EVALI and the Pulmonary Toxicity of Electronic Cigarettes: A Review

Winnicka, Lydia; Shenoy, Mangalore Amith

doi:10.1007/s11606-020-05813-2

Cited by 73 publications

(98 citation statements)

References 41 publications

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“…This prompted the FDA to restrict the production and sale of all flavored cartridge-based e-cigarettes to underage youth. 22 , 23 Yet, in our study, students were unaware of lung damage claims and perceived e-cigarettes to have the most benefit on the respiratory system. Moreover, the long-term health effects of these products are still unknown and widely debated.…”

Section: Discussionmentioning

confidence: 64%

“…Moreover, the long-term health effects of these products are still unknown and widely debated. 22,23 There is limited knowledge of tobacco-related products, particularly those that are novel in design, among young adults that leads them to a false sense of security. In a study among US students by Wang et al, 24 product knowledge and awareness were present in only 50.3% of students using ecigarettes and 41.2% using hookah.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the long-term health effects of these products are still unknown and widely debated. 22 , 23 …”

Section: Discussionmentioning

confidence: 99%

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Attitudes and Perceptions of Tobacco-Related Products in College Students

Dang

2020

Innov Pharm

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Background – Despite the highly publicized health consequences, some college students do not perceive tobacco consumption as harmful. Historically-Black College and Universities (HBCUs) have the lowest rates of tobacco-free policies compared to other colleges, universities, and minority-serving institutions, making their students at higher risk for tobacco abuse. A campus Alcohol, Tobacco, and Other Drug Prevention Committee (ATDP) was formed and led by a pharmacist to develop all tobacco cessation policies at the HBCU. Objectives – (1) To determine the knowledge and attitudes of cigarettes, cigars, smokeless tobacco, electronic cigarettes, and hookah among college students in a rural area with high tobacco usage; (2) To assess perceptions on the effectiveness of smoking cessation resources on the college campus led by the ATDP committee. Methods – A cross-sectional study was conducted on 99 students between 18 – 26 years attending a HBCU in Maryland. The online survey was disseminated to assess student’s health behaviors and attitudes towards tobacco products and their successfulness in abstinence using campus resources with the Health Belief Model. Results – Participants had more perceived harms with smoking tobacco (cigarettes and cigars) and smokeless tobacco, and greater perceived benefits with using electronic cigarettes and hookah (P < 0.001). Most students had limited knowledge of the four tobacco categories (5.8 ± 2.6 on a 10-point Likert scale). Self-efficacy to quit was 4.2 ± 1.7 on a 10-point Likert scale despite the current resources at the HBCU. Conclusion – Students had a perceived benefits sequential rank order with hookah, e-cigarettes, smokeless tobacco, followed by smoking tobacco. Campuses should investigate barriers for abstinence, raise awareness about the dangers of tobacco, and create programs that enhance self-efficacy when quitting. Innovation and Practice Implication - This is the first study of its kind that compares all major tobacco products head-to-head in a rural and underrepresented population. Additionally, the development of a campus-wide tobacco policy was novel as it was pharmacist-led. The results show this population has limited knowledge of tobacco products with more perceived benefits among newer nicotine delivery systems. Targeted education and public health programs should be implemented to prevent this susceptible group from initiating and continuing tobacco products. Article Type: Original Research

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

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Attitudes and Perceptions of Tobacco-Related Products in College Students

Dang

2020

Innov Pharm

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“…Podendo ainda induzir mecanismos de eliminação, incluindo recrutamento de células inflamatórias. 20,92,93,94 O CC16 (proteína 16 da célula surfactante) é uma proteína anti-inflamatória, produzida exclusivamente nas células colunares não ciliadas dos grandes e pequenos brônquios e bronquíolos do pulmão. Ela reduz a inflamação das vias aéreas e o estresse oxidativo, além de sequestrar algumas substâncias nocivas que podem ser depositadas no pulmão.…”

Section: Discussionunclassified

“…Isso ocorre, mais detalhadamente, pela interação dos óleos com a membrana de surfactante pulmonar. 29,94,96 Ademais, os isômeros da vitamina E exercem efeitos regulatórios sobre a proteína quinase C a (PKCa) nas células endoteliais respiratórias, determinando o recrutamento de leucócitos, fase importante no desencadeamento de uma resposta exacerbada das vias aéreas e de inflamação pulmonar. Esse mecanismo associado a outros efeitos deletérios do vaping promovem modificações do epitélio respiratório (transição epitelial para mesenquimal) e do seu potencial carcinogênico.…”

Section: Discussionunclassified

Lesões Pulmonares Associadas ao Uso do Cigarro Eletrônico

D’Almeida¹,

Silveira²,

Poiano³

et al. 2020

Blucher Medical Proceedings

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Vaping Associated Lung Injuries/Illnessess (lesões pulmonares/doenças pulmonares associadas ao cigarro eletrônico ou ao "vaping").Difundido pela indústria do tabaco como menos prejudicial à saúde, o cigarro eletrônico ganhou espaço entre jovens. Mas seu uso vem causando síndrome emergente, com manifestações clínicas importantes e até mesmo óbito. O diagnóstico é de exclusão. O tratamento é feito com cessação do uso do cigarro eletrônico e terapia empírica com corticóides, antimicrobianos e antivirais. OBJETIVO: Descrever as principais manifestações clínicas, radiológicas e anátomo patológicas em pacientes com EVALI. METODOLOGIA: Revisão narrativa sistematizada, em base de dados: Bireme, Cochrane Library, Pubmed e Scielo. Descritor utilizado: "Electronic Nicotine Delivery Systems" AND "Lung Injury". Selecionados publicações dos últimos dez anos (línguas inglesa, espanhola e portuguesa), sem restrição do tipo de estudo. 402 artigos incialmente; excluídos os repetidos em diferentes bases de dados e os que não se relacionavam ao tema ou se relacionavam com outras doenças. Por fim, 101 estudos foram utilizados. RESULTADOS: 2.668 relatos de pessoas com EVALI (até 14 janeiro 2020), média de idade 24 anos (13 a 85 anos); 66 % sexo masculino; Tempo médio de uso do cigarro eletrônico de 12,8 meses (variando de 1 dia a 5 anos de uso).Manifestações clínicas: dispneia (66,5%), tosse (64%), febre (60%), fadiga (40%) e dor torácica (35,5%). Sintomas gastrointestinais foram frequentes: vômitos (48%), náuseas (45%), diarréia (25%) e dor abdominal (19%). Cerca 25% dos pacientes apresentaram taquipneia e hipoxemia e 3,6% hemoptise. Manifestações radiológicas: infiltrado intersticial (vidro fosco) em mais de 90% dos casos e raramente consolidações, opacidades alveolares, lesões cavitárias e bronquiectasias. Análise anatomopatológica realizada em 164 desses indivíduos, (material via broncoscopia) e achados mais frequentes: dano alveolar difuso, hemorragia alveolar; pneumonia lipoide, proteinose alveolar e BOOP em alguns casos. E 68 casos evoluíram a óbito. CONCLUSÃO:O uso do cigarro eletrônico é uma nova forma de tabagismo

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Composition of e‐cigarette aerosols: A review and risk assessment of selected compounds

Heywood,

Abele,

Langenbach

et al. 2024

J of Applied Toxicology

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The potential harms and benefits of e‐cigarettes, or electronic nicotine delivery systems (ENDS), have received significant attention from public health and regulatory communities. Such products may provide a reduced risk means of nicotine delivery for combustible cigarette smokers while being inappropriately appealing to nicotine naive youth. Numerous authors have examined the chemical complexity of aerosols from various open‐ and closed‐system ENDS. This body of literature is reviewed here, with the risks of ENDS aerosol exposure among users evaluated with a margin of exposure (MoE) approach for two non‐carcinogens (methylglyoxal, butyraldehyde) and a cancer risk analysis for the carcinogen N‐nitrosonornicotine (NNN). We identified 96 relevant papers, including 17, 13, and 5 reporting data for methylglyoxal, butyraldehyde, and NNN, respectively. Using low‐end (minimum aerosol concentration, low ENDS use) and high‐end (maximum aerosol concentration, high ENDS use) assumptions, estimated doses for methylglyoxal (1.78 × 10−3–135 μg/kg‐bw/day) and butyraldehyde (1.9 × 10−4–66.54 μg/kg‐bw/day) corresponded to MoEs of 227–17,200,000 and 271–280,000,000, respectively, using identified points of departure (PoDs). Doses of 9.90 × 10−6–1.99 × 10−4 μg/kg‐bw/day NNN corresponded to 1.4–28 surplus cancers per 100,000 ENDS users, relative to a NNN‐attributable surplus of 7440 per 100,000 cigarette smokers. It was concluded that methylglyoxal and butyraldehyde in ENDS aerosols, while not innocuous, did not present a significant risk of irritant effects among ENDS users. The carcinogenic risks of NNN in ENDS aerosols were reduced, but not eliminated, relative to concentrations reported in combustible cigarette smoke.

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EVALI and the Pulmonary Toxicity of Electronic Cigarettes: A Review

Cited by 73 publications

References 41 publications

Attitudes and Perceptions of Tobacco-Related Products in College Students

Attitudes and Perceptions of Tobacco-Related Products in College Students

Lesões Pulmonares Associadas ao Uso do Cigarro Eletrônico

Composition of e‐cigarette aerosols: A review and risk assessment of selected compounds

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