Author Interviews, Tobacco Research / 21.09.2016
Voltage and Flavoring Contribute To Overall Toxicity of Aerosols from E-Cigarettes
MedicalResearch.com Interview with:
[caption id="attachment_28150" align="alignleft" width="143"]
Dr. Maciej L. Goniewicz[/caption]
Maciej L. Goniewicz, PhD PharmD
Assistant Professor of Oncology
Department of Health Behavior
Division of Cancer Prevention and Population Sciences
Roswell Park Cancer Institute
Elm & Carlton Streets / Carlton House A320
Buffalo, New York 14263, USA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We have previously identified several ingredients in e-cigarettes that may be potentially dangerous to users. The long-health effects of inhaling aerosol from e-cigarettes is currently unknown and we are looking for alternative ways to test the products safety. We have noticed previously that various brands and types of e-cigarettes differ in the toxicant levels and their potential toxic effects. So we systematically evaluated various product features and we were able to identify device power and flavoring additives as key components that significantly affect the potential toxicity of e-cigarettes. Interestingly, it was not nicotine or nicotine solvents but other additives in e-cigarettes that affected respiratory cells used in our study.
Dr. Maciej L. Goniewicz[/caption]
Maciej L. Goniewicz, PhD PharmD
Assistant Professor of Oncology
Department of Health Behavior
Division of Cancer Prevention and Population Sciences
Roswell Park Cancer Institute
Elm & Carlton Streets / Carlton House A320
Buffalo, New York 14263, USA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We have previously identified several ingredients in e-cigarettes that may be potentially dangerous to users. The long-health effects of inhaling aerosol from e-cigarettes is currently unknown and we are looking for alternative ways to test the products safety. We have noticed previously that various brands and types of e-cigarettes differ in the toxicant levels and their potential toxic effects. So we systematically evaluated various product features and we were able to identify device power and flavoring additives as key components that significantly affect the potential toxicity of e-cigarettes. Interestingly, it was not nicotine or nicotine solvents but other additives in e-cigarettes that affected respiratory cells used in our study.




Dr. Terry Gordon[/caption]
Terry Gordon, PhD
Professor, Department of Environmental Medicine
at NYU Langone Medical Center and at
New York University's College of Global Public Health
Medical Research: What is the background for this study? What are the main findings?
Dr. Gordon:I t is well established that the intentional inhalation of tobacco combustion products causes severe respiratory and cardiovascular health effects and, in fact, active smoking is the leading preventable cause of death in the US and worldwide. Importantly, secondhand smoke exposure also causes a range of serious health problems in adults, adolescents, and children exposed in the home or at work. Secondhand smoke exposure can be as harmful as active smoking and is a major cause of both cancer and cardiovascular disease itself, as well as having countless other harmful effects. It was the scientific findings of these effects that led to many clean air regulations across the nation and enabled the FDA to regulate a number of tobacco products. A growing number of studies in the U.S. and abroad have demonstrated poor indoor air quality in hookah bars, but none have looked at the effect of this on those who work in such establishments.
We, therefore, studied whether workplace exposure to secondhand hookah smoke affects the pulmonary and cardiovascular systems. One of our main findings was that occupational exposure to secondhand hookah smoke produces systemic effects as seen by increases in inflammatory cytokines in the blood after a 10 to 12 hour work shift. This is very worrisome as more and more diseases are being linked to chronic inflammation. Changes in heart rate suggested that the cardiovascular system was also altered during a single work shift. The most dramatic effect, however, appeared to be an increase in exhaled carbon monoxide after the work shift. The low temperature burning of charcoal used to heat the shisha in a water pipe produces large amounts of carbon monoxide, and we observed exhaled carbon monoxide levels as high as 90 ppm, which suggests significant exposure of workers to secondhand hookah smoke and the potential for impairment of hemoglobin to efficiently carry oxygen to the tissues.
Dr. Ralph Caraballo[/caption]
MedicalResearch.com Interview with:
Ralph S. Caraballo, PhD MPH
Branch Chief, Epidemiology Branch
Office on Smoking and Health
National Center for Chronic Disease Prevention and Health Promotion
CDC Atlanta GA
Medical Research: What is the background for this study? What are the main findings?
Dr. Caraballo: Electronic nicotine delivery system (ENDS) use has increased rapidly in the U.S. in recent years. The availability and use of ENDS raise new issues for public health practice and tobacco regulation, as it is unknown whether patterns of ENDS use enhance, deter, or have no impact on combustible tobacco product use. This study assessed past-month, lifetime, and frequency of ENDS use among current, former, and never adult cigarette smokers.
In 2014, overall lifetime and past-month ENDS use was 14.1% and 4.8%, respectively. By smoking status, 49.5% of current, 14.7% of former, and 4.1% of never cigarette smokers had used ENDS in their lifetime, whereas 20.6% of current, 4.0% of former, and 0.8% of never smokers used ENDS in the past month. Among current and former cigarette smokers who ever used ENDS, 44.1% and 44.7% reported using ENDS >10 days in their lifetime, respectively.
Dr. Weitzman[/caption]
MedicalResearch.com Interview with:
Michael L. Weitzman MD
Professor, Departments of Pediatrics and Environmental Medicine
NYU Langone Medical Center.
Medical Research: What is the background for this study? What are the main findings?
Dr. Weitzman: While the prevalence of cigarette smoking in the United States has recently seen a steady decline, more and more individuals report hookah (water pipe) usage. Researchers have shown that web queries for ‘hookah’ and ‘hookah bars’ have increased dramatically, but it is unclear whether this interest has led to an increase in the number of hookah bars in a given area. We first tested the website Yelp.com to see whether it could reliably provide us with information – such as the date of establishment of a hookah bar – by comparing the date of the first review written on Yelp.com with the actual opening date. We found that, for 2014 onwards, the first review posting on Yelp.com, on average, occurred within the first month of a hookah bar’s opening date. Additionally, we found a dramatic increase in the number of hookah bars in New York City over the past 5 years. These hookah bars tend to be not randomly distributed, but instead clustered near universities and specific ethnic neighborhoods.
Dr. Shadel[/caption]
MedicalResearch.com Interview with:
William G. Shadel, PhD
Associate Director, Population Health Program
Senior Behavioral Scientist
RAND Corporation
Pittsburgh, PA 15213
Medical Research: What is the background for this study? What are the main findings?
Dr. Shadel: The tobacco industry spends almost all of its multi-billion dollar advertising budget at retail point-of-sale locations. A key feature of their advertising strategy includes the tobacco power wall, a prominent behind the cashier display of hundreds of cigarette and tobacco product brands. The power wall also displays posters for those tobacco products as well as pricing information. As such, it conveys a lot of positive messages about tobacco products to consumers.
The purpose of this experiment was to evaluate whether hiding or moving the tobacco power wall from its highly conspicuous location reduced teens’ smoking risk when they shop at convenience stores. The study took place in the RAND StoreLab (RSL), a life-sized replica of a convenience store that was constructed to explore a range of options for regulating tobacco products at point-of-sale retail locations. A sample of 271 teens (ages 11-17) was randomized to one of three experimental conditions: cashier (the tobacco power wall was located in its usual location, behind the cashier); side wall (the tobacco power wall was moved from behind the cashier to an out of the way location in the RSL); and hidden (the tobacco power wall was located behind the cashier, but was hidden behind an opaque wall). After teens finished shopping in the RSL, they completed questionnaires that measured their susceptibility to future smoking.
Teens assigned to the condition where the power wall was hidden were significantly less likely to report that they would smoke in the future, compared with those that were assigned to the cashier condition. Locating the power wall to a sidewall had no effect on smoking susceptibility.


