigs have been promoted as an invention that can deliver a TS ‘high’ without TS negative effects. The population of E-cig users is rapidly rising, particularly in young adults. It has been estimated that 16% of high school students are E-cig smokers. Therefore, the health effects of E-cig smoke, particularly its carcinogenicity, deserve careful scrutiny.

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Smoking Associated With Comorbidities in Atopic Dermatitis

MedicalResearch.com Interview with:

Jacob P. Thyssen MD, PhD, DmSci Department of Dermatology and Allergy Herlev and Gentofte Hospital University of Copenhagen Hellerup, Denmark

Dr. Thyssen

Jacob P. Thyssen MD, PhD, DmSci
Department of Dermatology and Allergy
Herlev and Gentofte Hospital
University of Copenhagen
Hellerup, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Atopic dermatitis has been associated with various comorbidities. With the emergence of biologics for the treatment of atopic dermatitis, the hypothesis has been raised that atopic dermatitis is a systemic immune disease affecting more than just the skin.

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Cigarettes Continue To Vastly Outweigh Sales Of E-Cigarettes

MedicalResearch.com Interview with:

Kristy Marynak Master of Public Health Public Health Analyst at Centers for Disease Control and Prevention Centers for Disease Control and Prevention Duke University

Kristy Marynak

Kristy Marynak, Master of Public Health
Public Health Analyst at Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
Duke University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The background for our study is that in recent years, self-reported cigarette smoking has declined among youth and adults, while electronic cigarette (e-cigarette) use has increased. However, sales trends for these products are less certain. Our study assessed national and state patterns of U.S. cigarette and e-cigarette unit sales using retail scanner data from convenience and grocery stores; mass merchandisers like Walmart; drug, dollar, and club stores; and military commissaries.

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Patients Who Quit Smoking Had Fewer Adverse Events After Knee Replacement

MedicalResearch.com Interview with:
Amy Wasterlain, MD

Fourth-year orthopaedic surgery resident
NYU Langone Medical Center who led the study with Dr. Richard Iorio 

MedicalResearch.com: What is the background for this study?

Response:  We looked at smoking habits and outcomes for 539 smokers undergoing primary total hip or knee arthroplasty, 73 of whom participated in a pre-operative smoking cessation program. Patients who participated in program were 4.3 times more likely to quit than smokers who tried to quit on their own. Program participants also reduced their tobacco intake dramatically (10.6 fewer cigarettes/day) compared to smokers who didn’t participate (2.3 fewer cigarettes/day), even if they weren’t able to quit completely. Patients who completed the program before undergoing total knee arthroplasty had about 24% fewer adverse events (readmission, venous thromboembolism, stroke, urinary tract infection, pneumonia, and surgical site infection) than smokers who didn’t participate in the program.

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Prenatal Tobacco Smoke Raises Risk of Atopic Dermatitis in Offspring

MedicalResearch.com Interview with:

Dr. Saskia Trump PhD Helmholtz-Centre for Environmental Research – UFZ Department of Environmental Immunology Leipzig, Germany

Dr. Saskia Trump

Dr. Saskia Trump PhD
Helmholtz-Centre for Environmental Research – UFZ
Department of Environmental Immunology
Leipzig, Germany

MedicalResearch.com: What is the background for this study?

Response: Environmental chemicals have long been discussed to contribute to the exacerbation or even the development of allergic diseases. In our study we were particularly interested in the effect of tobacco smoke exposure, which is the main source for indoor benzene exposure, on regulatory T cell (Treg) function and its relation to the development of childhood atopic dermatitis (AD). Tregs play a critical in controlling T effector cell activity by avoiding overexpression. A deficiency in this T cell subset increases the risk for allergic inflammation.

We have previously described that exposure to tobacco smoke during pregnancy can decrease the number of regulatory T cells (Treg) in the cord blood and predispose the child to the development of AD (1). In this subsequent study we were interested in the underlying mechanism involved.

Benzene itself is not considered to be toxic, however its metabolization leads to the formation of highly reactive molecules. In humans for example the metabolite 1,4-benzochinone (1,4-BQ) can be found in the blood as a consequence of benzene exposure.

To further assess the effect of benzene on Treg and the development of AD we combined in vitro studies, evaluating the impact of 1,4-BQ on human expanded Treg, with data from our prospective mother-child cohort LINA. The LINA study, recruited in Leipzig, Germany, is a longitudinal evaluation of mother-child pairs with respect to lifestyle and environmental factors that might contribute to disease development in the child. Based on this deeply phenotyped cohort we were able to translate our in vitro findings to the in vivo scenario.

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CVS Pharmacy’s Discontinuance of Tobacco Sales Led To Big Drop In Cigarette Purchases

MedicalResearch.com Interview with:

Jennifer M. Polinski PhD Senior Director, Enterprise Evaluation and Population Health Analytics, CVS Health CVS Caremark Corporation Harvard School of Public Health

Dr. Jennifer Polinski

Jennifer M. Polinski PhD
Senior Director, Enterprise Evaluation and Population Health Analytics, CVS Health
CVS Caremark Corporation
Harvard School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Nearly three years ago, we removed tobacco products from all CVS Pharmacy locations to help our customers on their path to better health. While there is a growing body of evidence that suggests that restricting access to tobacco helps reduce its use, we wanted to understand if our decision to remove tobacco had a nationwide impact on our customers’ purchasing behavior and presumed smoking habits.

In fact, our research findings, published in the American Journal of Public Health, show that CVS Health’s decision to remove tobacco from all CVS Pharmacy stores reduced the number of cigarette purchases across all other retail settings, including gas stations, convenience stores, and other outlets. In addition, customers who exclusively purchased cigarettes at CVS Pharmacy were 38 percent more likely to stop buying cigarettes, and those who purchased three or more packs of cigarettes per month at a CVS Pharmacy were more than twice as likely to stop buying cigarettes altogether.

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High Achieving Adolescents Less Likely To Smoke, But More Likely to Drink, Use Pot

MedicalResearch.com Interview with:
Dr. James Williams
UCL Medical School
UCL
, London, UK

MedicalResearch.com: What is the background for this study?

Response: Despite a downward trend over the last decade in the usage of particular substances amongst adolescents in the UK, smoking cigarettes, drinking alcohol and smoking cannabis remain prevalent behaviours in this demographic. These risky health behaviours present a large problem in terms of public health due to the immediate and long-term health problems they cause, as well as negative non-health outcomes such as poor educational attainment and reduced employment.

The role of academic ability in determining patterns of substance use is not clear and no study has evaluated academic ability at age 11 in relation to the onset and persistence of all three substances from early to late adolescence and into young adulthood. Our study sought to determine the association between academic ability and the onset and persistence of substance use in adolescence in a representative sample of English school pupils. This would answer for the first time whether ability was associated with ‘experimentation’ in early adolescence or if the association persists into late adolescence.

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Smokers Who Switch Completely To E-Cigs Reduce Their Exposure to Toxins

MedicalResearch.com Interview with:
Dr Lion Shahab
MA (Oxon) MSc MSc PhD CPsychol AFBPsS PGCLTHE
Senior Lecturer in Health Psychology
Department of Behavioural Science and Health
University College London
London 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: To date most studies on e-cigs have either looked at the product itself, i.e. analysed vapour/aerosol or e-liquid, or investigated its effects on animal and cell models. Only very few studies have looked at actual body-level exposure in users of e-cigarettes to evaluate their safety, and this study is the first to explore this in long-term real-life users of e-cigs.

We find that compared with people who continue to smoke conventional cigarettes, those who switch over completely to using e-cigarettes long-term (1.5 years) dramatically reduce their exposure to cancer-causing chemicals to levels observed in users of nicotine replacement products like nicotine patch or gum (which are known to be safe when used long-term).

Our results also suggest that while e-cigarettes are not only safer, the amount of nicotine they provide is not noticeably different to conventional cigarettes. This can help people to stop smoking altogether by dealing with their cravings in a safer way.

MedicalResearch.com: What should readers take away from your report?

Response: The public has been receiving very mixed signals about the safety of e-cigarettes, with some reports claiming to show that they are as harmful as smoking. These reports have been based on studies that bear little relationship to exposure of e-cigarette users in the real world.

We report the first study that has actually measured the intake of potentially harmful chemicals in e-cigarette users, and compared this with people using licensed nicotine products (e.g. nicotine patches), and cigarettes. This study should reassure smokers who are thinking of switching to an e-cigarette that if they manage to cut out cigarettes altogether, they should see a large benefit in terms of their health.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: The next step would be would be to follow smokers over a longer period of time who switch over to using e-cigarettes and measure potential harm and risks not only in relation to cancer but also lung function and cardiovascular health.

MedicalResearch.com: Is there anything else you would like to add?

Response: None of the other authors have received funding from an e-cigarette company or any organisation acting for one.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Shahab L, Goniewicz ML, Blount BC, Brown J, McNeill A, Alwis KU, et al. Nicotine, Carcinogen, and Toxin Exposure in Long-Term E-Cigarette and Nicotine Replacement Therapy Users: A Cross-sectional Study. Ann Intern Med. [Epub ahead of print 7 February 2017] doi: 10.7326/M16-1107

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Teen Vaping is a Risk Factor for Future Smoking

MedicalResearch.com Interview with:

Professor Richard Miech Institute for Social Research University of Michigan

Prof. Richard Miech

Professor Richard Miech
Institute for Social Research
University of Michigan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The main finding of this study is that teen vaping predicts future smoking.  We surveyed a nationally-representative sample of 12th graders in 2014 and then re-surveyed them a year later.  We found:

  • Among teens who had never smoked at baseline, those who vaped were more than four times more likely to have smoked a year later than those who didn’t vape
  • Among teens who were former smokers at baseline, those who vaped were more than twice as likely to have smoked a year later than those who didn’t vape
  • Among teens who were current smokers at baseline, smoking levels a the one-year followup were the same for vapers and non-vapers.

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