Estudio cualitativo del uso de los cigarrillos electrónicos en los estudiantes universitarios / Qualitative Study of E-Cigarette Use in College Students

Objetivos: El propósito de esta investigación fue determinar el nivel de conocimiento, creencias, percepción y practicas asociadas al consumo de cigarrillos electrónicos en los estudiantes universitarios (UASD), recinto Santiago, República Dominicana. Cada estudiante firmó un consentimiento informado certificando que éste respondió cada pregunta realizada por el entrevistador de manera voluntaria. El método de recolección de los datos fue mediante entrevistas, las cuales fueron grabadas por los entrevistadores. La muestra fue de 53 entrevistas, 48 individuales y 5 grupos focales, la misma se tomó hasta alcanzar el punto de saturación de cada pregunta, es decir cuando todas las respuestas se tornaron repetitivas. Materiales y métodos: Se realizó un estudio cualitativo de tipo fenomenológico y de fuentes primarias en el período mayo-agosto del año 2019 en la universidad privada Pontificia Universidad Católica Madre y Maestra (PUCMM) y la universidad pública Universidad Autónoma de Santo Domingo. (UASD), campus Santiago, República Dominicana. El método de recolección de datos se realizó a través de entrevistas, las cuales fueron grabadas por los entrevistadores. Cada estudiante entrevistado firmó un consentimiento informado certificando que respondió voluntariamente a cada pregunta formulada por el entrevistador. La muestra estuvo compuesta por 53 entrevistas, 48 personas y cinco grupos focales. Las entrevistas se realizaron hasta llegar al punto de saturación de cada pregunta, que es cuando todas las respuestas se volvieron repetitivas. Resultados: El conocimiento que tiene los estudiantes universitarios sobre cigarrillo electrónico (CE), es pobre, desde su funcionamiento, partes, sustancias e incluso las posibles complicaciones que puede traer a la salud, tanto en la Pontificia Universidad Católica Madre y Maestra (PUCMM) como en la Universidad Autónoma de Santo Domingo (UASD), pero es más notable en la universidad pública. Por otro lado, muchos perciben el CE, como una alternativa del uso de tabaco, que posee diversidad de sabores, olor agradable, atractivo, práctico y capaz de ofrecer relajación. En cuanto a la actitud hacia el dispositivo, en PUCMM exhibe un mayor nivel de rechazo con respecto al uso. Es importante mencionar, que mayoría de los entrevistados son o alguna vez fueron usuarios de este, no obstante, no lo recomiendan en gran medida, ya que asumen que puede causar daño y ser adictivo, aunque en menor medida al cigarrillo convencional. La población más susceptible a su uso, son los jóvenes y el sexo masculino, aunque las féminas se han ido sumando de manera significativa. De igual modo, se logró apreciar las grandes influencias que mueven a los jóvenes a su consumo, incluyendo, las redes sociales, familia, amigos, en general el entorno en que se rodean. Conclusión: Concluimos que los estudiantes universitarios carecen de conocimiento con respecto al cigarrillo electrónico, tanto en el funcionamiento, sustancias y complicaciones para la salud. Muchos observan al cigarrillo electrónico como un dispositivo para fumar con un olor agradable, por lo cual puede ser muy atractivo para los usuarios. Se logró apreciar el importante papel que juegan las influencias sociales para el uso del dispositivo, promovido por las redes sociales y relaciones cercanas. Otro problema en la sociedad actual es el uso de CE en menores de edad. Según los resultados existe una gran necesidad de intervención y educación, principalmente en los jóvenes.

Objective: The purpose of this research was to determine the level of knowledge, beliefs, perception, and practices associated with consuming electronic cigarettes among university students. Materials and methods: A qualitative study of phenome-nological type and from primary sources was carried out in the period of May-August of the year 2019 at the private university Pontificia Universidad Católica Madre y Mae-stra (PUCMM) and the public university Universidad Autónoma de Santo Domingo (UASD), Santiago campus, Dominican Republic. The data collection method was done through interviews, which the interviewers recorded. Each student interviewed signed an informed consent cer-tifying that they answered voluntarily each question asked by the interviewer. The sample consisted of 53 interviews, 48 individuals, and five focus groups. Interviews were done until reaching the saturation point of each question, which is when all the answers became repetitive. Results: University students' knowledge regarding elec-tronic cigarettes (EC) is poor. Knowledge regarding its mechanism, parts, substances, and possible complications to one's health, is scarce both in PUCMM and the UASD, but this is more notable at the public university. Addition-ally, many perceive EC as an alternative to tobacco use, the former, as per our study population, having a variety of fla-vors, a pleasant smell, being attractive, practical, and capa-ble of offering relaxation. Regarding the attitude towards the device, PUCMM exhibits a higher level of rejection regarding its use. It is essential to mention that most inter-viewees were once users of EC. However, they do not rec-ommend it to a great extent since they assume that it can cause harm and be addictive, although to a lesser extent than conventional cigarettes. The population most suscep-tible to its use are young people, including minors and the male gender, although females have been significantly increasing its use. Similarly, it was possible to appreciate the influences that greatly evoke the younger population's consumption, including social networks, family, friends, and the surrounding environment. Conclusion: We concluded that university students have insufficient knowledge regarding electronic cigarettes, both in their mechanism, substances, and health compli-cations. Most see electronic cigarettes as smoking devices with a pleasant smell, which can be very attractive to users. It was possible to observe the critical role played by social influences on the use of the device, promoted by social networks and close relationships. Another problem in cur-rent society is the use of CE in minors. According to the results, there is a great need for intervention and educa-tion, mainly among the younger generation.

Global research trends and visual analysis of e-cigarette in public health : 2010-2020 / 环境与职业医学

Background In recent years, due to the increasing number of e-cigarette users, the health problems caused by e-cigarettes are attracting people's attention. Objective This study is designed to analyze the characteristics of e-cigarette-related research literature, research trends, and its toxicity from 2010 to 2020 through bibliometric analysis to provide a reference for studies related to the health effects of e-cigarettes. Methods The studies related to e-cigarettes in the Web of Science were retrieved, and the functions of "Creating citation report" and "Analyzing retrieval results" provided by Web of Science were used to conduct statistical analysis on publication time, literature type, publication source, country/region, research interests, research institution, etc. With the help of the knowledge function of CiteSpace V5.7, author collaboration, organization cooperation, keyword co-occurrence and keyword emergence, and reference co-citation were visualized. Results A total of 3094 studies related to health risks of e-cigarettes (public health) wereretrieved from 2010 to 2020, and the number of articles published between 2018 and 2020 accounted for 54.7% of total number. The top research institutions were from the United States (68.0%), the United Kingdom (7.6%), and Canada (6.1%). The most published author is King BA (67). The journal that published the most relevant studies was Nicotine Tobacco Research (536). The hot topics of e-cigarette research included "socioeconomic patterning," "multiple healthy behaviors," "expressive suppression emotion regulation strategies," "smoking cessation intervention studies" and "computer-delivered brief intervention". The burst intensity of keywords "cigarette smoking" was the highest, reaching 24.2. Between 2010 and 2020, the keywords "Nicotine dependence" and "Disease" emerged for the longest period of five years. "Policy" was the latest high-frequency word. The literature "Levels of selected carcinogens and toxicants in vapour from electronic cigarettes" was cited for the highest frequency, totaling 266 times. Conclusion The number of articles published has notably increased in 2018-2020, suggesting that researchers are paying attention to the health risks of e-cigarettes worldwide. The United States leads the world in the research of e-cigarette health risks. The future research direction will be focused on e-cigarette policy.

Daño pulmonar asociado al uso de cigarrillos electrónicos-vapeadores / Pulmonary damage associated with the use of electronic cigarettes or vapers

Ha habido mucha discusión sobre los efectos dañinos para la salud producidos por los cigarrillos electrónicos o vapeadores y su utilidad como ayuda para dejar de fumar. Cada vez aparecen más publicaciones con efectos deletéreos sobre la salud. Esta discusión se ha acentuado en los últimos años, por el importante aumento del uso de los vapeadores en todo el mundo, especialmente entre los adolescentes y adultos jóvenes. En septiembre de 2019 el Centro de Control y Prevención de Enfermedades (CDC) de los EE. UU. alertó sobre un importante número de casos de enfermedad pulmonar asociada al uso de cigarrillo electrónico (EVALI: e-cigarette or vaping associated lung injury). Epidemiológicamente se consideró un brote que al 17 de enero, 2020 ha presentado 2.668 pacientes hospitalizados, con 57 fallecidos. Durante la semana del 15 de septiembre 2019 ocurrió el 'peak' de hospitalizaciones por EVALI. La mayoría eran varones jóvenes. El 82% usó productos con Tetrahidrocanabinoides (THC) y el 14% productos con nicotina. En el lavado bronquio-alveolar de 51 casos de EVALI se encontró la presencia de acetato de Vitamina E, producto utilizado como espesante para la elaboración de productos de 'vapeo' que contienen THC, lo que lo hace un posible factor causal, pero no se puede descartar el papel de otros compuestos tóxicos. Las principales sociedades científicas del mundo y la OMS han advertido de los riesgos a largo plazo del uso de los cigarrillos electrónicos y recomiendan su control y regulación.

There has been a lot of discussion about the harmful health effects caused by electronic cigarettes or vapers and their usefulness as a smoking cessation aid. More and more publications appear with deleterious effects on health. This discussion has been straightened in recent years, due to the significant increase in the use of vapers worldwide, especially among adolescents and young adults. In September 2019, the US Center for Disease Control and Prevention warned of a significant number of cases of lung disease associated with the use of electronic cigarettes (EVALI: e-cigarette or vaping associated lung injury). Epidemiologically it was considered an outbreak that as of January 17, 2020 presented 2668 hospitalized patients, with 57 deaths. During the week of September 15, 2019 the peak of hospitalizations for EVALI occurred. The majority were young men. 82% of them used products with Tetrahydrocanabinoids (THC) and 14% products with nicotine. In the bronchoalveolar lavage of 51 cases of EVALI, the presence of Vitamin E acetate was found, a product used as a thickener for the elaboration of vaping products containing THC, which makes it a possible causal factor, but it cannot be ruled out the contribution of other toxic compounds. The world's leading scientific societies and World Health Organization have warned of the long-term risks of using electronic cigarettes and recommend their control and regulation.

Comparison of Information between Domestic and International Web-Pages for E-Cigarettes: What Are the Differences between Naver and Google?

BACKGROUND: Online health information can influence consumers to make informed decisions. There are conflicting messages online about health concerns on the use of e-cigarettes. We aimed to investigate differences in those messages through Naver and Google's English versions, which are the most representative portal sites in Korea and in the world. METHODS: We reviewed the top 100 web pages related to health effects of e-cigarettes on Naver and Google in May 2018. Two medical doctors sorted the web pages into three groups as positive, negative, and mixed messages for e-cigarettes, as well as two groups based on the relative safety of conventional smoking versus e-cigarettes. RESULTS: There were 10 and 27 positive, 65 and 45 negative, and 25 and 28 mixed messages on Naver and Google, respectively. There were 15 messages on Naver and 53 on Google that considered e-cigarettes safer than conventional cigarettes. The most frequent topics were toxicity (71%) and diseases (22%) on Naver. Google provides topics of health concerns for young people, including gateway effect (47%), diseases (35%), and toxicity (25%). Particularly, harm reduction which was not present on Naver, came up on Google as 24%. CONCLUSIONS: We found that Naver provides more negative messages on e-cigarettes than does Google, which means that Koreans are exposed more to negative information on e-cigarettes than are foreign people who use Google. In future, more open discussions about harm reduction should be conducted to resolve the imbalance in information regarding health effects of e-cigarettes in Korea.

Health impact of and policy regulations on electronic cigarettes

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> New findings on the detrimental health effects of electronic nicotine delivery system (ENDS)/ electronic non-nicotine delivery system (ENNDS) confounds the "harm reduction" perspective of using it as an alternative to conventional cigarettes. In the Philippines, the pressing debate on its safety and efficacy had initiated actions from policy makers on legislative issues such as draft DOH Administrative Order, House Bill 4325 and House Bill 532.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> The study aimed to craft an evidence-based policy position on the regulation of ENDS/ENNDS.</p><p style="text-align: justify;"><b>METHODS:</b> Review of literature was conducted, and the proposed scope and measures on electronic cigarette regulation were compared with WHO Framework Convention on Tobacco Control (WHO-FCTC) and existing policies of US FDA regulations on ENDS. Further, UP Manila convened experts of various related fields for evidence-based review and discussion of policy issues to arrive at a consensus policy statement and recommendations. Results. Findings showed that ENDS/ENNDS still need further research to have conclusive results on long term safety and efficacy as smoking cessation methods.</p><p style="text-align: justify;"><strong>CONCLUSION: </strong>Regulations for tobacco control should be clear and supported with strict guidelines in manufacturing, distribution, advertisement, selling, and usage restrictions in public. With the current review, it is recommended that ENDS/ENNDS regulation be under the mandate of the FDA in alignment to WHO-FCTC and to engage different stakeholders from policy makers, implementers, and other involved organizations.</p>

Nicotine, Propylene Glycol and Tobacco-specific Nitrosamines Content in Selected E-Liquids in Malaysia: The Case Support for Initiation of Standards or Guidelines

@#Introduction: Electronic Cigarette (EC) usage has been gaining acceptance in Malaysia despite its lack of analytical evidence on the chemical constituents of its liquid formulations. This study aims to evaluate the chemical concentrations of nicotine, propylene glycol (PG) and selected Tobacco-Specific Nitrosamines (TSNAs); 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and N’-nitrosonornicotine (NNN) in e-liquids locally sourced from the Malaysian market. Methods: A total of 17 e-liquids from a variety of flavours and brands were purchased from local EC retailers in Klang Valley, Malaysia. Nicotine and PG concentrations were assessed using Gas Chromatography-Flame Ionization Detector (GC-FID) while NNK and NNN were quantified using Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). The concentrations of nicotine and PG (mg/mL) were described in comparison with the levels indicated on the labels when present while levels of TSNAs were descriptively explained. Results: Nicotine was detected in all e-liquid samples, despite several samples being declared as nicotine-free. The average (standard deviation) level of nicotine, PG, NNN and NNK were 3.26 (1.04) mg/mL, 484.10 (98.24) mg/mL, 0.383(0.288) µg/L and 0.086 (0.057) µg/L, respectively. Labelling discrepancies (when indicated on the label) of nicotine and PG were between the range of 27%-73% and 3%-63%, respectively. Conclusion: The concentrations of nicotine and PG in local e-liquids were varied. There were evidences of labelling discrepancy in that local e-liquids. TSNAs were detected in all samples of e-liquids. This study brought forth strong evidence on the need for the implementation of regulation on e-liquid manufacturing and sales, particularly on the accuracy of labelling and licensing to protect the public health.