Electronic Cigarette Use Scale: Development and evaluation of a measure among Chinese students

Objective:To develop the Electronic Cigarette Use Scale(ECUS)based on social cognitive theory and test its reliability and validity,so as to provide a scientific tool for evaluating the use of e-cigarette smokers in China.Methods:Based on the review of social cognitive theory and literature analysis,the item pool of ECUS was constructed to form the initial version.From January to March in 2022,using the convenient sampling method,electronic questionnaires were distributed to college students in Guangdong Province through the questionnaire star platform,and a total of 1047 valid questionnaires were collected for item screening.The total sample was randomly divided into sample 1(n=517)and sample 2(n=530)for Exploratory Factor Analysis(EFA)and Confirmatory Factor Analysis(CFA)respectively to further test the reliability and validity of the scale and finally form a 24-item scale.Results:The formal ECUS included 24 items,6 factors were extracted by EFA,and the cumulative explanatory variance was 72.774%.CFA showed that the goodness-of-fit indices were acceptable:χ^(2)/df=2.61,CFI=0.938,TLI=0.928,RMSEA=0.055,90%CI(0.050,0.061),SRMR=0.046,AIC=34694.405,BIC=35036.235.The Cronbach’saof the 24-item scale was 0.898,and the Cronbach’saof each dimension was between 0.839 and 0.954.Both convergent validity and discriminant validity reached the standard.Conclusion:The 24-item ECUS developed in this study has been tested with good reliability and validity and is suitable for evaluating the use of e-cigarette smokers in China.

Electronic cigarettes — myocardial infarction, hemodynamic compromise during pregnancy, and systolic and diastolic dysfunction: Minireview

The aim of this study was to review the most recent literature on the safety of electronic cigarettes(ECs)in the context of cardiovascular disease and in the context as a tool for smoking cessation and recreational purposes.The format of this review begins with relevant research from the basic sciences and follows through with a pertinent review of clinical trials.Daily use of ECs has implications in myocardial infarction(MI)with an odds ratio of 1.70 compared to healthy,nonsmokers and even worse risk for MI with dual use of combustible cigarettes together with EC with an odds ratio of 4.62.Studies measuring cardiac function with echocardiography reported both systolic and diastolic dysfunction along with reduced ejection fractions.Platelet aggregation,endothelial function,and hemodynamics during pregnancy were all but some of the pernicious cardiovascular implications of EC exposure.Though more studies need to be done on the topic of EC use and cardiovascular disease,the majority of studies considered in this review concluded some level of harm albeit in some instances less than that of traditional combustible cigarettes.ECs are toxic to human beings and their harmful effects cannot be overlooked.There is some favorable evidence of efficacy in smoking cessation though mixed with concern of chronic EC use.It will take decades to collect data for chronic EC use on long term sequelae,such as lung cancer.Though more and more reports of acute lung injury and hospitalizations related to EC use have been reported.Due to undergoing investigations of possible harm and life threatening complications of EC use,we cannot recommend ECs as safer or a more efficacious method of smoking cessation to traditional nicotine replacement therapies.A notable consideration for much of the literature reviewed are that standardization of EC use is difficult as device generation and battery voltage,frequency of use,and contents of ECliquid are just some of the vast complicating factors that limit the ability to effectively compare data.

Health outcomes of electronic cigarettes

The usage of electronic cigarettes(e-cigarettes)sparked an outbreak of unidentified vaping-related lung disease in the US during late 2019.With e-cigarettes becoming more and more popular,smokers have more options other than conventional cigarettes.Under these circumstances,a comprehensive evaluation of the general safety of new tobacco and tobacco-related products,represented by e-cigarettes,to human health is necessary.In this review,we summarize the current research on potential negative impacts of e-cigarette exposure on human health.In particular,studies detailing the relationship between e-cigarettes and the digestive system are summarized,with mechanisms mainly including hepatic metabolic dysfunction,impaired gut barrier,and worsened outcomes of inflammatory bowel disease(IBD).Although believed to be safer than traditional cigarettes,e-cigarettes exert adverse effects on systemic health and induce the development of multiple diseases including asthma,cardiovascular disease,and IBD.Moreover,nicotine-containing e-cigarettes have a negative impact on the childhood development and increase the risk of arterial stiffness compared to the non-nicotine e-cigarettes.However,non-nicotine e-cigarette components have detrimental effects including promoting liver damage and metabolic disorders.

Arsenic species in electronic cigarettes:Determination and potential health risk

Human exposure to contaminants from electronic cigarettes(e-cigarettes)and the associated health effects are poorly understood.There has been no report on the speciation of arsenic in e-liquid(solution used for e-cigarettes)and aerosols.We report here determination of arsenic species in e-liquids and aerosols generated from vaping the e-liquid.Seventeen e-liquid samples of major brands,purchased from local and online stores in Canada and China,were analyzed for arsenic species using high-performance liquid chromatography and inductively coupled plasma mass spectrometry.Aerosols condensed from vaping the eliquids were also analyzed and compared for arsenic species.Six arsenic species were detected,including inorganic arsenate(iAsⅤ),arsenite(iAsⅢ),monomethylarsonic acid(MMA),and three new arsenic species not reported previously.In e-liquids,iAsⅢwas detected in 59%,iAsⅤin 94%,and MMA in 47%of the samples.In the condensate of aerosols from vaping the e-liquids,iAsⅢwas detected in 100%,iAsv in 88%,and MMA in 13%of the samples.Inorganic arsenic species were predominant in e-liquids and aerosols of e-cigarettes.The concentration of iAsⅢin the condensate of aerosols(median 3.27μg/kg)was significantly higher than that in the e-liquid(median 1.08μg/kg)samples.The concentration of inorganic arsenic in the vaping air was approximately 3.4μg/m3,which approaches to the permissible exposure limit(10μg/m3)set by the United States Occupational Safety and Health Administration(OSHA).According to the Environmental Protection Agency’s unit risk factor(4.3×10-3 perμg/m3)for inhalation exposure to inorganic arsenic in the air,the estimated excess lung cancer risk from lifetime exposure to inorganic arsenic in the ecigarette vaping air(3.4μg/m3),assuming e-cigarette vaping at 1%of the time,is as high as1.5×10-4.These results raise health concerns over the exposure to arsenic from electronic cigarettes.

Burns resulting from spontaneous combustion of electronic cigarettes: a case series

Background:Electronic cigarette(e-cigarette)sales have grown rapidly in recent years,coinciding with a public perception that they are a safer alternative to traditional cigarettes.However,there have been numerous media reports of fires associated with e-cigarette spontaneous combustion.Case Presentation:Three severe burns caused by spontaneous combustion of e-cigarettes within a 6-month period were treated at the Santa Clara Valley Medical Center Burn Unit.Patients sustained partial and full-thickness burns.Two required hospitalization and surgical treatment.Conclusions:E-cigarettes are dangerous devices and have the potential to cause significant burns.Consumers and the general public should be made aware of these life-threatening devices.

Is there a correlation between the changes in airway inflammation and the changes in respiratory mechanics after vaping in patients with asthma?

BACKGROUND Electronic cigarettes(ECs)have been promoted as alternatives to traditional cigarettes.To investigate ECs’effects on respiratory system,especially in patients with respiratory diseases.METHODS We randomly selected 25 smokers with stable moderate asthma and matched them with 25 healthy smokers.All were subjucted to pulmonary function tests(PFTs),impulse oscillometry(IOS),fraction exhaled Nitric Oxide(FeNO),exhaled breathe condensate(EBC)and biomarker measurements before and after vaping one nicotinecontaining EC.RESULTS The increase in FeNO 30 minutes after EC,reflecting airway inflammation,significantly correlated with increase of residual volume(RV),total lung capacity,respiratory impedance at 5 Hz(Z5Hz)and respiratory resistance at 5 and 20 Hz(R5Hz and R20Hz).No significant correlations were found between EBC biomarkers'changes and respiratory mechanics.CONCLUSION This is the first study demonstrating that the changes in airway inflammation caused by EC have direct effects in respiratory mechanics of asthmatic patients.

Toxicology of Commonly Found Ingredients in E-Cigarettes: A Brief Review

Electronic cigarettes (EC) have gained popularity among smokers due to their taste, smell, appearance, and easy availability compared to traditional cigarettes, as well as the perception that they are safer than traditional cigarettes. These devices result in aerosols containing nicotine, propylene glycol, glycerin, ethylene glycol, vitamin E, and chemical flavors inhaled into the lungs. Other components found in these vapors include heavy metals such as nickel, chromium, lead, manganese, and tin. In addition, some ingredients volatilization leads to toxic aldehydes formation such as formaldehyde, acetaldehyde, and acrolein. Smoking cigarettes is addictive and has been associated with many health issues such as heart disease, lung cancer, etc. Rising awareness of these dangers moves more people towards these electronic delivery systems, reducing the health effects of cigarettes. The toxicity of EC’s ingredients is well studied when ingested;however, their toxicity through inhalation remains unclear. Consequently, the use of ECs has become a significant concern worldwide and raises whether it is indeed safe to use. This paper will serve as a literature review paper to discuss the toxicity of commonly found ingredients in ECs and their associated health issues. Our conclusion emphasizes that even though smoking EC is less risker than smoking traditional cigarettes, it is still not safe due to the potentially harmful effect these E-cig’s ingredients have on the human’s health. In addition, E-cigarette’s aerosol could also contain toxic compounds such as formaldehyde, acetaldehyde, and acrolein due to glycerin’s thermo-degradation.