Electronic nicotine delivery system-induced alterations in oral health via saliva assessment.
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ABSTRACT: Impact statement
The use of traditional tobacco products is a known risk factor for the development of diseases including periodontal disease. To date, the potential oral health effects related to electronic nicotine delivery systems (ENDS) use is unknown. This study collected saliva from ENDS users and never tobacco users to examine differences in the oral cavity of inflammatory cytokines and metabolites. The identification and measurement of these ENDS-related changes provide insight into disease pathways potentially associated with ENDS use. The utilization of saliva samples collected from human participates enhances the application of the findings compared to the majority of studies using cell culture and animal models. In addition, these foundational findings can inform future studies to examining specific pathways identified, interventional approaches, and application of translatable biomarkers of ENDS use.
SUBMITTER: Alqahtani S
PROVIDER: S-EPMC7441347 | biostudies-literature | 2020 Sep
REPOSITORIES: biostudies-literature
Publications
Electronic nicotine delivery system-induced alterations in oral health via saliva assessment.
Alqahtani Saeed S Cooper Bruce B Spears Claire A CA Wright Christa C Shannahan Jonathan J
Experimental biology and medicine (Maywood, N.J.) 20200708 15
<h4>Impact statement</h4>The use of traditional tobacco products is a known risk factor for the development of diseases including periodontal disease. To date, the potential oral health effects related to electronic nicotine delivery systems (ENDS) use is unknown. This study collected saliva from ENDS users and never tobacco users to examine differences in the oral cavity of inflammatory cytokines and metabolites. The identification and measurement of these ENDS-related changes provide insight i ...[more]
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Project description:BackgroundPrevious studies have examined the characteristics of open and closed system electronic nicotine delivery system (ENDS) users, but population-level information on nicotine exposure among these users has not been available.MethodsWe analyzed nicotine biomarker and survey data from Wave 3 of the Population Assessment of Tobacco and Health (PATH) study collected from October 2015 to October 2016. We identified 277 exclusive ENDS users and 468 dual cigarette and ENDS users and analyzed concentrations of nicotine and its metabolites obtained from urine samples by device type and other characteristics, such as frequency of use and e-liquid flavor.ResultsAmong exclusive ENDS users, open system users had higher levels of total nicotine exposure (TNE-2) than closed system users [8.8 μmol/g creatinine (95% confidence interval [CI] = 5.3-14.8 μmol/g vs. 2.0 μmol/g (95% CI = 0.7-5.4 μmol/g)]. However, TNE-2 concentrations were similar when open and closed system users were stratified as daily [26.4 μmol/g (95% CI = 20.1-34.7 μmol/g) vs. 27.1 μmol/g (95% CI = 16.4-44.9 μmol/g)] and nondaily [0.5 μmol/g (95% CI = 0.1-1.9 μmol/g) vs. 0.2 μmol/g (95% CI = 0.0-0.7 μmol/g)] ENDS users. Dual users generally had higher nicotine exposure than exclusive users.ConclusionsNicotine exposure was observed to be higher among exclusive open system ENDS users compared with closed system users, but levels were similar when users were stratified by frequency of use.ImpactThese results suggest that exclusive ENDS users with similar use patterns receive comparable levels of nicotine, regardless of whether they use open or closed system devices.
| S-EPMC7541662 | biostudies-literature
Project description:RationaleElectronic nicotine delivery systems and heated tobacco products are noncombustible alternatives for adult smokers. Evidence suggests sufficient nicotine delivery and satisfying effects are necessary to facilitate switching away from smoking; nicotine delivery varies across electronic nicotine delivery systems within limited nicotine concentrations.ObjectivesTo assess the nicotine delivery and subjective effects of prototype JUUL2 System in two nicotine concentrations, currently-marketed US JUUL System ("JUUL"), IQOS-brand heated tobacco product, and combustible cigarettes.MethodsAdult smokers (N = 40) completed a 5-arm cross-over product-use laboratory confinement study. Nicotine pharmacokinetics and subjective effects were assessed following use of: (1) JUUL2 prototype 18 mg/mL nicotine; (2) JUUL2 prototype 40 mg/mL; (3) JUUL 59 mg/mL; (4) IQOS 18 mg/g; and (5) usual brand combustible cigarette, each evaluated during ad libitum (10 min) and controlled (5 min, 10 standardized puffs) use.ResultsNicotine delivery was greatest for combustible cigarettes, followed by JUUL2 prototype 40 mg/mL, IQOS, JUUL2 prototype 18 mg/mL, and JUUL 59 mg/mL. Nicotine delivery from JUUL2 prototype 18 mg/mL was significantly greater than JUUL 59 mg/mL after ad libitum use. JUUL products were significantly more satisfying and effective at reducing craving than IQOS. JUUL2 prototype 40 mg/mL was significantly more aversive than other JUUL products.ConclusionsPrototype JUUL2 and JUUL 59 mg/mL products were rated higher than IQOS on subjective measures associated with switching away from smoking. The JUUL2 prototype 40 mg/mL produced aversive responses and would require modifications to be a viable product for adult smokers. Nicotine delivery and subjective responses to JUUL2 prototype 18 mg/mL suggest a product based on this prototype may facilitate increased switching among adult smokers.
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Project description:AimsTo estimate the effect of potential regulations of electronic nicotine delivery systems (ENDS) among adult smokers, including increasing taxes, reducing flavor availability and adding warning labels communicating various levels of risk.DesignWe performed a discrete choice experiment (DCE) among a national sample of 1200 adult smokers. We examined heterogeneity in policy responses by age, cigarette quitting interest and current ENDS use. Our experiment overlapped January 2015 by design, providing exogenous variation in cigarette quitting interest from New Year resolutions.SettingKnowledgePanel, an online panel of recruited respondents.ParticipantsA total of 1200 adult smokers from the United States.MeasurementsHypothetical purchase choice of cigarettes, nicotine replacement therapy and a disposable ENDS.FindingsIncreasing ENDS prices from $3 to $6 was associated with a 13.6 percentage point reduction in ENDS selection (P < 0.001). Restricting flavor availability in ENDS to tobacco and menthol was associated with a 2.1 percentage point reduction in ENDS selection (P < 0.001). The proposed Food and Drug Administration (FDA) warning label was associated with a 1.1 percentage point reduction in ENDS selection (P < 0.05) and the MarkTen warning label with a 5.1 percentage point reduction (P < 0.001). We estimated an ENDS price elasticity of -1.8 (P < 0.001) among adult smokers. Statistically significant interaction terms (P < 0.001) imply that price responsiveness was higher among adult smokers 18-24 years of age, smokers who have vaped over the last month and smokers with above the median quitting interest. Young adult smokers were 3.7 percentage points more likely to choose ENDS when multiple flavors were available than older adults (P < 0.001). Young adult smokers and those with above the median cigarette quitting interest were also more likely to reduce cigarette selection and increase ENDS selection in January 2015 (P < 0.001), potentially in response to New Year's resolutions to quit smoking.ConclusionsIncreased taxes, a proposed US Food and Drug Administration warning label for electronic nicotine delivery systems and a more severe warning label may discourage adult smokers from switching to electronic nicotine delivery systems. Reducing the availability of flavors may reduce ENDS use by young adult smokers.
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Project description:(1) Background: Electronic nicotine delivery systems (ENDSs) are rapidly increasing in the U.S., however, information about their long-term risks and benefits remains limited. This study examined the relationship between ENDS use and periodontal health among U.S. adults. (2) Methods: Data came from 33,822 adults who participated in the 2016-2018 wave of the Population Assessment of Tobacco and Health (PATH) study. Inclusion criteria were adults without a history of cigarette smoking or diabetes. Logistic regression analysis was performed to estimate the associations between ENDS use and a history of periodontal disease, with multivariable logistic regression adjusting for factors associated with poor oral health. (3) Results: Of the study participants, 2321 were never ENDS users, 38 were regular ENDS users, and 512 were non-regular ENDS users. Compared to never ENDS users, regular ENDS users had higher odds of poor periodontal health including bone loss around teeth. Regular ENDS use was also independently associated with higher odds of poor oral health compared to non-regular ENDS users. (4) Conclusions: This study suggests an association between ENDS use and increased risk of periodontal health issues in the United States. These findings align with previous research linking ENDS use to poor oral health.
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Project description:Cannabis legalization continues to spread, with 38 states permitting the use of medical marijuana, 22 states permitting recreational use, and growing political momentum for federal legalization. The last time the Food and Drug Administration (FDA) was tasked with regulating a new product occurred with 2009's Family Smoking Prevention and Tobacco Control Act, which created the Center for Tobacco Products (CTP). Thus, the time is ripe to review the history of CTP with particular attention to difficulties the nascent center faced in regulating novel products such as e-cigarettes or electronic nicotine delivery systems (ENDS). Specifically, FDA has struggled with defining its scope of authority, determining which review pathway(s) to utilize, and promulgating timely and transparent product standards for marketing authorization-all of which offer lessons for improving cannabis product oversight and enforcement.
| S-EPMC11350284 | biostudies-literature
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| S-EPMC7272070 | biostudies-literature
Project description:Purpose of reviewThe objective of this scoping review is to use a health equity lens to understand the extent and type of evidence that exists about the use of electronic nicotine delivery systems (ENDS) based on socioecological understandings of health influences (i.e., the US National Institute of Minority Health and Health Disparities' (NIMHD) Research Framework). The research question guiding the review was as follows: What is the range and scope of research that exists to help characterize health disparities related to ENDS use?Recent findingsNinety-eight articles published between 2019 and 2022 often examined racial/ethnic differences in ENDS use; however, other demographic characteristics, domains of influence across the life course, and levels of influence beyond individuals were rarely considered. As most studies were derived from large-scale, cross-sectional US national surveys, few longitudinal studies or intervention trials were published.SummaryThe use of the NIMHD framework to analyze recent literature helped identify research patterns and gaps that may be important to recognize for optimizing population health strategies to advance health equity. Future research on non-individual level factors influencing ENDS, interventions to effectively use ENDS for combustible cigarette cessation, and subpopulations susceptible to dual use may enhance existing science. Monitoring research using the NIMHD research framework can help researchers and policy makers to identify and when appropriate, prioritize support for overlooked but important research questions.
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