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Some E-Cigarette Chemicals Mimic Nicotine, Possibly Bypassing Regulation

The AHA! Team — Fri, 11 Oct 2024 08:21:24 +0000

Duke Health – In what appears to be an effort to bypass public health regulations covering vaping products, some tobacco companies have begun replacing nicotine in e-cigarettes with related chemicals that have similar properties but unknown health effects, Duke Health researchers report. In a research letter appearing Aug. 7 in JAMA, study authors at Duke and Yale University also found that the quantity of these chemicals, known as nicotine analogs, are not accurately disclosed on the packaging. “Vaping products containing nicotine are subject to federal laws that prohibit sales to people under the age of 21,” said study co-author Sairam V. Jabba, D.V.M., Ph.D., a senior research scientist at Duke University School of Medicine. Nicotine analogs are currently not subject to the FDA process “Nicotine analogs are currently not subject to the FDA process and have not been studied for their health effects,” Jabba said. “Our analysis of some of these analog-containing vaping products sold in the U.S. found significant and concerning inaccuracies in the ingredients these products claim to contain and what they actually contain. Further, it’s possible manufacturers are attempting to avoid FDA tobacco regulation.” One chemical, known as 6-methyl nicotine, has been shown in rodent experiments to be far more potent than nicotine in targeting the brain’s nicotine receptors and more toxic than nicotine. Another, called nicotinamide, is marketed as targeting the same brain receptors as nicotine, despite evidence it does not bind to these receptors. The nicotine analogs were included in flavored e-cigarettes, which prior research has indicated are preferred by youths and those who vape for the first time. Jabba and colleagues, including co-senior author Sven Eric Jordt, Ph.D., analyzed an e-cigarette product sold under the brand name Spree Bar, which comes in at least nine flavors and is listed as containing 5 percent 6-methyl nicotine. Study results showed the actual amount of the chemical was about 88% less than labeled. The e-cigarettes also included an artificial sweetener that is up to 13,000 times sweeter than table sugar, and an artificial coolant that mimics menthol’s effects. A second brand of e-cigarettes — marketed as Nixotine, Nixodine, Nixamide and Nic-Safe – contained a nicotine analog called nicotinamide, also at levels lower than the labels indicated, and combined with undisclosed amounts of 6-methyl nicotine. This brand did not include sweeteners or coolants. These products appear to be designed to circumvent the laws and regulations “These products appear to be designed to circumvent the laws and regulations in place to protect people — especially children — from the harmful effects of smoking and tobacco use,” Jordt said. “We do not know what these chemicals do when they are heated and inhaled. These are questions that should be answered before we allow products on the market.” In addition to Jordt and Jabba, study authors include Hanno C. Erythropel, Peter Silinski, Paul T. Anastas, Suchitra Krishnan-Sarin and Julie B. Zimmerman. Yale’s Tobacco Center of Regulatory Science received funding support for the study from the National Institute on Drug Abuse, which is part of the National Institutes of Health (U54DA036151), and the Center for Tobacco Products of the FDA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the FDA. To read the original article click here.

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Prevalence of Nicotine Pouch Use Found to be Low Among U.S. Adults

The AHA! Team — Tue, 20 Aug 2024 04:45:40 +0000

Keck School of Medicine of USC via News-Medical – A new study found that the prevalence of nicotine pouch use was low in U.S. adults despite a 641% increase in sales of the products between 2019 and 2022. Researchers say the findings raise questions about who is using the millions of nicotine pouches sold in the U.S. and why. Nicotine pouches, a new commercial tobacco product, contain a crystalline powder with nicotine, flavorings (including fruit, mint or candy) and other additives. They do not cause respiratory harm and are perceived by some as an alternative to help adults who smoke tobacco quit. Nicotine pouches have recently gained attention over concerns that their flavors and trendy social media marketing campaigns are attracting youth users. However, limited data on usage among adults has been collected since the new products entered the market. Now, a study from the Keck School of Medicine of USC and the University of Nebraska Medical Center analyzed nicotine pouch use in a nationally representative sample of 39,557 U.S. adults. The study found that 2.9% of adults had ever used nicotine pouches, with 0.4% reporting current use. The majority of adults currently using pouches also currently smoke cigarettes. Additionally, 5.2% of those who attempted to quit smoking in the past year and had relapsed back to smoking reported using pouches to help with their cessation efforts. The study, funded by the National Institutes of Health (NIH), was just published in JAMA. “The low prevalence of nicotine pouch use in adults surprised us, given the rapid increase in sales. But it’s also possible that the sales are being diverted to adolescents, who were not represented in this survey.” – Adam Matthew Leventhal, PhD, study coauthor, professor in the department of population and public health sciences at the Keck School of Medicine and executive director of the USC Institute for Addiction Science Patterns of pouch use Data for the study were collected through the Current Population Survey (CPS) Tobacco Use Supplement in September 2022. The CPS is a monthly survey of U.S. adults that uses rigorous research methods to ensure its participants represent an accurate cross-section of the country’s population, making the results reliable enough to influence important policy decisions. The Tobacco Use Supplement includes straightforward questions about cigarette smoking, attempts to quit smoking and-;for the first time in September 2022-;the use of nicotine pouches. Of 39,558 survey respondents, 2.9% had ever used nicotine pouches, and 0.4% were currently using them. Adults who currently smoked (10.8%) or formerly smoked (6.7%) were more likely to report ever using nicotine pouches compared to people who had never smoked (1.1%). Current use of nicotine pouches was also higher among adults who currently smoked (1%) and formerly smoked (0.7%) compared to those who had never smoked (0.2%). Pouch use, both past and present, was lower in adults under 65, but higher in males and non-Hispanic whites. Among those who currently smoked who tried to quit in the past year, more reported trying to switch to e-cigarettes (21.6%) than nicotine pouches (5.2%) to help them quit. One question raised by the findings is whether adults who use nicotine pouches may be using them to “top off” nicotine in situations where they cannot smoke or use other tobacco products, Leventhal said, rather than as a way to quit smoking. Instead of reducing the health risks of cigarette smoking, that use pattern could actually make nicotine dependence more severe. Based on the study results, Leventhal estimates that of all U.S. adults who currently used nicotine pouches in 2022, about 35% had previously smoked cigarettes and 25% were currently smoking cigarettes. The remaining 40% of adult pouch consumers had never regularly smoked cigarettes and could be at risk for developing nicotine dependence. “In summary, we didn’t see a large population of adults using nicotine pouches, and fewer appear to be using them in a fashion that would potentially reduce their harm from smoking cigarettes,” Leventhal said. Regulating nicotine pouches New nicotine products typically go straight to market before the U.S. Food and Drug Administration (FDA) reviews marketing applications and decides whether to authorize or ban each product. That decision involves weighing potential public health benefits, such as whether a product provides a safer alternative for adults who smoke, against risks, such as whether it may increase nicotine dependence among youth. Applications from major manufacturers of nicotine pouches are currently under review by the FDA. “Regulators can take our data and put it into that equation,” Leventhal said. “What our study suggests is that there’s not a large population of adults who smoke who are using these products to quit.” This study is part of the USC Tobacco Center of Regulatory Science, one of seven national centers supported by the NIH and FDA to collect evidence that can inform tobacco product regulation. In collaboration with the University of Michigan and other institutions, USC researchers are also conducting a parallel study to investigate adolescent use of nicotine pouches. They are looking at how pouch use relates to shifting teen usage patterns of other nicotine products, including e-cigarettes. About this research In addition to Leventhal, the study’s other author is Hongying Daisy Dai from the College of Public Health, University of Nebraska Medical Center, Omaha. This work was supported by the National Cancer Institute [U54CA180905] and the National Institute on Drug Abuse [R21DA058328]. Source: Keck School of Medicine of USC Journal reference: Dai, H. D., et al. (2024). Prevalence of Nicotine Pouch Use Among US Adults. JAMA. doi.org/10.1001/jama.2024.10686. To read the original article click here.

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Microbiome to Blame for Weight Gain After You Quit Smoking

AHA Publisher — Wed, 15 Dec 2021 08:00:47 +0000

Jon Schiller via Israel21c – It’s estimated that more than a billion people smoke cigarettes despite its role in causing disease. Recent studies have shown that 70 percent of smokers are interested in quitting but are concerned that they will gain weight. For years, the cause of weight gain as the result of quitting smoking has been unclear. In a recent study published in Nature, Weizmann Institute of Science researchers say the culprit may be weight-modulating compounds released by gut microbes. The researchers found that mice regularly exposed to cigarette smoke failed to gain weight, despite consuming a diet high in fat and sugar. When the smoke exposure stopped, the mice rapidly gained weight. But when the mice were given broad-spectrum antibiotics that depleted their microbiome, they gained much less weight after undergoing smoking cessation, staying slim for months regardless of their diet. The scientists believe that smoking-related compounds such as nicotine penetrated the gut of the smoke-exposed mice, altering the gut’s bacterial composition and, consequently, the body’s metabolism. They also assessed the microbiomes of 96 smoking and nonsmoking people. They found marked alterations in the microbiome of smokers, as well as microbial metabolite changes similar to those found in the smoke-exposed mice. “Our findings exemplify how the host and microbiome act as partners in regulating weight and metabolism,” said immunologist Prof. Eran Elinav, who headed the research team. “The compounds we have identified may lead to new treatments that will help people avoid weight gain when quitting smoking. Moreover, these compounds may be further developed into therapies to fight obesity even among nonsmokers.” To read the original article click here.

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Research Demonstrates a Clear Link Between Nicotine Withdrawal and Poor Eating Habits

AHA Publisher — Tue, 28 Sep 2021 07:00:05 +0000

University of Minnesota Medical School via News-Medical – New data collected by University of Minnesota Medical School researchers demonstrate a clear connection between nicotine withdrawal and poor eating habits. Their findings point to the opioid system, the brain functions responsible for addiction and appetite regulation, as a possible cause for smoker preference of energy-dense, high-calorie food during nicotine withdrawal. This can lead to weight gain, for those who quit smoking, which, in turn, may increase the risk of relapse. Mustafa al’Absi, PhD, a licensed psychologist and professor in the Department of Family Medicine and Biobehavioral Health at the U of M Medical School, Duluth Campus, is the principal investigator and the senior author of the study recently published in the Journal of Drug and Alcohol Dependence. “We looked at whether or not acute nicotine withdrawal increases the intake of junk food -; high in salt, fat and sugar -; and how the stress-relieving receptors of the opioid system are involved. Mitigating these challenges during the treatment process will help patients quit smoking while understanding their eating habits and encourage healthier decisions.” Mustafa al’Absi, PhD, Professor, Department of Family Medicine and Biobehavioral Health, U of M Medical School The team studied a group of smoking and non-smoking participants between the ages of 18 and 75 during two laboratory sessions. All were randomly assigned to do a 24-hour withdrawal from nicotine products and administered either a placebo or 50 mg of naltrexone. At the end of each session, participants were given a tray of snack items that differed in high to low energy density and dimensions of salty, sweet and fat. The study found that: Smokers undergoing nicotine withdrawal consumed more calories than non-smokers. Participants were also less likely to select high-fat food after the naltrexone was administered than placebo. “The study’s findings may be related to the use of food, especially those high in calories, to cope with the negative affect and distress that characterizes the feelings people experience during smoking withdrawal,” al’Absi said. “Results from preclinical and clinical research support this and demonstrate that stress increases proclivity for high-fat and high-sugar foods.” Naltrexone normalized calorie intake to levels seen in non-smokers, suggesting that the opioid system may be a mechanism of withdrawal-induced intake of calories. “This is rather a novel finding in the context of nicotine addiction and has lots of implications for the development of future treatment,” al’Absi said. The choice and consumption of food items were impacted by the participants’ smoking backgrounds. al’Absi and his team are now focusing on the impact of appetite changes on weight gain post-cessation and the extent to which these changes hinder smoking cessation and increase the risk of relapse. Future work will be critical to identifying the mechanisms of these changes and could be targeted for therapeutic interventions. “These findings extend earlier studies that indicate the impact of tobacco use on appetite and help identify the influence of an important biological link, the brain opioid system, on craving during nicotine withdrawal,” al’Absi said. “The fear of weight gain is a major concern among smokers who think about quitting. The key to removing these barriers is to better understand the factors that increase the urge for high-caloric foods.” To read the original article click here.

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Flavored E-Cigarettes May Affect the Brain Differently Than Non-Flavored

AHA Publisher — Wed, 30 Jun 2021 07:00:21 +0000

Penn State via EurekAlert – Flavoring can change how the brain responds to e-cigarette aerosols that contain nicotine, according to Penn State College of Medicine researchers. Andrea Hobkirk and her team used functional magnetic resonance imaging (MRI) to understand how the brain’s reward areas react to e-cigarette aerosol with and without flavor. “There are nearly 12 million e-cigarette users in the United States,” Hobkirk, an assistant professor of psychiatry and behavioral health at Penn State College of Medicine, said. “The vast majority use e-cigarettes with menthol, mint, fruity and dessert-type flavors. Although regulations that limit the sale of flavored e-cigarettes may help curb use among youth, they might also stop adults from using e-cigarettes as a smoking reduction or cessation aid. We are trying to understand how flavor influences e-cigarette reward and satisfaction for smokers and the risk of nicotine addiction for non-smokers.” The team first developed a device to deliver e-cigarette aerosols during brain scanning. Next, the research team used this new device to deliver aerosols containing a low dose of nicotine to nine adult female smokers during a single laboratory visit. One aerosol had a strawberry-vanilla flavor, and the other aerosol was flavorless. The team compared the strength of brain activation and reward brain region involvement between flavored and unflavored aerosols. “For our study, we were interested in looking first at, for smokers, how flavor might affect their response to nicotine e-cigarettes,” Hobkirk said. “We recruited smokers who had never used e-cigarettes before or were not regular e-cigarette users. What we were interested in is figuring out whether or not flavor changed how they perceived or how their brain responded to this e-cigarette use.” The researchers found that the strawberry-vanilla aerosol engaged the brain’s taste region. In contrast, the unflavored aerosol engaged the brain’s reward region, similar to observations during cigarette smoking. The researchers published their results in the journal Experimental and Clinical Psychopharmacology. The researchers also assessed patterns of neural activity between brain regions. Stronger connectivity between two brain regions typically means that these regions are working together. They found that key brain reward regions were strongly connected with flavored aerosol and not unflavored. The findings suggest that, for smokers, unflavored e-cigarettes may mimic the typical smoking experience more than flavored e-cigarettes. “We found that for smokers who had never really used e-cigarettes before, the flavor did not make the experience more rewarding for them, at least in terms of what we saw in the brain,” Hobkirk said. “It did not make the experience of breathing in these aerosols more like a smoking experience. Typically, that’s what smokers are looking for when they’re trying to transition over to a healthier product. They want something that gives all the similar rewarding and sensory-motor effects of their regular combustible cigarette, but without all the harmful effects that come in the toxins of a cigarette. We found that adding flavor doesn’t necessarily do that for these smokers, at least what we saw in their response to them in the brain. This could suggest that, potentially, smokers do not necessarily need these flavors to make the transition from a combustible cigarette to an e-cigarette.” To read the original article click here.

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