October 20, 2014
Almost the entire discussion of e-cigarette toxicity so far has focused on the fact that they expose users to lower levels of carcinogens (cancer-causing chemicals) than conventional cigarettes. At the same time, by design e-cigarettes expose users to nicotine in an aerosol of ultrafine particles that also have direct bilogical effects, particularly on the cardiovascular system and lungs.
Holly Middlekauff and collegaues just published an excellent review on the effects of nicotine and fine particle air pollution (from cigarettes and other sources) in the Journal of the American College of Cardiology that describes how these agents act on the sympathetic nervous system (which controls reflexes) in ways that increase the risk of heart attacks. While they note that there are not yet direct evidence on the effects of e-cigarettes on the sympathetic nervous system, they make a good case for being concerned until people show that such effects are not present.
The paper, "Adverse Effects of Cigarette and Noncigarette Smoke Exposure on the Autonomic Nervous SystemMechanisms and Implications for Cardiovascular Risk," is available here.
Here is the abstract:
October 20, 2014
Lois Biener and J Lee Hargraves just published a nicely done longitudinal study that followed smokers in two cites for around two years and found that, controlling for level of nicotine addiction and demographics, intensive e-cigarette users (defined as using e-cigarettes daily for at least a month) were 6 times more likely to have quit smoking (defined as not smoking for at least 30 days) than smokers who did not use e-cigarettes.
They also found that intermittent e-cigarette users (defined as people had used e-cigarettes more than once or twice, but not daily for a month) were no more or less likely to have stopped smoking than non-users, but were were 6 times more likely to expect that they would still be smoking one year into the future.
There was not much difference in the motivations for using e-cigarettes (Table 3 of their paper), athough there was a suggestion (p=0.08) that the intensive useres were using them because of health concerns compared to the other groups. This may explain why the intensive useres were more successful at quitting smoking. It may be that the intensive users were replacing cigarettes while the non-intensive users were not.
October 9, 2014
RJ Reynolds just announced that it was "partnering" with the National School Boards Association to promote RJR's new "Right Decisions Right Now" youth smoking prevention program. RJR's press release proudly announces that its curriculum is "aligned with the Common Core Standards."
The Common Core is supposed to promote critical thinking skills and in-depth examination of issues. One wonders if the NSBA reviewed federal Judge Gladys Kessler's landmark ruling that RJ Reynolds violated the Racketeer Influenced and Corrupt Organization Act (RICO) by forming an illegal enterprise to defraud the public that is continuing.
October 8, 2014
Robin Koval, the new President and CEO of the Legacy Foundation will keynote the 2015 "It's ABout a Billion Lives" symposium on January 30, 2015. Our closing speaker will be Joseph Gugliemo, Dean of the UCSF School of Pharmacy.
As always, there will be presentations by two UCSF faculty and two UCSF postdoctoral fellows as well as posters from a wide range of UCSF researchers.
The symposium will be in Cole Hall on the UCSF Parnassus campus. A light breakfast will be available starting at 8:00 AM. The symposium will end around 12:30 pm.
This event is open to all in the UCSF community as well as the public. Save the date!
You can view videos of past years' symposia at https://tobacco.ucsf.edu/about-a-billion-lives.
October 5, 2014
Esteve Fernández' group has just published an important paper, "Cigarettes vs. e-cigarettes:Passive exposure at home measured by means of airborne marker and biomarkers," that found elevated levels of airborne nicotine in homes of e-cigarette users that, while not as high as in cigarette smoekrs' homes was significantly elevated over that observed in nonsmokers' homes. More important, the levels of salivary and urinary cotinine, measures of absorbed nicotine was elevated to similar levels in bystanders in both the e-cigarette and cigarette users' homes.
This paper shows in real world enviornments, that bystanders are bystanders are taking nicotine into their bodies (and, by inference, the other pollutants that e-cigas put into the air) as a result of passive exposure.
This paper, together with earlier research (from chamber studies), provides a compelling case for including e-cigarettes in clean indoor air laws and for people to prohibit their use in smokefree homes.
Here is the abstract: