Acetal Formation of Flavoring Agents with Propylene Glycol in E-Cigarettes: Impacts on Indoor Partitioning and Thirdhand Exposure.

The widespread use of flavored e-cigarettes has led to a significant rise in teenage nicotine use. In e-liquids, the flavor carbonyls can form acetals with unknown chemical and toxicological properties. These acetals can cause adverse health effects on both smokers and nonsmokers through thirdhand exposure. This study aims to explore the impacts of these acetals formed in e-cigarettes on indoor partitioning and thirdhand exposure. Specifically, the acetalization reactions of commonly used flavor carbonyls in laboratory-made e-liquids were monitored using proton nuclear magnetic resonance (1H NMR) spectroscopy. EAS-E Suite and polyparameter linear free energy relationships (PP-LFERs) were employed to estimate the partitioning coefficients for species. Further, a chemical two-dimensional partitioning model was applied to visualize the indoor equilibrium partitioning and estimate the distribution of flavor carbonyls and their acetals in the gas phase, aerosol phase, and surface reservoirs. Our results demonstrate that a substantial fraction of carbonyls were converted into acetals in e-liquids and their chemical partitioning was significantly influenced. This study shows that acetalization is a determinant factor in the exposure and toxicology of harmful carbonyl flavorings, with its impact extending to both direct exposure to smokers and involuntary exposure to nonsmokers.

Nutrient digestibility, ruminal fermentation, and blood metabolites of growing cattle-fed fermented cassava pulp with added flavoring agents.

Objective: This study aimed to assess the effect of adding flavoring agents to fermented cassava pulp (FCPU) on nutrient utilization, ruminal fermentation characteristics, and blood metabolites in growing cattle. Materials and Methods: A duplicated 3 × 3 Latin square design was randomly assigned to six growing beef cattle. Treatments were: 1) untreated FCPU (control), 2) 0.05% w/v vanilla-flavored FCPU, and 3) 0.05% w/v amyl acetate-flavored FCPU. Results: The results showed that flavoring agents did not affect dry matter intake (DMI) or digestibility of nutrients. Rumen pH and ammonia nitrogen concentrations did not change all treatments postfeeding. Flavoring added to FCPU after feeding did not affect total volatile fatty acid (VFA) or VFA percentage. However, propionic acid levels tended to be lower in the vanilla-flavored FCPU group than those in the unflavored FCPU group at 0 h postfeeding (p < 0.01). Growing bulls fed vanilla-flavored FCPU tended to have greater fungal zoospores in the rumen than those fed amyl acetate-flavored FCPU (p < 0.1) at 2 h after feeding. Dietary treatments did not affect blood glucose and urea nitrogen concentrations (p > 0.05). However, blood triglyceride concentration was greater for cattle fed a control diet than other treatments at 0 h postfeeding (p < 0.05) and tended to be higher than those fed vanilla-flavored FCPU at 2 h afterfeeding (p < 0.1). Conclusion: It was suggested that adding vanilla or amyl acetate flavor to the FCPU showed no adverse effects on ruminal fermentation, blood metabolites, or nutritional digestibility; however, it did not increase DMI.

Flavored Tobacco and Nicotine Use Among California Adolescents: Preferences by Use Experience and Survey Format Effects.

PURPOSE: This study assessed flavored tobacco use among adolescent e-cigarette, cigarette, cigar, hookah, and smokeless tobacco users; specific e-cigarette flavor preferences; risk profiles of youth that use various flavors; and the impact of survey question wording on prevalence. METHODS: Cross-sectional data from 4,956 California adolescent participants (aged 12-17 years) in the Teens, Nicotine, and Tobacco 2021-2022 online panel survey estimated the survey-weighted prevalence of flavored tobacco use. An embedded randomized experiment assessed survey wording effects (i.e., any vs. "usual" flavor use). Qualitative data from four contemporaneous cycles of Teens, Nicotine, and Tobacco focus groups with California adolescents (N = 63) added themes relevant to the quantitative findings. RESULTS: 88.1% of current any tobacco users reported flavored tobacco use in the past 30 days. Flavor use was lowest for cigarettes (66.7%) and highest for hookah (92.8%). Fruit was the most popular e-cigarette flavor (51.6% any use; 28.8% usual use). E-cigarette users also commonly reported use of candy and cooling flavors. Sweet flavors were used most often among adolescents otherwise at low risk of tobacco use. Survey item format did not meaningfully affect overall prevalence of flavored product use but did impact reports of specific e-cigarette flavors. Focus group participants described sweet and fruity flavors as a motivating factor in their own e-cigarette use and as designed to appeal to children. DISCUSSION: Despite local policies, flavored tobacco use remains common among California adolescents. Survey items asking about any flavor use rather than usual use provide more information without affecting the overall prevalence of flavored tobacco use.

Monosodium Glutamate Intake and Risk Assessment in China Nationwide, and a Comparative Analysis Worldwide.

The sixth Total Diet Study (TDS) of China included a countrywide study to assess the health effects of MSG (monosodium glutamate). MSG detection, consumption analysis, and risk assessment were conducted on 168 samples from seven food categories of the most typical Chinese daily diet. The highest value of MSG in the daily diet of the Chinese population was 8.63 g/kg. An MSG intake of 17.63 mg/kg bw/d for the general population of China was obtained from content measurements combined with food consumption, while the data from the apparent consumption survey alone gave 40.20 mg/kg bw/d. The apparent consumption did not consider the loss of MSG during food cooking, resulting in an overestimate. To offer a global perspective, MSG content, food category contributions, and ingestion levels across nations were summarized and thoroughly investigated. A realistic, logical, and precise risk assessment protocol for MSG daily intake was developed in this article.

In vitro and in vivo acute toxicity of an artificial butter flavoring.

Flavorings used in cookies, electronic cigarettes, popcorn, and breads contain approximately 30 chemical compounds, which makes it difficult to determine and correlate signs and symptoms of acute, subacute or chronic toxicity. The aim of this study was to characterize a butter flavoring chemically and subsequently examine the in vitro and in vivo toxicological profile using cellular techniques, invertebrates, and lab mammals. For the first time, the ethyl butanoate was found as the main compound of a butter flavoring (97.75%) and 24 h-toxicity assay employing Artemia salina larvae revealed a linear effect and LC50 value of 14.7 (13.7-15.7) mg/ml (R2 = 0.9448). Previous reports about higher oral doses of ethyl butanoate were not found. Observational screening with doses between 150-1000 mg/kg by gavage displayed increased amount of defecation, palpebral ptosis, and grip strength reduction, predominantly at higher doses. The flavoring also produced clinical signs of toxicity and diazepam-like behavioral changes in mice, including loss of motor coordination, muscle relaxation, increase of locomotor activity and intestinal motility, and induction of diarrhea, with deaths occurring after 48 h exposure. This substance fits into category 3 of the Globally Harmonized System. Data demonstrated that butter flavoring altered the emotional state in Swiss mice and disrupted intestinal motility, which may be a result of neurochemical changes or direct lesions in the central/peripheral nervous systems.

Xenobiotics Delivered by Electronic Nicotine Delivery Systems: Potential Cellular and Molecular Mechanisms on the Pathogenesis of Chronic Kidney Disease.

Chronic kidney disease (CKD) is characterized as sustained damage to the renal parenchyma, leading to impaired renal functions and gradually progressing to end-stage renal disease (ESRD). Diabetes mellitus (DM) and arterial hypertension (AH) are underlying diseases of CKD. Genetic background, lifestyle, and xenobiotic exposures can favor CKD onset and trigger its underlying diseases. Cigarette smoking (CS) is a known modified risk factor for CKD. Compounds from tobacco combustion act through multi-mediated mechanisms that impair renal function. Electronic nicotine delivery systems (ENDS) consumption, such as e-cigarettes and heated tobacco devices, is growing worldwide. ENDS release mainly nicotine, humectants, and flavorings, which generate several byproducts when heated, including volatile organic compounds and ultrafine particles. The toxicity assessment of these products is emerging in human and experimental studies, but data are yet incipient to achieve truthful conclusions about their safety. To build up the knowledge about the effect of currently employed ENDS on the pathogenesis of CKD, cellular and molecular mechanisms of ENDS xenobiotic on DM, AH, and kidney functions were reviewed. Unraveling the toxic mechanisms of action and endpoints of ENDS exposures will contribute to the risk assessment and implementation of proper health and regulatory interventions.

Use of monosodium glutamate in foods: the good, the bad, and the controversial side / Uso de glutamato monossódico em alimentos: o bom, o mau e o lado controverso

Introduction: Monosodium glutamate (MSG) is known as a flavor-enhancing compound and also the fifth basic taste (umami). About the safety of using MSG as a food additive, some studies show indications that there is no threat and others showthe opposite. There is no consensus about the advantages and disadvantages of using MSG. Objective: To systematically review studies in the international literature on the knowledge of the pros and cons of using glutamate in food. Methods: Systematic review of studies published in journals indexed in ScienceDirect and PubMed databases. Articles published until 2020 were included. The aspects involving the advantages and disadvantages were discussed, as well as the health risks related to the MSG intake from diet. Results: The revised studies showed that MSG can reduce the amount of sodium in foods without modifying flavor. Although authorities indicate that MSG is safe for human consumption, some studies highlight that health risk is real. The use of MSG is still controversial because there are some misunderstandings in the applied amounts of MSG absorption and metabolism. Conclusion: MSG is widely applied in industrial and homemade food. The need for further studies is crucial, and aspects such as metabolism and amounts of MSG effectively consumed must be better evaluated.

Metabolome-wide association study of flavorant vanillin exposure in bronchial epithelial cells reveals disease-related perturbations in metabolism.

Electronic cigarettes (e-cig) are an increasingly popular alternative to traditional smoking but have been in use for too short of a period of time to fully understand health risks. Furthermore, associated health risks are difficult to evaluate because of a large range of flavoring agents and their combinations for use with e-cig. Many flavoring agents are generally regarded as safe but have limited studies for effects on lung. Vanillin, an aromatic aldehyde, is one of the most commonly used flavoring agents in e-cig. Vanillin is electrophilic and can be redox active, with chemical properties expected to interact within biologic systems. Because accumulating lung metabolomics studies have identified metabolic disruptions associated with idiopathic pulmonary fibrosis, asthma and acute respiratory distress syndrome, we used human bronchial epithelial cells (BEAS-2B) with high-resolution metabolomics analysis to determine whether these disease-associated pathways are impacted by vanillin over the range used in e-cig. A metabolome-wide association study showed that vanillin perturbed specific energy, amino acid, antioxidant and sphingolipid pathways previously associated with human disease. Analysis of a small publicly available human dataset showed associations with several of the same pathways. Because vanillin is a common and high-abundance flavorant in e-cig, these results show that vanillin has potential to be mechanistically important in lung diseases and warrants in vivo toxicity testing in the context of e-cig use.

E-cigarettes use in the United States: reasons for use, perceptions, and effects on health.

BACKGROUND: Many researchers claim electronic cigarettes (e-cigarettes) to be a breakthrough invention for tobacco users that aspires to curb their addiction to conventional cigarettes. Claimed to be safer by their promoters, these smokeless devices have become increasingly popular since their arrival on the market among users of all ages, especially adolescents. This paper investigated the trends in e-cigarette usage since the time it arrived in the United States, highlighting the highest surge that has occurred in adolescent e-cigarette use. It also aimed to understand the reasons and perceptions behind the ever-increasing use of e-cigarettes by adolescents. MAIN BODY: With the advent of e-cigarettes and common positive perceptions regarding their use, we are at risk of reversing the years of efforts regarding tobacco control and instead advance towards a new addiction with currently unknown long-term health hazards. There is substantial data showing a significant increase of e-cigarette users in the United States, especially among adolescents. The aim of this review was to explore the reasons behind this widespread increase in the use of e-cigarettes among the teenage population in the US and also to uncover the common perceptions about these new electronic delivery systems. In addition, this review attempted to summarize health benefits and hazards associated with e-cigarette use as it crucial to have the right information among its users regarding the health effects of e-cigarette use. CONCLUSION: E-cigarettes are more appealing than c-cigarettes for a variety of reasons, including cost, choice of different flavors, ease of accessibility, and use and impact of social media. There are also different perceptions among e-cigarette users, including both adolescents and adults. The former group may use them because of the sense of fashion associated with this novel device, and the latter might intend to quit conventional/combustible cigarettes (c-cigarettes) by switching to e-cigarettes. However, it is important to note that e-cigarettes are a recent phenomenon; therefore, there is a lack of many long-term studies that can identify future health risks associated with e-cigarette use. We need more detailed studies that focus on the long-term health effects of e-cigarette use. Moreover, with the ever-increasing usage of e-cigarettes by adolescents (10 and 19 years), it is very important that e-cigarettes be incorporated into the current tobacco-free laws and ordinances. We conclude by stating that e-cigarettes need stronger regulations to prevent youth access and use.

Salt Preference is Linked to Hypertension and not to Aging / A Preferência ao Sal está Relacionada à Hipertensão e não ao Envelhecimento

Abstract Background: Seasoning is one of the recommended strategies to reduce salt in foods. However, only a few studies have studied salt preference changes using seasoning. Objectives: The aim of this study was to compare preference for salty bread, and if seasoning can change preference in hypertensive and normotensive, young and older outpatients. Methods: Outpatients (n = 118) were classified in four groups: older hypertensive subjects (OH) (n = 32), young hypertensive (YH) (n = 25); older normotensive individuals (ON) (n = 28), and young normotensive (YN) (n = 33). First, volunteers random tasted bread samples with three different salt concentrations. After two weeks, they tasted the same types of breads, with seasoning added in all. Blood pressure (BP), 24-hour urinary sodium and potassium excretion (UNaV, UKV) were measured twice. Analysis: Fisher exact test, McNamer's test and ANCOVA. Statistical significance: p < 0.05. Results: Systolic BP, UNaV, and UKV were greater in HO and HY and they had a higher preference for saltier samples than normotensive groups (HO: 71.9%, HY: 56% vs. NO: 25%, NY; 6%, p<0.01). With oregano, hypertensive individuals preferred smaller concentrations of salt, with reduced choice for saltier samples (HO: 71.9% to 21.9%, and HY: 56% to 16%, p = 0.02), NO preferred the lowest salt concentration sample (53.6% vs. 14.3%, p < 0.01), and NY further increased the preference for the lowest one (63.6% vs. 39.4%, p = 0.03). Conclusions: Older and younger hypertensive individuals prefer and consume more salt than normotensive ones, and the seasoned bread induced all groups to choose food with less salt. Salt preference is linked to hypertension and not to aging in outpatients.

Resumo Fundamento: Adicionar temperos aos alimentos é umas das estratégias recomendadas para diminuir a quantidade de sal nos alimentos. No entanto, poucos estudos investigaram alterações na preferência ao sal através do uso de temperos. Objetivos: O objetivo deste estudo foi comparar a preferência pelo pão salgado, e até que ponto o uso de temperos pode alterar as preferências dos indivíduos hipertensos e normotensos, pacientes ambulatoriais jovens e idosos. Métodos: Os pacientes ambulatoriais (n = 118) foram classificados em quatro grupos: idosos com hipertensão (IH) (n = 32), jovens hipertensos (JH) (n = 25); indivíduos idosos normotensos (IN) (n = 28), e jovens normotensos (JN) (n = 33). Primeiro, os voluntários provaram amostras aleatórias de pão com três diferentes concentrações de sal. Após duas semanas, eles provaram os mesmos tipos de pão, porém acrescidos de temperos. A pressão arterial (PA), e a excreção urinária de sódio e potássio de 24 horas (UNaV, UKV) foram medidas duas vezes. Análise: Teste exato de Fisher, teste de McNemar e teste ANCOVA. Significância estatística: p < 0,05. Resultados: A PA sistólica e a excreção urinária de sódio e potássio foram maiores nos grupos IH e JH, e eles tiveram maior preferência por amostras mais salgadas quando comparados com os grupos de normotensos (IH: 71,9%, JH: 56% vs. IN: 25%, JN; 6%, p < 0,01). Quando o orégano foi adicionado, a preferência dos indivíduos hipertensos foi pelas amostras com menores concentrações de sal, com uma diminuição da escolha por amostras mais salgadas (IH: 71,9% a 21,9%, e JH: 56% a 16%, p = 0,02); o grupo IN preferiu a amostra com a concentração de sal mais baixa (53,6% vs. 14,3%, p < 0,01) e no grupo JN aumentou ainda mais o número de indivíduos com preferência pela amostra com concentrações mais baixas de sal (63,6% vs. 39,4%, p = 0,03). Conclusões: Os idosos e jovens hipertensos preferem e consomem mais sal do que os normotensos, e o pão adicionado de tempero ajudou todos os grupos a escolher alimentos menos salgados. A preferência ao sal está ligada à hipertensão e não à idade nos pacientes ambulatoriais.

The role of flavors in vaping initiation and satisfaction among U.S. adults.

BACKGROUND: The prevalence of electronic cigarette use has grown over the past decade, with some users reportedly initiating e-cigarette use primarily due to flavors. This study examined the role of flavors in initiation among adult e-cigarette users, as well as the association of flavors with satisfaction and perceived addiction to vaping. METHODS: The analysis sample consisted of 1492 current e-cigarette users aged 18 or older, drawn from an online quantitative survey conducted in 2016. Multivariable logistic regression and general linear models were used. RESULTS: Most current e-cigarette users (62.9%) typically used flavors other than tobacco (including fruit, mint/menthol, sweet, candy, coffee and other), 24.2% typically used tobacco flavors, and 12.9% typically used non-flavored e-cigarettes. Flavor was a common reason for vaping initiation, selected by 29.5% of the sample. Flavor, particularly fruit flavor, was more likely to motivate young adults 18-24 to initiate vaping compared adults 35-44. Those who used flavors, particularly mint/menthol and flavors other than tobacco flavor, had higher odds of reporting high satisfaction with vaping and had higher odds of perceived addiction to vaping than respondents who did not use flavored e-cigarettes. CONCLUSIONS: Users of flavored e-cigarettes reported greater satisfaction and self-perceived addiction than users of non-flavored e-cigarettes. The appeal of flavors, particularly among young adults, has implications for regulatory policy regarding the marketing and promotion of flavored products. These findings may provide direction for the Food and Drug Administration's plans to restrict flavors other than menthol, mint, and tobacco.

Modificação e avaliação de gel de ácido fosfórico 35% com agente aromatizante / Modification and evaluation of 35% phosphoric acid gel with flavoring agent

Objetivos: O condicionamento da superfície dos tecidos dentários duros com ácido fosfórico 35% é normalmente utilizado para fornecer retenção micromecânica para adesivos odontológicos. Quando lavado da superfície, o ácido pode gerar gosto amargo e desagradável ao paladar do paciente. O objetivo deste estudo foi analisar o efeito da adição de um agente aromatizante à composição do gel de ácido fosfórico 35% e investigar se existe alteração de características fundamentais deste material, como sua capacidade de desmineralizar a superfície dentária. Métodos: Além de um grupo controle (sem flavorizante), foram testados grupos de ácido fosfórico 35% com a adição de 0,5% ou 3% do aromatizante (Aroma Abacaxi Pó; Bio Green Ingredients). Foram realizadas análises de viscosidade, estabilidade do pH e de desmineralização da superfície de esmalte condicionada por microscopia eletrônica de varredura, além de teste de resistência de união ao esmalte por microcisalhamento. Resultados: Apesar dos grupos apresentarem pequenas diferenças entre si, nenhuma das alterações se mostrou significativa, exceto o aumento da viscosidade do gel contendo 3% do aromatizante. Conclusões: A adição de agente aromatizante ao gel condicionador de ácido fosfórico 35% parece ser alternativa viável para reduzir os problemas relacionados ao contato com o sabor desagradável do material, uma vez que não promoveu alteração negativa significativa nas características e comportamento do ácido(AU)

Objectives: Etching of dental hard tissues surfaces with 35% phosphoric acid is usually used to provide micromechanical interlocking with dental adhesives. When washed from the surface, the acid can cause a bitter taste unpleasant to the patient. The aim of this study was to analyze the effect of the addition of a flavoring agent to 35% phosphoric acid gel and investigate whether there is change in the fundamental characteristics of this material, including its ability to demineralize dental surfaces. Methods: In addition to a control group (without flavoring agent), groups were tested with the addition of 0.5% or 3% of the flavoring compound (pineapple flavor powder, Bio Green Ingredients) to 35% phosphoric acid. Analyses of viscosity, pH stability and demineralization of enamel surfaces by scanning electron microscopy were carried out, as well microshear bond strength to enamel. Results: Although the groups had minor differences among themselves, none of the changes were significant, except the increased viscosity of the gel containing 3% of the flavoring agent. Conclusions: The addition of flavoring agent to 35% phosphoric acid gel conditioner seems to be a viable alternative to reduce the problems related to contact with the unpleasant taste of the material, since it promoted no negative changes in the characteristics and behavior of the acid(AU)

E-cigarette palatability in smokers as a function of flavorings, nicotine content and propylthiouracil (PROP) taster phenotype.

BACKGROUND: The popularity of E-cigarettes is due in part to their flavorings. The purpose of this study was to determine the effect on smokers' sensory perceptions and liking of various e-cigarette flavorings, and the degree to which those perceptions are influenced by nicotine level, sex, and PROP bitter taster phenotype. METHODS: We recruited 132 non-treatment-seeking, daily cigarette smokers. In repeated trials in one laboratory session participants vaped the Joyetech eGo-C e-cigarette with each of the following flavorings (in random order): unflavored, tobacco, cherry, chocolate, and menthol. Participants vaped the e-juice first without nicotine and then with high nicotine (18 mg/ml), and provided sensory (bitterness/sourness, irritation, sweetness) and liking ratings. Perceived intensity of 6-n-propylthiouracil (PROP) was used to classify the participants as non-tasters (n = 28), medium-tasters (n = 74), or supertasters (n = 28). Mixed-effects linear models and generalized estimating equations were used to evaluate ratings as a function of flavor interacting with nicotine content, sex and taster phenotype, adjusting for age, race/ethnicity, menthol use, and nicotine dependence. RESULTS: Regardless of nicotine level, cherry (ß = 1.76, p < .001) and chocolate (ß = 0.69, p < .001) were rated as sweeter, but were not better liked, than unflavored e-juice. Menthol elicited the highest liking rating, especially for women (ß = 12.23, p < .05) and supertasters (ß = 20.52, p < .05). Regardless of flavor, high nicotine was rated as more irritating (OR = 1.43, 95% CI = 1.02-2.01) than the no-nicotine e-juice. Irritation (ß = -13.65, p < .001), bitterness/sourness (ß = -11.38, p < .001), and sweetness (ß = 4.79, p < .001) were associated with liking. CONCLUSION: Menthol may enhance e-cigarette palatability for some smokers, which may increase e-cigarette utility in smoking cessation.

Influence of Flavors on the Propagation of E-Cigarette-Related Information: Social Media Study.

BACKGROUND: Modeling the influence of e-cigarette flavors on information propagation could provide quantitative policy decision support concerning smoking initiation and contagion, as well as e-cigarette regulations. OBJECTIVE: The objective of this study was to characterize the influence of flavors on e-cigarette-related information propagation on social media. METHODS: We collected a comprehensive dataset of e-cigarette-related discussions from public Pages on Facebook. We identified 11 categories of flavors based on commonly used categorizations. Each post's frequency of being shared served as a proxy measure of information propagation. We evaluated a set of regression models and chose the hurdle negative binomial model to characterize the influence of different flavors and nonflavor control variables on e-cigarette-related information propagation. RESULTS: We found that 5 flavors (sweet, dessert & bakery, fruits, herbs & spices, and tobacco) had significantly negative influences on e-cigarette-related information propagation, indicating the users' tendency not to share posts related to these flavors. We did not find a positive significance of any flavors, which is contradictory to previous research. In addition, we found that a set of nonflavor-related factors were associated with information propagation. CONCLUSIONS: Mentions of flavors in posts did not enhance the popularity of e-cigarette-related information. Certain flavors could even have reduced the popularity of information, indicating users' lack of interest in flavors. Promoting e-cigarette-related information with mention of flavors is not an effective marketing approach. This study implies the potential concern of users about flavorings and suggests a need to regulate the use of flavorings in e-cigarettes.

Cigarette flavors, package shape, and cigarette brand perceptions: an experiment among young Brazilian women.

OBJECTIVE: In 2012, a new Brazilian regulation prohibited the use of flavor additives in tobacco products. To better understand the potential impact of this regulation, this study examines how flavor descriptors on cigarette packaging influence brand perceptions among young Brazilian women. METHODS: An online cross-sectional experiment was conducted with Brazilian women aged 16-26 (N = 640: 182 smokers and 458 nonsmokers) who rated 10 cigarette packages from one of three conditions: 1) branded packs; 2) packs with the same size, shape, and verbal descriptions as in condition 1, but without brand imagery (i.e., "plain pack"); and 3) packs from condition 2 but without brand descriptors (i.e., "plain pack, no descriptors"). Mixed-effects linear regression models were utilized to determine what associations that pack features (i.e., experimental condition; flavor descriptor vs. not; slim pack vs. not) had with participant ratings of nine characteristics, including appeal, taste, smoothness, and attributes of people who smoke the brand. RESULTS: Flavored branded packs were rated as more appealing, better tasting, and smoother than flavored plain packs with descriptors. Compared to flavored plain packs with descriptors, the same packs without descriptors were rated less positively on eight of the nine characteristics. Compared to nonsusceptible nonsmokers, susceptible nonsmokers rated flavored packs more positively on eight of the nine characteristics. Slim packs were rated more positively than regular packs on eight of the nine characteristics. CONCLUSIONS: Slim packs and brands highlighting tobacco flavors appear to increase positive perceptions of tobacco products. Banning tobacco flavorings and slim packs may reduce the appeal of smoking for young Brazilian women, as well as for other vulnerable populations.

Cigarette flavors, package shape, and cigarette brand perceptions: an experiment among young Brazilian women / Los sabores de cigarrillos, la forma del paquete y las percepciones de las marcas de cigarrillos: un experimento entre las jóvenes brasileñas / Sabores do cigarro, forma do pacote e percepções da marca do cigarro: um experimento entre mulheres jovens brasileiras

ABSTRACT Objective In 2012, a new Brazilian regulation prohibited the use of flavor additives in tobacco products. To better understand the potential impact of this regulation, this study examines how flavor descriptors on cigarette packaging influence brand perceptions among young Brazilian women. Methods An online cross-sectional experiment was conducted with Brazilian women aged 16-26 (N = 640: 182 smokers and 458 nonsmokers) who rated 10 cigarette packages from one of three conditions: 1) branded packs; 2) packs with the same size, shape, and verbal descriptions as in condition 1, but without brand imagery (i.e., "plain pack"); and 3) packs from condition 2 but without brand descriptors (i.e., "plain pack, no descriptors"). Mixed-effects linear regression models were utilized to determine what associations that pack features (i.e., experimental condition; flavor descriptor vs. not; slim pack vs. not) had with participant ratings of nine characteristics, including appeal, taste, smoothness, and attributes of people who smoke the brand. Results Flavored branded packs were rated as more appealing, better tasting, and smoother than flavored plain packs with descriptors. Compared to flavored plain packs with descriptors, the same packs without descriptors were rated less positively on eight of the nine characteristics. Compared to nonsusceptible nonsmokers, susceptible nonsmokers rated flavored packs more positively on eight of the nine characteristics. Slim packs were rated more positively than regular packs on eight of the nine characteristics. Conclusions Slim packs and brands highlighting tobacco flavors appear to increase positive perceptions of tobacco products. Banning tobacco flavorings and slim packs may reduce the appeal of smoking for young Brazilian women, as well as for other vulnerable populations.

RESUMEN Objetivo En 2012, una nueva regulación brasileña prohibió el uso de aditivos de sabor en los productos de tabaco. Para comprender mejor el impacto potencial de esta regulación, este estudio examina cómo los descriptores de sabor en los envases de cigarrillos influyen en las percepciones de marca entre las jóvenes brasileñas. Métodos Se realizó un estudio transversal, en línea con mujeres brasileñas de entre 16 y 26 años (N = 640: 182 fumadores y 458 no fumadores) que calificaron 10 paquetes de cigarrillos de acuerdo a una de las siguientes condiciones: 1) paquetes de marca; 2) paquetes con el mismo tamaño, forma y descripciones verbales que en la condición 1, pero sin imágenes de marca (es decir, "paquete simple"); y 3) paquetes de la condición 2 pero sin descriptores de marca (es decir, "paquete simple, sin descriptores"). Se utilizaron modelos de regresión lineal de efectos mixtos para determinar qué asociación existía entre las diferentes condiciones (es decir, condición experimental, descriptor de sabor vs. no, paquete delgado vs. no) con las calificaciones de los participantes de nueve características, incluyendo atractivo, sabor, suavidad y atributos de personas que fuman la marca. Resultados Los paquetes de marca con sabor se calificaron como más atractivos, de mejor sabor y más suaves que los paquetes simples con sabores y descriptores. En comparación con los paquetes simples con sabores con descriptores, los mismos paquetes sin descriptores fueron calificados de manera menos positiva en ocho de las nueve características. En comparación con los no fumadores no susceptibles, los no fumadores susceptibles calificaron los paquetes con sabor de forma más positiva en ocho de las nueve características. Los paquetes delgados fueron clasificados más positivamente que los paquetes regulares en ocho de las nueve características. Conclusiones Los paquetes delgados y las marcas que destacan los sabores del tabaco parecen aumentar las percepciones positivas de los productos de tabaco. Prohibir los sabores del tabaco y los paquetes delgados puede reducir el atractivo del tabaco para las jóvenes brasileñas, así como para otras poblaciones vulnerables.

RESUMO Objetivo Em 2012, uma nova regulamentação brasileira proibiu o uso de aditivos aromáticos nos produtos tabagísticos. Para entender melhor o impacto potencial desta regulação, este estudo examinou como a propaganda de aroma em embalagens de cigarros influencia a percepção das brasileiras jovens sobre a marca do produto. Método Estudo transversal em que 640 brasileiras (168 fumantes e 458 não fumantes) avaliaram online, uma entre três das seguintes características de 10 pacotes de cigarros: 1) embalagem com a imagem da marca; 2) pacotes com o mesmo tamanho, formato e descrição das características do produto 1, mas sem marca (havia apenas a descrição do produto) e, 3) embalagens nas condições 2, mas sem a descrição do produto (embalagem em branco). O modelo de regressão linear misto foi utilizado para determinar associações das características da embalagem do cigarro (Ex: situação experimental, descrição de aroma versus não, pacotes finos versus não) com as avaliações das participantes para nove características do produto, incluindo a apelação, aroma, suavidade e atributos de quem fuma certa marca. Resultados Pacotes aromatizados de marca foram classificados como mais atraentes, com melhor sabor e suavidade em relação aos que tinham simples descrição do produto. Os pacotes descritos como aromatizados comparados ao mesmo produto sem descrição obtiveram menores escores para oito dentre nove características avaliadas. Em comparação as não fumantes sem suscetibilidade ao tabagismo, as que eram suscetíveis classificaram produtos aromatizados mais positivamente em oito de suas nove características. As embalagens finas receberam julgamento mais positivo do que as com espessura regular para oito dentre nove itens analisados. Conclusões Pacotes finos e marcas que destacam os aromas do tabaco parecem aumentar a percepção positiva deste produto. Proibir a aromatização do tabaco e a oferta de pacotes finos de cigarros reduzem o apelo de fumar entre brasileiras jovens, bem como para outros grupos vulneráveis.

Cigarrillos eléctrónicos: ¿Podemos recomendar su uso? / Electronic cigarettes: can we recommend its use?

Los cigarrillos electrónicos (Cig-e) son dispositivos que contienen un líquido compuesto por un solvente, saborizantes y, en la mayoría de los casos, nicotina. Este liquido, al ser calentado en el dispositivo, se vaporiza, siendo aspirado por el usuario. En los últimos años, el uso de los Cig-e ha aumentado rápidamente, especialmente entre escolares y gente joven, sin existir hasta el día de hoy evidencias ciertas sobre su seguridad y efectos a largo plazo. En este artículo revisamos la evidencia existente en cuanto a los efectos y seguridad de cada uno de los componentes de los Cig-e y analizamos sus potenciales indicaciones en distintos escenarios clínicos.

Electronic cigarettes (Cig-e) are devices that contain a liquid composed of a solvent, flavors and, in most cases, nicotine. This liquid, when heated in the device, vaporizes, being aspirated by the user. In recent years, the use of Cig-e has increased rapidly, especially among schoolchildren and young people, with no clear evidence of safety and long-term effects to date. In this article we review the existing evidence regarding the effects and safety of each of the components of Cig-e and analyze their potential indications in different clinical scenarios.

Chemical Reactivity and Respiratory Toxicity of the α-Diketone Flavoring Agents: 2,3-Butanedione, 2,3-Pentanedione, and 2,3-Hexanedione.

Occupational exposure to 2,3-butanedione (BD) vapors has been associated with severe respiratory disease leading to the use of potentially toxic substitutes. We compared the reactivity and respiratory toxicity of BD with that of two structurally related substitutes, 2,3-pentanedione (PD) and 2,3-hexanedione (HD). Chemical reactivity of the diketones with an arginine substrate decreased with increasing chain length (BD > PD > HD). Animals were evaluated the morning after a 2-week exposure to 0, 100, 150, or 200 ppm BD, PD, or HD (postexposure) or 2 weeks later (recovery). Bronchial fibrosis was observed in 5/5 BD and 5/5 PD rats at 200 ppm and in 4/6 BD and 6/6 PD rats at 150 ppm in the postexposure groups. Following recovery, bronchial fibrosis was observed in all surviving rats exposed to 200 ppm BD (5/5) or PD (3/3) and in 2/10 BD and 7/9 PD rats exposed to 150 ppm. Bronchial fibrosis was observed only in 2/12 HD-exposed rats in the 200 ppm postexposure group. Patchy interstitial fibrosis affected lungs of recovery groups exposed to 200 ppm PD (3/3) or BD (1/5) and to 150 ppm PD (4/9) or BD (7/10) and correlated with pulmonary function deficits. BD and PD were more reactive and produced more bronchial fibrosis than HD.

Flavored-little-cigar and flavored-cigarette use among U.S. middle and high school students.

PURPOSE: Flavors can mask the harshness and taste of tobacco, making flavored tobacco products appealing to youth. We assessed the prevalence and correlates of flavored-little-cigar and flavored-cigarette use among U.S. middle and high school students in 2011. METHODS: Data were obtained from the 2011 National Youth Tobacco Survey, a nationally representative school-based survey of U.S. students in grades 6-12. National estimates of current flavored-little-cigar use, flavored-cigarette use, and combined use of either product were calculated overall and among current smokers by respondent characteristics, including sex, race/ethnicity, school level, and grade. Additionally, intention to quit tobacco and smoking frequency were assessed by flavored product use. RESULTS: The overall prevalence of current use was 4.2% for flavored cigarettes, 3.3% for flavored little cigars, and 6.3% for either product. Among current cigar smokers, 35.9% reported using flavored little cigars, and among current cigarette smokers, 35.4% reported using flavored cigarettes. Among current cigar or cigarette smokers, 42.4% reported using flavored little cigars or flavored cigarettes. Flavored product use among current smokers was higher among non-Hispanic whites than among blacks and Hispanics, higher among high school students than middle school students, and increased with grade. Among cigar smokers, prevalence of no intention to quit tobacco was higher among flavored-little-cigar users (59.7%) than nonusers (49.3%). CONCLUSIONS: More than two fifths of U.S. middle and high school smokers report using flavored little cigars or flavored cigarettes, and disparities in the use of these products exist across subpopulations. Efforts are needed to reduce flavored tobacco product use among youth.