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1 Million Adult Vapers in England Have Never Regularly Smoked

The AHA! Team — Fri, 15 Nov 2024 06:20:34 +0000

Priyanjana Pramanik, MSc. via News-Medical – This rapid increase between 2021 and 2024 was particularly among younger age groups. In a recent study published in The Lancet Public Health, researchers estimate trends in vaping among adults in the United Kingdom who have not smoked regularly. The health implications of vaping In the past, vaping or the use of e-cigarettes in England was primarily reported among current or former smokers trying to reduce or quit smoking. If vaping were only adopted by those who would otherwise smoke, the overall rate of smoking or vaping would remain constant or show signs of declining rather than increasing. The rising rate of vaping could be attributed to the widespread availability of disposable e-cigarettes in recent years, which has led to a rapid increase in vaping among regular and non-regular smokers. Although e-cigarettes may be less harmful than smoking, these devices contain toxic chemicals that the user consumes. In fact, several studies indicate that vapers are exposed to higher levels of toxicants than non-users. About the study Researchers collected data using a monthly cross-sectional survey across England, Wales, and Scotland to ensure a nationally representative sample. Approximately 2,450 individuals participated in the survey each month between 2016 and early 2024. The vaping status of adults who reported never regularly smoking was evaluated using questions about their current e-cigarette use, daily or non-daily e-cigarette use, as well as as the type of device and strength of nicotine used. Study participants also provided sociodemographic data such as gender, age, and social class, as well as lifestyle information such as alcohol consumption. Statistical models were used to calculate trends in the prevalence of smoking after adjusting for alcohol consumption and sociodemographic characteristics. These trends were then assessed according to age, with the prevalence of vaping compared before and after the increased availability of disposable e-cigarettes. Study findings The analysis included 94,107 unique never-regular smokers, as well as younger individuals who had never smoked. Vaping among never-regular smokers was stable at approximately 0.5% until 2021. From 2021 onwards, vaping increased rapidly to 3.5% in April 2024. This increased prevalence of vaping was primarily attributed to younger adults under the age of 24, 14.4% of whom vaped, as compared to those over the age of 48, less than 1% of whom vaped. Although age differences were significant, trends were similar across social class and gender. Alcohol consumption was positively correlated with vaping prevalence, with heavy drinkers more likely to vape at a rate of 22.1%. Comparatively, only 3% of low-risk drinkers and 1.3% of non-drinkers vaped. Throughout the analysis period, non-daily vaping was less common than daily vaping, but the prevalence of daily vaping was four times greater than that of non-daily vaping. Researchers also found clear indications that disposable e-cigarettes are implicated in these trends. In the post-disposable period, users were more likely to report longer vaping durations, with a reduced prevalence of short-term use. Since disposable devices have become more common, vapers are increasingly younger, heavier drinkers, and more likely to be female. There is also a pronounced shift towards disposable e-cigarettes and devices with higher nicotine strengths. More purchases were also reported from convenience stores or supermarkets, and fewer from vape shops. Conclusions The study findings demonstrate the significant rise in vaping rates in England over the past three years, specifically among those who are not regular smokers, as well as younger adults and heavier drinkers. In 2021, one in 200 never-regular smokers reported vaping. By April 2024, this rate increased to one in 28. Disposable e-cigarettes, which appear to appeal to younger adults and women, may encourage the use of higher nicotine strengths. The health impacts of these behavioral shifts may be significant, particularly among individuals who would not typically engage in vaping, which increases their exposure to toxins they would have otherwise avoided. Addressing these issues is associated with various challenges as policymakers seek to reduce vaping among non-smokers while ensuring that e-cigarettes are available and remain attractive to smokers who would like to quit. Stricter regulations on the appearance, pricing, and marketing of these products may support these public health efforts to reduce the appeal of vaping. Journal reference: Jackson, S.E., Shahab, L., Tattan-Birch, H., & Brown, J. (2024). Vaping among adults in England who have never regularly smoked: a population-based study, 2016–24. The Lancet Public Health. doi:10.1016/S2468-2667(24)00183-X To read the original article click here.

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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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Harmful Metals Found in Vapors From Tank-Style Electronic Cigarettes

AHA Publisher — Mon, 30 Sep 2019 07:00:34 +0000

University of California – Riverside via EurekAlert – “Concentrations of the metals, such as lead, in the aerosols increased with more voltage,” Williams said. “Concentrations of some elements – chromium, lead, and nickel – were high enough to be a health concern. We found the concentrations of chromium, copper, lead, nickel, and zinc exceeded the proposed permissible exposure limit from the Occupational Safety and Health Administration.” RIVERSIDE, Calif. – A team of scientists at the University of California, Riverside, has found the concentration of metals in electronic cigarette aerosols – or vapor – has increased since tank-style electronic cigarettes were introduced in 2013. Electronic cigarettes, which consist of a battery, atomizing unit, and refill fluid, are now available in new tank-style designs, equipped with more powerful batteries and larger capacity reservoirs for storing more refill fluid. But the high-power batteries and atomizers used in these new styles can alter the metal concentrations that transfer into the aerosol. “These tank-style e-cigarettes operate at higher voltage and power, resulting in higher concentrations of metals, such as lead, nickel, iron, and copper, in their aerosols,” said Monique Williams, a postdoctoral researcher in the Department of Molecular, Cell, and Systems Biology, and the first author of the research paper that appears today in Scientific Reports. “Most of the metals in e-cigarette aerosols likely come from the nichrome wire, tin solder joints, brass clamps, insulating sheaths, and wicks – components of the atomizer unit.” The researchers examined six tank-style electronic cigarettes and found all the aerosols had metals that appeared to originate in the atomizers. Further, they found the model with fewest metal parts in its atomizer had the fewest metals in its aerosol. Of the 19 metals they screened, aluminum, calcium, chromium, copper, iron, lead, magnesium, nickel, silicon, tin, and zinc were from components in the atomizing units. “Concentrations of the metals, such as lead, in the aerosols increased with more voltage,” Williams said. “Concentrations of some elements – chromium, lead, and nickel – were high enough to be a health concern. We found the concentrations of chromium, copper, lead, nickel, and zinc exceeded the proposed permissible exposure limit from the Occupational Safety and Health Administration.” Chromium, lead, and nickel are known carcinogens. Prolonged exposure to chromium could cause gastrointestinal effects, nasal and lung cancer, respiratory irritation, and lung function impairment. Prolonged exposure to lead could produce vomiting, diarrhea, cardiovascular effects, and lung cancer. Nickel inhalation could cause lung disease, damage to the nasal cavity, lung irritation, lung inflammation, hyperplasia in pulmonary cells, and fibrosis. The researchers analyzed the following six tanks and their atomizers: Kangertech Protank, Aspire Nautilus tank, Kanger T3S tank, Tsunami 2.4, Smok tank, and Clone. They collected aerosols from these brands using two methods and found the total concentrations of metals varied, ranging from 43 to 3,138 micrograms per liter with the “impinger method” of collection and 226 to 6,767 micrograms per liter with the “cold trap method.” “When batteries with more power are used in these tank-style e-cigarettes, their atomizing units can heat to temperatures greater than 300 C, which could produce harmful byproducts,” said Prue Talbot, a professor of cell biology, who led the research team. “The presence of heavy metals, including some known carcinogens, in e-cigarette aerosols is concerning because with prolonged exposure they could cause adverse health effects. “Our data on tank-style e-cigarettes and the concentrations of metals they deliver may be useful to regulatory agencies, health care providers, and consumers,” she added. To read the original article click here.

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Mysterious Vaping Illness Characterized by Fat-Laden Cells in the Lung

The AHA! Team — Wed, 11 Sep 2019 07:00:00 +0000

University of Utah via EurekAlert (Salt Lake City) – Lung scans from patients with vaping illness look like a serious viral or bacterial pneumonia, but those tests come back negative. Instead, diagnosis has been based on exclusion of known causes of similar respiratory illnesses combined with knowing the patient has a history of vaping. Doctors have identified a previously unrecognized characteristic of the vaping-related respiratory illness that has been emerging in clusters across the U.S. in recent months. Within the lungs of these patients are large immune cells containing numerous oily droplets, called lipid-laden macrophages. (Lipid-laden macrophages found in patients with vaping-related respiratory illness. Oily lipids are stained in red. Photo via Andrew Hansen, MD, Jordan Valley Medical Center). The finding may allow doctors to definitively diagnose the nascent syndrome more quickly and provide the right treatment sooner. It could also provide clues into the causes of the new and mysterious condition. Investigators at University of Utah Health reported the findings in a letter published in the New England Journal of Medicine on Sept. 6. “While it is too soon to be sure, these lipid-laden macrophages may turn out to be useful to confirm or rule out this disease,” said the study’s senior author Scott Aberegg, M.D., a critical care pulmonologist at U of U Health. “They may also be helpful in understanding what is causing this illness,” Aberegg added. Watch a video of physicians and patients talking about their experiences with the vaping illness here. Lung scans from patients with vaping illness look like a serious viral or bacterial pneumonia, but those tests come back negative. Instead, diagnosis has been based on exclusion of known causes of similar respiratory illnesses combined with knowing the patient has a history of vaping. U of U Health investigators identified the lipid-laden macrophages in six out of six cases seen at University of Utah Hospital in Salt Lake City by the time of submitting the results for publication. The cells were found in samples after performing a procedure called bronchoalveolar lavage where fluid is squirted into a small section of the lungs and then collected for examination. Macrophages are a type of cell from the immune system that gather at sites of infection and perform the role of cleaning up debris. Staining them with a dye called Oil-red-O highlighted the oily droplets littered throughout these cells. Distinctive cells “These cells are very distinctive, and we don’t often see them. That made everybody start to think carefully about why they were there. Are they scavenging debris in the lungs that was introduced through vaping?” Aberegg said. Doctors at the U had the test performed on the first vaping patient treated at U of U Health in July 2019, after the referring doctor had suggested the patient could have lipoid pneumonia. The condition is diagnosed by screening for lipid-laden macrophages. After finding the marker in this patient, doctors performed the same test in subsequent patients suspected to have the vaping illness, and all were positive. Since submitting their findings for publication, the number of vaping illness cases with lipid-laden macrophages has risen to ten of ten patients examined, with new cases arriving weekly. The question remains as to whether the vaping respiratory illness is a type of lipoid pneumonia. Despite similarities, there are also differences. Unlike the vaping illness, classic lipoid pneumonia is typically seen in older individuals, typically caused by accidentally breathing in oil-based laxatives. Classic lipoid pneumonia also presents differently on x-rays of the lungs. Additional testing will need to be done to determine whether the vaping illness can be categorized as a new kind of lipoid pneumonia. “We need to determine if these cells are specific for the illness or whether they are also seen in vaping patients who are not ill and don’t have symptoms. If they are only seen in patients who get sick, we can begin to make some connections between what we’re seeing in the lipid laden macrophages and whatever components of the vaping oils may be causing this syndrome” Aberegg said. To read the original article click here.

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