Tag: vaping

Categories : AddictionTags :

e-Cigarettes Could Unravel Decades of Tobacco Control

On By ModernMedia

New research finds that UK teens who vape are 33% more likely to smoke cigarettes

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Teens who regularly use e-cigarettes are equally as likely as their peers from the 1970s to take up cigarette smoking, despite a substantial reduction in the prevalence of teenage cigarette use over the last 50 years, according to a study co-led by the University of Michigan.

U-M researchers, in collaboration with Penn State University and Purdue University, concluded that teenagers who had never used e-cigarettes had an approximately less than 1 in 50 chance of weekly cigarette use, whereas those who had previously used e-cigarettes had more than a 1 in 10 chance. More importantly, teenagers who reported consistent e-cigarette use had nearly a 1 in 3 chance of also reporting current conventional cigarette use.

The study illustrates shifts in the likelihood of youth cigarette use over time and the impacts of e-cigarettes on this trend. The results were derived from three longitudinal studies collected by the Centre for Longitudinal Studies at the University College of London, following teens from three different U.K. birth cohorts.

The research was published in the journal Tobacco Control and was supported by the National Cancer Institute, part of the National Institutes of Health, and a seed grant from the Criminal Justice Research Center at Penn State University, while data collection by the Centre for Longitudinal Studies was supported by funding from the Economic and Social Research Council.

“The use of e-cigarettes and the proliferation of e-cigarettes have really disrupted those awesome trends and improvements. For kids who have never used e-cigarettes, we do see those historic declines in risk,” said Jessica Mongilio, a research fellow at the U-M School of Nursing and one of the lead researchers on the study. “But for kids who do use e-cigarettes, it’s almost as if all of those policies and all of those perceptions have done nothing, and they’ve got a really high risk of smoking cigarettes.”

Over the past few decades, cigarette smoking has evolved from a once glamorous status symbol to an unhealthy and socially discouraged practice, according to the researchers. This evolution was, in large part, driven by aggressive campaigning that labeled cigarette smoking as a public health risk.

By the late 1990s and into the early 2000s, cigarette smoking was structurally and socially stigmatized, embedded in national federal regulations and health policy. In recent years, cigarette smoking in youths dropped to an all-time low, according to research from the Centers for Disease Control.

E-cigarettes, colloquially known as vapes, often sold in bright colorways and in fruity flavors, have quickly emerged as a perceived “safer” alternative to the conventional cigarette. They stand to threaten decades of advocacy, health policy and cultural aversion toward smoking in both the U.K. and United States, the researchers say.

The Millennium Cohort Study, or MCS, tracked teens born in England, Scotland, Wales and Northern Ireland in 2000 and 2001 and who were children when e-cigarettes were first commercialised. The British Cohort Study tracked individuals born in 1970, who were teenagers during the 1980s when cigarette use was fairly common and in their 40s when e-cigarettes were commercially available. Finally, the National Child Development Study tracked individuals born in 1958, who were young children when cigarette use was at its cultural peak.

“We took data from different cohorts, essentially different generations of people who live in the U.K., and looked at their probability of smoking cigarettes at least once a week, based on some well-known risk and protective factors,” Mongilio said. “For the most recent cohort, we also examined how use of e-cigarettes changed those probabilities.”

According to Mongilio and her collaborators, it’s not entirely clear whether e-cigarette use directly caused cigarette use, but it’s clear their incidences are strongly related. Still, the MCS cohort will be continuously surveyed over time to further understand how the use of e-cigarettes during the critical developmental teen years will affect their health in the long term.

Ultimately, with the findings of this study, the researchers hope to demonstrate the profound impact of e-cigarettes on today’s youth in an attempt to exact meaningful legislative, social and economic change.

“The more you can build evidence – the bigger the pile of support – the harder you can make it to ignore. This will lead toward policy changes and toward increased regulations for e-cigarettes and for producers of e-cigarettes,” Mongilio said. “I think we’re in a place where change is possible and to have increased regulations and enforcement of those regulations for companies that are producing e-cigarettes.”

Source: University of Michigan

Categories : Substance UseTags :

Flavoured Marijuana Vapes Becoming New Face of Teen Drug Use, Sparking Addiction Fears

On By ModernMedia
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Flavoured marijuana vaping is now the most common form of use among American teenagers who vape cannabis, according to new findings from the University of Michigan.

The research, published in the Journal for Adolescent Health, found particularly sharp increases among younger teens between 2021 and 2024. Among eighth graders who vaped marijuana, the percentage using flavoured solutions jumped from 47% in 2021 to 63% in 2024. The trend was similar for older students, with use climbing from 41% to 53% for 10th graders and from 36% to 50% for 12th graders.

“The findings suggest that these products are gaining traction among youth; in fact, since the pandemic onset in 2020 youth appear to be turning toward these products while reducing their use of all other drugs,” said Richard Miech, principal investigator of the Monitoring the Future study at U-M’s Institute for Social Research.

The overall percentage of marijuana users who chose to vape the drug also grew over the study period. Among eighth graders who had used marijuana in the past 12 months, the percentage who vaped it increased from 48% to 57%. In 10th grade, the number went from 60% to 66%, and among 12th graders, it rose from 58% to 67%.

“Flavoured vaping solutions offer a discreet mode of cannabis use, with flavours apparently enhancing their appeal,” Miech said. “The study results suggest that a growing proportion of youth find the newly available flavours – especially fruit flavours – more attractive than the standard cannabis taste.

“Vaping does not produce the distinctive odor that comes from smoking cannabis, and vaping devices can be quickly concealed if an authority figure appears unexpectedly.”

More addictive?

This increase in those who vaped highlights growing public health concerns about changing patterns of substance use among teens.

“As for health consequences for cannabis use, one of the most potentially serious is addiction,” Miech said. “Should cannabis use become more popular among youth in future years, then a greater number will end up with an addiction that can impair their social and academic life. Many people may not realize that more adolescents meet the criteria for cannabis use disorder than for alcohol use disorder, with 5% affected by cannabis compared to 3% for alcohol.”

These results point to flavored marijuana vaping solutions as a critical area for future research and policy development. The study’s authors suggest that these findings underscore the need for targeted policies, interventions and educational campaigns to address and mitigate this escalating concern among young people.

“Our survey includes questions on both cannabis’s perceived risk and its social acceptability,” Miech said. “Interestingly, perceived risk among adolescents actually increased over the study period from 2021-24, and social acceptability has gone down. That being said, our questions so far have been about cannabis use in general, and not flavoured cannabis solutions, which students may view differently.”

Would restricting flavoured vapes work?

Recent trends in adolescent cannabis vaping raise concerns about the best way to protect youth. Restricting flavors may seem like an easy solution, but it is by no means a guaranteed success, researchers said.

Teens who seek flavored cannabis products could easily shift to unflavored options or return to smoking cannabis in traditional forms. At the same time, adults in states with legal cannabis may resist limits on flavor choices, and industry lobbying could block such policies.

“An alternative approach to restricting supply of cannabis flavours is to restrict demand,” Miech said. “That is, to reduce teens’ interest and willingness to use cannabis, including flavoured vaping solutions. A demand reduction approach has been very effective for cigarettes.”

Evidence from previous studies on cigarette use supports this approach. In 1998, 35% of 12th graders had used cigarettes in the past month. By 2024, that number dropped to 3%. Cigarettes remained legal and available, but broad-based media campaigns, public education and tighter rules on marketing to youth drove the change.

Source: University of Michigan

Categories : Addiction Mental HealthTags :

Teen Smokers and Vapers Have Higher Rates of Depression and Anxiety, Study Finds

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Study analysed data from the US National Youth Tobacco Survey on more than 60 000 middle and high school students.

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Adolescents who use either e-cigarettes or conventional tobacco products (CTP) – like cigarettes, cigars, hookah and pipes – are significantly more likely to report symptoms of depression and anxiety than teens who don’t use tobacco products at all, according to a study published this week in the open-access journal PLOS Mental Health by Noor Abdulhay of West Virginia University, USA, and colleagues.

Tobacco use and mental health challenges are known to have a complex, bidirectional relationship. Understanding the interplay between adolescent tobacco use and mental health is particularly important, since adolescence is a critical developmental period during which many health-related risk-taking behaviors begin. Moreover, there are increasing rates of anxiety, depression, and suicide among adolescents in the U.S. as well as shifting patterns of tobacco use.

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In the new study, researchers used data on tobacco use, depression and anxiety symptoms, among different demographics, from the 2021-2023 National Youth Tobacco Survey. Among the 60,072 middle and high school students who had completed all questionnaires in full, 21.37% had used tobacco products, with 9.94% using only e-cigarettes, 3.61% using only CTPs, and 7.80% using both.

Overall, 25.21% of respondents reported symptoms associated with depression and 29.55% reported anxiety symptoms. Compared to adolescents who had not used any tobacco products, users of e-cigarettes or CTPs displayed a potentially heightened risk of depression and anxiety, whilst those who used both CTPs and e-cigarettes had the highest odds of reporting mental health struggles

The authors conclude that “while causality cannot be determined, the results from this study showed that all forms of tobacco use were significantly associated with mental health issues. There is a need to continue promoting mental health support and implementing tailored interventions to combat all forms of tobacco use among adolescents”.

Provided by PLOS

Categories : Addiction Healthcare Politics and RegulationsTags :

Doctors Lean on Science When it Comes to Smoking Cessation Best Practice

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Vaping with an e-cigarette
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Scientific evidence that supports vaping as an additional approach to tackle smoking-related morbidity and mortality is fast growing. The time is ripe for decisionmakers to embrace tobacco harm reduction and to steer away from precautionary principle-based tobacco control policies. This is according to Dr Riccardo Polosa, Founder of the Centre of Excellence for the Acceleration of Harm Reduction (CoEHAR) and Professor of Internal Medicine of the University of Catania, Italy.

Towards the end of 2022, the South African Tobacco Products and Electronic Delivery Systems Control Bill was officially introduced into parliament by the Minister of Health. Now, in the coming months, it will be discussed and possibly amended by a portfolio committee.

With this Bill lumping Electronic Nicotine Delivery Systems (ENDS, i.e. e-cigarettes and vapes) in the same category as smoking, Kurt Yeo, co-founder of consumer advocacy group Vaping Saved My Life (VSML), explains that it is essential for those involved in this process to consider the mounting scientific evidence demonstrating that vaping is far less harmful than tobacco smoking and is an effective way to support smokers seeking less risky alternatives and/or wanting to quit.

Dr Colin Mendelsohn is an Australian academic, researcher and clinician, who has helped smokers quit for over 30 years, says that vaping nicotine is a more effective quitting aid than nicotine replacement products such as patches and gums and is the most popular aid for quitting or reducing smoking globally. “It has the potential to save the lives of hundreds of thousands of South African smokers and prevent untold disease and suffering.”

He adds that vaping has been estimated to cause no more than 5% of the harm from smoking. “While the long-term effects have not yet been established, e-cigarettes are certain to be far less harmful than smoking. Vaping carries only a small fraction of the risk of tobacco smoking and is an effective quitting aid or long-term safer substitute for smoking. Vaping should be easily accessible to help adult smokers to quit deadly cigarettes.”

Dr Polosa highlights that decisionmakers and the public should also beware of many flawed articles scientific and fake news that are propagating ‘findings’ of potential harms, thus feeding the counter-narrative that e-cigarettes are ‘not as safe as promoted’. “Proliferation of poor-quality science and fake news need to be actively contrasted by good quality science and by correct information/education.”

The proof is in the numbers

“Countries which have supported vaping such as the United Kingdom and New Zealand have had accelerated declines in smoking rates,” explains Dr Mendelsohn. “For example, in New Zealand the national adult smoking rate fell by an unprecedented 33% in the two years between 2020 and 2022 after vaping was legalised.”

Illustrating this point further, Dr Polosa says that according to the same national surveys used for reporting smoking prevalence to the World Health Organization (WHO), these countries show faster declines in smoking prevalence compared with neighbouring countries with lower uptake of these alternatives. “In Sweden and Norway, eradication of smoking is now almost a reality with a daily smoking prevalence among Norwegian and Swedish youth close to zero (1% and 3%, respectively). Widespread diffusion of e-cigarettes in New Zealand and the United States is also contributing to the historical acceleration in the downward trend in daily prevalence of smoking among young people (1.3% and 1.9%, respectively).”

Regulation is essential, but the proposed Bill is deeply flawed

When it comes to regulation, Dr Polosa asserts that vaping and smoking are completely different animals. “Smoking kills. Vaping does not.”

Therefore, to regulate vaping in the same way as smoking does not make any sense, says Dr Polosa. “Doing so denies smokers access to much lower risk products. Rather, the South African government should table a risk-proportionate approach where the main regulatory levers are applied differentially.”

“This means that the most stringent and restrictive regulation would be applied to the most harmful products: tobacco cigarettes. Regulation of the smoke-free alternatives would focus on consumer protection (i.e., benefits to the consumer) and control of uptake by adolescents in a way that does not cause significant harm to adult smokers. This would meet the demands of people who cannot or do not wish to quit completely, but with much less cancer, cardiovascular and respiratory disease as a result,” Dr Polosa explains.

Dr Mendelsohn agrees and says that the preferred regulatory model is for nicotine liquids for vaping to be sold as adult consumer products from licensed premises, with strict age verification, like cigarettes and alcohol. “Regulation of e-cigarettes should be proportionate to risk and a light touch approach is more appropriate. A balanced regulatory model is needed which allows adult smokers easy access to regulated vaping products while restricting access to underage users. The current proposals will restrict adult smokers’ access to an effective quitting aid which can save lives and prevent smoking-related illness.”

“A precautionary approach to prevent the use of much less harmful smoke-free products is unjustified in the face of the massive burden of smoked tobacco products, which are widely available. This principle requires policymakers to compare the risks of introducing a product with the risks of delaying its introduction. In the case of vaping, the relatively small risks of harm will be outweighed by the far more substantial harms from delaying access to current smokers,” Dr Mendelsohn explains.

He points out that harsh restrictions on the sale and marketing of electronic cigarettes will have negative unintended consequences and will lead to black market sales of unregulated products to both adults and children. “The public health goal should be to encourage smokers who are unable to quit to switch to vaping, a far safer alternative.”

Yeo concludes by saying: “With the Bill aiming to reduce the incidence of tobacco-related illness, disability and death, regulations should be drawn up based on all available research and case studies to ensure South Africa’s smokers are truly helped.”

Categories : DentistryTags :

Vaping Device Use Tied to Increased Risk of Developing Cavities

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Research published in The Journal of the American Dental Association found patients who said they used vaping devices were more likely to have a higher risk of developing cavities. The findings of this study on the association between vaping and risk of caries serve as an alert that this once seemingly harmless habit may be very detrimental, says Karina Irusa, assistant professor of comprehensive care at Tuftst University and lead author on the paper.

Over the last few years, public awareness has increased about the dangers of vaping to systemic health, particularly after the use of vaping devices was tied to lung disease. Some dental research has shown ties between e-cigarette use and increased markers for gum disease, and, separately, damage to the tooth’s enamel, its outer shell. But relatively little emphasis has been placed on the intersection between e-cigarette use and oral health, even by dentists, says Irusa.

Irusa says that the finding may be just a hint of the damage vaping causes to the mouth. “The extent of the effects on dental health, specifically on dental decay, are still relatively unknown,” she says. “At this point, I’m just trying to raise awareness,” among both dentists and patients.

This study, Irusa says, is the first known specifically to investigate the association of vaping and e-cigarettes with the increased risk for getting cavities. She and her colleagues analysed data from more than 13 000 patients older than 16 who were treated at Tufts dental clinics from 2019–2022.

Irusa found a significant difference in dental caries risk levels between the e-cigarette/vaping group and the control group. Some 79% of the vaping patients were categorised as having high-caries risk, compared to just about 60% of the control group. The vaping patients were not asked whether they used devices that contained nicotine or THC, although nicotine is more common.

“It’s important to understand this is preliminary data,” Irusa says. “This is not 100% conclusive, but people do need to be aware of what we’re seeing.” Further studies need to be done, and Irusa wants to take a closer look at how vaping affects the microbiology of saliva.

One reason why e-cigarette use could contribute to a high risk of cavities is the sugary content and viscosity of vaping liquid, which, when aerosolised and then inhaled through the mouth, sticks to the teeth. (A 2018 study published in the journal PLOS One likened the properties of sweet-flavoured e-cigarettes to gummy candies and acidic drinks.) Vaping aerosols have been shown to change the oral microbiome making it more hospitable to decay-causing bacteria. It’s also been observed that vaping seems to encourage decay in areas where it usually doesn’t occur – such as the bottom edges of front teeth. “It takes an aesthetic toll,” Irusa says.

The Tufts researchers recommend that dentists should routinely ask about e-cigarette use as part of a patient’s medical history, including paediatric dentists who see adolescents. According to the FDA/CDC, 7.6% of middle- and high-school students said they used e-cigarettes in 2021.

The researchers also suggest patients who use e-cigarettes should be considered for a “more rigorous caries management protocol,” which could include prescription-strength fluoride toothpaste and fluoride rinse, in-office fluoride applications, and checkups more often than twice a year.

“It takes a lot of investment of time and money to manage dental caries, depending on how bad it gets,” Irusa says. “Once you’ve started the habit, even if you get fillings, as long as you continue, you’re still at risk of secondary caries. It’s a vicious cycle that will not stop.”

Source: Tufts University

Categories : Substance UseTags :

Surprising Trends among Vaping Teens Reveal Vulnerable Groups

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A study published today in the American Journal of Preventive Medicine used survey data from US high school students to determine how prevalent vaping is in different sexual orientation, race, and ethnicity groups. They found dramatic differences and surprising patterns in vaping rates across these identity markers.

Vaping is on the rise among teens, with half of all US high school students in having tried vaping at least once and a third of these students vaping regularly.

From 2019–2020, the popularity of disposable e-cigarette use among US high school students who currently vaped went up by 1000%, from 2.4% to 26.5%, according to the CDC. Since nicotine in e-cigarettes is highly addictive, and e-cigarette use in teens leads to higher risks of smoking regular cigarettes later in life, researchers wanted to know more about which groups of teens are currently vaping and possible predisposing factors.

The study, which uses survey data of over 38 000 high school students from 2015–2019, fills in a wide gap that exists in e-cigarette studies: research on vaping prevalence among young people at the intersections of more than one minoritised identity.

The study uncovered significant differences in the prevalence of current e-cigarette use between lesbian and heterosexual girls when comparing across racial groups. 

Current e-cigarette use was higher in Black lesbian girls compared to Black heterosexual girls (18.2% vs 7.1%). The rate was also higher in multiracial girls who identify as lesbian compared to multiracial girls who identify as heterosexual (17.9% vs 11.9%). On the other hand, White lesbian girls were found to be at lower risk of current vaping compared to White heterosexual girls (9.1% vs 16.1%).

Among boys, there were no significant interactions between sexual orientation and race or ethnicity in relation to vaping prevalence. 

Previous surveys of gay and lesbian teens suggest that e-cigarette use might be a coping mechanism to deal with the stress of sexual orientation or gender identity-based discrimination or bullying, or a way to bond with others in their social circle, the authors say. However, prior studies have not reported how e-cigarette use prevalence among youth differ at the intersections of sexual orientation, sex, race, and ethnicity. 

One possible reason for finding disparities in e-cigarette use at the intersection of sexual orientation and race among girls, but not boys may be due to higher levels of targeted e-cigarette marketing toward queer women of color, the authors say. 

Prior research has found that when compared to White heterosexual young women (aged 18-24), bisexual Black and Hispanic women reported higher levels of exposure to ads for tobacco products, while there were no substantial differences in exposure to these ads among young adult men.

“For years, the tobacco industry has targeted marketing toward traditionally marginalised groups, whether in clubs, bars, Pride events, or through magazines,” said co-author Andy Tan, associate professor at the Annenberg School for Communication. “Sexual, racial, and ethnic minority youth are more likely to report engaging with online tobacco advertising including e-cigarette ads on social media.”

Source: University of Pennsylvania

Categories : General Interest PaediatricsTags :

How Do You Do, Fellow Kids? Making Anti-vaping Messaging Work

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Vaping with an e-cigarette
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Effective anti-vaping advertisements geared to teens have the greatest impact when they emphasise the adverse consequences and harms of vaping e-cigarettes, use negative imagery, and avoid memes, hashtags and other ‘teen-centric’ communication styles, according to a first-of-its-kind study by researchers in the journal Tobacco Control.

The researchers also found that certain messaging content currently being used, especially sweets and flavour-related imagery, increases the appeal of vaping and should be avoided when designing prevention messages.

“E-cigarettes and vaping have become a major public health concern, with nicotine addiction and other harmful outcomes looming large for youth,” said Seth M. Noar, PhD, the paper’s corresponding author and UNC Lineberger professor. “The percentage of teens vaping increased from about 5% in 2011 to over 25% in 2019,” Prof Noar said. “That is an alarming trend, making an understanding of effective vaping prevention messages especially urgent.”

Since the introduction of e-cigarettes, numerous US health departments have created their own anti-vaping messaging geared to teens, as have national health organisations such as the US Food and Drug Administration and Centers for Disease Control and Prevention.

The online study asked 1501 teens to rate seven randomly selected vaping prevention ads from a pool of more than 200 ads. Vaping prevention ads that clearly communicated the health harms of vaping, or compared vaping to cigarette smoking, were comparatively more effective. Neutral or less personally relevant content, such as referencing the environmental impact of vaping or the targeting of youth by the tobacco industry, was less impactful.

“Although we anticipated that vaping prevention ads with neutral or pleasant imagery would not be as effective, we were alarmed to find that flavour-related messages actually heightened the attractiveness of vaping,” said Marcella H. Boynton, PhD, first author

“In retrospect, it stands to reason that by reminding teens about pleasurable aspects of e-cigarettes, even within the context of a prevention ad, we run the risk of doing harm. Notably, we found that flavour-related prevention ad content was associated with vaping appeal among both users and non-users of e-cigarettes, which is a good reminder of how much candy and fruit flavours in e-cigarettes have driven the youth vaping epidemic.”

The researchers hope to next investigate the effects of other types of anti-vaping ads on a wide range of audiences. They also are developing a series of messages and a companion website to test the ability of a text message-driven intervention to reduce youth vaping. In that regard, Prof Noar noted that “We have been developing our own evidence-based messages based on the latest science about the harms of vaping. Our messaging approach has been greatly influenced by the insights generated by this study.”

The study used UNC’s Vaping Prevention Resource, a website designed to provide practitioners, researchers and communities with vaping prevention media content from around the world, as well as strategies and resources for youth vaping prevention. It is the largest repository of free, open-access vaping prevention materials, all available for download at https://vapingprevention.org/.

Source: UNC Lineberger Comprehensive Cancer Center

Categories : Metabolic DisordersTags :

Use of e-cigarettes Associated With Prediabetes Risk

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Vaping with an e-cigarette
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Analysis of a large representative database shows that e-cigarette use is associated with an increased risk of prediabetes, posing a new concern for public health.

“Our study demonstrated a clear association of prediabetes risk with the use of e-cigarettes,” explained lead researcher Shyam Biswal, PhD, at Johns Hopkins Bloomberg School of Public Health. “With both e-cigarette use and prevalence of prediabetes dramatically on the rise in the past decade, our discovery that e-cigarettes carry a similar risk to traditional cigarettes with respect to diabetes is important for understanding and treating vulnerable individuals.”

According to the Centers for Disease Control and Prevention (CDC), traditional cigarette smokers are 30% to 40% more likely than non-smokers to develop type 2 diabetes, which increases their risk for cardiovascular diseases. e-cigarettes are sometimes promoted as a healthier option for cigarette smokers, and e-cigarettes use is rising among younger demographics.

The study analysed 2016–2018 data from the Behavioral Risk Factor Surveillance System (BRFSS), the largest annual nationally representative health survey of US adults. Among the 600 046 respondents, 9% were current e-cigarette users who self-reported prediabetes diagnoses. The data also showed that e-cigarette users have a higher prevalence of high-risk lifestyle factors and worse self-related mental and physical health status than non-smokers.

In this representative sample of US adults, e-cigarette use was associated with greater odds of prediabetes compared to those who did not use e-cigarettes or traditional cigarettes – a worrying link from a public health standpoint.

“We were surprised by the findings associating prediabetes with e-cigarettes because they are touted as a safer alternative, which we now know is not the case,” commented Dr Biswal. “In the case of cigarette smoking, nicotine has a detrimental effect on insulin action, and it appears that e-cigarettes may also have the same effect.”

Prediabetes is fortunately a reversible condition, given appropriate lifestyle management. The authors make a compelling recommendation for targeting the reduction in e-cigarette use and education of young adults to reduce diabetes risk.

“Our effort for smoking cessation has led to a decrease in smoking traditional cigarettes. With this information, it is time for us to ramp up our public health efforts to promote the cessation of e-cigarettes,” cautioned Dr Biswal.

The researchers published their findings in the American Journal of Preventive Medicine.

The World Health Organization (WHO) defines prediabetes as a state of intermediate hyperglycaemia using impaired fasting glucose, defined as fasting plasma glucose of 6.1–6.9 mmol/L (110 to 125 mg/dL) and impaired glucose tolerance defined as 2h plasma glucose of 7.8–11.0mmol/L (140–200 mg/dL) after ingestion of 75g of oral glucose or a combination of the two based on a 2h oral glucose tolerance test. It is estimated that by 2030, more than 470 million people worldwide will be diagnosed with prediabetes.

Source: EurekAlert!

Categories : Diseases, Syndromes and ConditionsTags :

Investigating Vaping’s Impact on Gum Disease

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A series of new studies investigates how e-cigarettes alter oral health and may be contributing to gum disease. The latest, published in mBio, finds that e-cigarette users have a distinctive oral microbiome that is less healthy than nonsmokers but potentially healthier than cigarette smokers, and measures worsening gum disease over time.

“To our knowledge, this is the first longitudinal study of oral health and e-cigarette use. We are now beginning to understand how e-cigarettes and the chemicals they contain are changing the oral microbiome and disrupting the balance of bacteria,” said co-lead researcher Prof Deepak Saxena.

While cigarette smoking is known to increase gum disease risk, much less is known about the impact of e-cigarette use on oral health, especially in the long term.

The researchers studied the oral health of 84 adults from three groups: cigarette smokers, e-cigarette users, and people who have never smoked. Gum disease was assessed through two dental exams six months apart, during which plaque samples were taken to analyse the bacteria present.

Gum health changes
All participants had some gum disease at the start of the study, with cigarette smokers having the most severe disease, followed by e-cigarette users. After six months, the researchers observed that gum disease had worsened in some participants in each group, including several e-cigarette users.

Clinical attachment loss is a key indicator of gum disease, measured by gum ligament and tissue separating from a tooth’s surface, leading the gum to recede and form pockets. These pockets are bacterial breeding grounds and can lead to worsening gum disease. In a study of the same participants published in Frontiers in Oral Health, the research team found that clinical attachment loss was significantly worse only in the e-cigarette smokers after six months.

A unique microbiome
Analysis of the bacteria in plaque samples showed that e-cigarette users had a different oral microbiome than smokers and nonsmokers, in line with their earlier results.

While all groups shared roughly a fifth of the types of bacteria, the bacterial makeup for e-cigarette users had strikingly more in common with cigarette smokers than nonsmokers. Several types of bacteria, including Selenomonas, Leptotrichia, and Saccharibacteria, were abundant in both smokers and vapers compared to nonsmokers. Several other bacteria – including Fusobacterium and Bacteroidales, linked to gum disease – were particularly dominant in the mouths of e-cigarette users.

When plaque samples were gathered and analysed in the six-month follow-up, the researchers found greater diversity in bacteria for all groups studied, yet each group maintained its own distinct microbiome.

“Vaping appears to be driving unique patterns in bacteria and influencing the growth of some bacteria in a manner akin to cigarette smoking, but with its own profile and risks to oral health,” said Fangxi Xu, study co-first author.

An altered immune response
The researchers found that the distinct microbiome in e-cigarette users was correlated with clinical measures of gum disease and changes to the host immune environment. In particular, vaping was associated with different levels of cytokines. Certain cytokines are linked to an imbalance in oral bacteria and can worsen gum disease by making people prone to inflammation and infection.

TNFα, a cytokine that causes inflammation, was significantly elevated among e-cigarette users. In contrast, cytokines IL-4 and IL-1β were lower among e-cigarette users; because IL-4 tends to be reduced in people with gum disease and increases after treatment, it suggests that certain bacteria in the mouths of e-cigarette users are worsening inflammation.

The researchers concluded that the distinct oral microbiome of e-cigarette users elicits altered immune responses, which along with clinical markers for gum disease illustrate how vaping presents its own challenge to oral health.

“E-cigarette use is a relatively new human habit,” said Scott Thomas, study co-first author. “Unlike smoking, which has been studied extensively for decades, we know little about the health consequences of e-cigarette use and are just starting to understand how the unique microbiome promoted by vaping impacts oral health and disease.”

Source: New York University

Categories : Healthcare Politics and RegulationsTags :

National Treasury Proposes e-Cigarette Tax

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The National Treasury is proposing to impose a tax on both the non-nicotine and nicotine solutions in e-cigarettes (EC), and is asking for public comment by 7 February 2022.

The National Treasury published a draft discussion paper in December 2021 on the proposed taxation of e-cigarettes (ECs). The National Treasury defines e-cigarettes as battery powered devices that do not burn or use tobacco leaves but vaporise e-liquid solutions for inhalation.

In its discussion paper, the Treasury notes the uncertainty of e-cigarettes’ health risks, so it seeks stakeholder engagement on its proposal for the taxation of ECs.

The National Treasury proposes to introduce a specific excise tax on both the non-nicotine and nicotine solutions used in ECs and intends to use its existing policy guidelines applicable to other excisable products to do so. For example, traditional tobacco products are subject to excise duties at a rate of 40% of the price of the most popular brand in each tobacco category. 

For EC users, that would mean paying R2.03 per mL of EC solution nicotine-containing nicotine and R0.87 per mL of nicotine-free EC solution, if the draft proposals are accepted and become legislation. It is also proposed that EC products with a higher nicotine content will attract a higher duty rate.
Certain stakeholders may question that the Treasury’s proposed EC tax extends to nicotine-free liquids, as it does not necessarily support the government’s stated policy intention of reducing the consumption of tobacco products. The use of ECs as a means of quitting tobacco products is well established, with a Cochrane review showing that nicotine-containing ECs resulted in increased odds of quitting than nicotine-free ECs. 
It could also generate a knock-on illicit trade in e-cigarettes, as has  already happened in the tobacco sector.

Manufacturers and importers who would be taxed on ECs will need stringent certifications by accredited laboratories, which use either South African National Accreditation or International Laboratory Accreditation Cooperation (ILAC) approved methodologies.  Where such certifications are not available, a penalty rate of duty is being proposed.

Comments on the draft discussion document are due by 7 February 2022.

Source: Webber Wentzel