"When I Don't Have a Cigarette It's Helpful, but It Really Don't Satisfy:" Qualitative Study of Electronic Nicotine Delivery Systems (ENDS) Use among Low-Income Smokers.

BACKGROUND: Little is known about the use of electronic nicotine delivery systems (ENDS) among low-income adult cigarette smokers, who experience severe tobacco-related health disparities. METHODS: This study conducted interviews to examine experiences and perceptions associated with ENDS use among predominantly low-income adult smokers (n = 30; mean age 30.2 ± 12.9; 60% male, 46.7% African American, 30% white, 10% more than one race; 76.7% annual household income ≤USD 24,000). Interviews were transcribed verbatim and coded in NVivo 11. RESULTS: Overall, participants reported complementing rather than substituting their smoking with ENDS use (e.g., using ENDS only when smoking is not allowed). Predominant reasons for vaping were convenience, smoking reduction/cessation, stress management, social acceptability, lower long-term costs than smoking, and appealing flavors. Common reasons for not switching to exclusive vaping were that ENDS did not satisfy cigarette cravings and concerns about ENDS health effects. Participants indicated higher likelihood of switching to exclusive ENDS use if the products were more affordable, perceived as substantially less harmful, tasted and felt more like smoking a cigarette, and more effective for reducing cravings. CONCLUSIONS: Continued research is needed to maximize any harm reduction potential of ENDS and ensure that these products do not contribute to worsening health disparities.

Obstructive sleep apnea negatively impacts objectively measured physical activity.

PURPOSE: Obesity and obstructive sleep apnea (OSA) are frequent comorbid conditions. The impact of OSA on objectively measured physical activity (PA), independent of obesity, is not clear. The purpose of this study is to examine the effect of OSA on PA measured via accelerometer. METHODS: Overweight-to-obese individuals were recruited and screened for the presence of OSA via portable diagnostic device and divided into an OSA (n = 35) and control group (n = 24). Daytime sleepiness was assessed with the Epworth Sleepiness Scale. Body composition was assessed with dual-energy X-ray absorptiometry. Subjects wore an accelerometer (Actigraph GT3X+, Actigraph Corp., Pensacola, FL) for a minimum of 4 and maximum of 7 days, including at least one weekend day. RESULTS: There were no group differences in body mass index (BMI) or daytime sleepiness. Waist and neck circumference were higher in the OSA group. The OSA group was significantly older than the control group. The OSA group had fewer steps, moderate intensity minutes, moderate-to-vigorous minutes, number of PA bouts per day (≥ moderate intensity PA for ≥ 10 consecutive minutes), and total number of PA bouts. When adjusted for age, the PA bout data was no longer significant. CONCLUSION: Individuals screened as likely possessing OSA were less physically active than individuals without OSA when measured through objective means. We found no group differences in daytime sleepiness, BMI, or percent fat, suggesting other mechanisms than obesity and sleepiness for this difference.

The effect of acute aerobic exercise on hemostasis in obstructive sleep apnea.

PURPOSE: Individuals with obstructive sleep apnea (OSA) have an altered hemostatic balance; however, the exercise response is less described. The purpose of this study is to determine the hemostatic response after acute aerobic exercise in obstructive sleep apnea. METHODS: Eighteen males (nine OSA vs. nine controls) were recruited from the university and local community. Individuals with evidence of cardiovascular, pulmonary, or metabolic disease were excluded. An apnea-hypopnea index (AHI) of >5 was a criterion for OSA. Subjects performed a treadmill exercise test at 35 and 70% predicted VO2 reserve during the morning hours. Pre-exercise blood samples were obtained after 15 min supine rest and within 2 min following exercise. Repeated measures ANOVA were performed for factor VIII antigen, tissue plasminogen activator (tPA) antigen, tPA activity, and PAI-1 activity. Correlational analysis compared resting and post-exercise hemostatic factors with age, BMI, and AHI. RESULTS: Mean AHI was 13.00 ± 12.6. No exercise × condition interactions were observed for hemostatic markers. There was a main effect for exercise in factor VIII, tPA antigen, and tPA activity in both groups. PAI-1 activity tended to be elevated in OSA (145%) compared to controls which remained after exercise (205%) (P = 0.05). Post-exercise FVIII/Ag correlated with BMI (r = 0.52), while resting tPA/Ag correlated with AHI (r = 0.49) and age (r = 0.50). CONCLUSION: The hemostatic response after acute aerobic exercise is unaffected in mild OSA, although PAI-1 activity seems to be elevated, reducing fibrinolytic potential. BMI seems to correlate with FVIII/Ag, while tPA/Ag is associated with AHI and age.