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2013 SRNT Conference
« em: 2013.03.11 | 16:01:08 »
Chuva de estudos sobre cigarros electrónicos prestes a cair.


Pelo menos 9 dos estudos são sobre cigarros electrónicos.
A maior parte reporta benefícios para a saúde e nenhum malefícios:

Blair N. Coleman, M.P.H.*, Eva Sharma, M.P.H., Magdalena Ignaczak, B.S., and Pamela I. Clark, Ph.D., University of Maryland-College Park
Background: Electronic nicotine delivery devices (ENDS; or e-cigarettes) have surged in popularity in recent years, however further research is needed to determine consumer perceptions of their acceptability as smoking cessation aids. The aim of this pilot study was to explore smokers’ perceptions of the effectiveness of using ENDS during a 2-week cessation attempt. Methods: After
a laboratory-based study that had the advantage of familiarizing participants with use of the ENDS, smokers motivated to quit were provided with an e-cigarette and a 2-week supply of cartridges in the style (menthol or non-menthol) of their choice.
They received two in-person behavioral counseling sessions and two telephone counseling sessions. At the end of the two-week quit attempt, in-depth qualitative interviews were conducted to assess the subjects’ perceptions of the effectiveness of using ENDS as a cessation tool. Sessions were audio-recorded and the data transcribed and analyzed using a thematic approach. Results: Themes that emerged included lower perceptions of nicotine content compared to own brand cigarettes, a higher sense of control with regards to nicotine self-administration compared to other cessation mechanisms (e.g., nicotine gum, patch), and an ease of transition to the e-cigarette to assist with a quit attempt. Additionally, similarities between own brand of cigarettes and e-cigarettes generally included similar smoking patterns (in terms of duration and time of day), but participants found greater resistance to draw with the e-cigarette compared to conventional cigarettes, and reported that they often failed to provide the level of satisfaction produced by conventional cigarette. Lastly, participants noted that the e-cigarette drew attention from by-standers who were interested in knowing more about the product, and some were uncomfortable with the attention the product elicited, opting to use the e-cigarette in private locations only. Conclusions: Understanding the consumer acceptability of using ENDS has important implications as to how these products could be used as smoking cessation devices and how they could potentially be prescribed to help smokers quit.
Supported by NIH/NIDA Grant #5R21DA030622.
CORRESPONDING AUTHOR: Blair N. Coleman, MPH, University of Maryland, Behavioral and Community Health, 2387 SPH Building, Valley Drive, College Park, MD 20742, United States, Phone: 3014058740, Email: bcolema2@umd.edu

Amy M. Wermert, M.P.H.*, Nancy E. Hood, Ph.D., Sherry T. Liu, M.P.H., and Mary Ellen Wewers, Ph.D., The Ohio State University, College of Public Health Electronic cigarette (ecig) use is growing in popularity. Little is known about the use of ecigs among adult smokers in Appalachian Ohio. The purpose of this study was to describe the use of ecigs among participants living in Appalachian Ohio
enrolled in a group randomized cessation trial (n=467 participants) that included behavioral counseling and free nicotine replacement therapy (NRT) (i.e., 21 mg patch) over a 10 week protocol. Study eligibility criteria included: resident of a participating Appalachian county, 18 years or older, self-reported daily cigarette use, willing to quit in the next 30 days, no medical contraindication to NRT use, and if female, not pregnant. Data collection started in November 2010; items to
assess ecig use were added to the existing survey in April 2012. As a result, ecig use was not collected for all participants. This abstract reports on a subset of the sample (n=252 participants) and includes data collected at baseline, 3, 6, or 12 months post-intervention. Of the subset of participants, 10% reported currently using an ecig every day or some days. Most ecig users were between 25-54 years old (54%), female (65%) and had more than a HS/GED education (50%). Most
were not employed (69%) but had health care coverage (77%). Most ecig users were living at 200% below poverty (77%). For those interviewed post-intervention, 5.9% (n=15 participants) reported use of ecigs, primarily to assist in efforts to quit smoking. Most were using ecigs with nicotine (67%) and most believed that ecigs are less harmful than regular cigarettes (87%). The primary reasons given for ecig use included: “they make it easier for you to cut down on the number of cigarettes you smoke” (53%), “they might help you quit” (47%). These findings support previous studies that demonstrate ecigs being used as a smoking cessation aid. Limitations of this study include a small sample size and a homogenous study population (i.e., those trying to quit, living in Appalachia, Ohio). This study emphasizes the importance of continued research into the efficacy and safety of the use of ecigs as a long-term smoking cessation aid.
This study was conducted while the first author was at The Ohio State University.
Supported by NIH grant # R01 CA129771.
CORRESPONDING AUTHOR: Amy Wermert, MPH, Program Manager, The Ohio State University, College of Public Health, Health Behavior Health Promotion, 359-4 Cunz Hall, Columbus, OH 43210, United States, Phone: 614-292-8193, Email: awermert@cph.osu.edu

Pallav Pokhrel, Ph.D., M.P.H.*, Pebbles Fagan, Ph.D., M.P.H., Melissa Little, Ph.D., Crissy Terawaki Kawamoto, B.S., and Thaddeus A. Herzog, Ph.D., Cancer Prevention & Control Program, University of Hawaii Cancer Center, Honolulu, HI Electronic cigarettes or e-cigarettes are commonly marketed as smoking cessation aids and their popularity appears to be on the rise. But little is known about the characteristics of smokers who use e-cigarettes to quit smoking, including their motivation to quit, quitting self-efficacy, and experience with Food and Drug Administration (FDA) approved cessation aids. In this study, we tested the associations between smokers’ ever use e-cigarettes for cessation and their demographic characteristics (e.g., gender, ethnicity), motivation to quit, and other smoking- and cessation-related characteristics. Cross-sectional data were obtained from 1567 adult daily smokers in Hawaii using paper-and-pencil survey in 2010-2012, as part of a smoking cessation study. Participants represented 50% women, 21% Asian, 31% Native Hawaiian, 34% White, and 14% Other ethnicity.
e-Cigarette use was significantly associated with age (OR= 0.98, 95% CI [0.97, 0.99]), Native Hawaiian ethnicity (OR= 0.68, 95% CI [0.45, 0.99]), motivation to quit (OR= 1.14, 95% CI [1.08, 1.21]), quitting self-efficacy (OR= 1.18, 95% CI [1.06, 1.36]), and the use of conventional cessation products or medications such as nicotine replacement gum (OR= 3.72, 95% CI [2.67, 5.19]) and Bupropion (OR=2.29, 95% CI [1.38, 3.79]). Our data suggests that smokers who use
e-cigarettes appear to be serious about wanting to quit. Research is needed to clarify the effectiveness of e-cigarette use in smoking cessation. Clinicians and public health practitioners need to be prepared to clearly communicate the risks and benefits of e-cigarette use to smokers who are highly motivated to quit.
This study was supported by an R01 grant (# CA2079905) from the National Cancer Institute to T.A. Herzog.
CORRESPONDING AUTHOR: Pallav Pokhrel, Ph.D., M.P.H., Assistant Professor, University of Hawaii Cancer Center, Cancer Prevention & Control, 677 Ala Moana Blvd., Suite 200, Honolulu, HI 96813, United States, Phone: 8084417711, Email: ppokhrel@cc.hawaii.edu

Kelvin Choi, M.P.H., Ph.D.*, and Jean L. Forster, Ph.D., M.P.H., University of Minnesota
Objective: Young adults are experimenting with new tobacco products like snus and electronic cigarettes (e-cigarettes), and exposure to pro-snus and pro-e-cigarette messages may contribute to this phenomenon. We conducted the first analysis to examine young adults’ exposure to these messages and its associations with trying these products. Methods: Young adults (ages 20-25)
from the U.S. upper Midwest region were surveyed in 2009 and again in 2011 (n=2339). In 2011, participants were asked if they have received advertisements and coupons for non-cigarette products in the mail, have seen Facebook pages/ groups and advertisements for snus and e-cigarettes, and have seen kiosks in shopping malls promoting e-cigarettes. Ever use of these products was assessed in 2011. Baseline tobacco use behaviors were assessed in 2009 (before these
products were available nationwide). Using multivariate logistic regression models, we assessed characteristics associated with exposure to different types of pro-snus and pro-e-cigarette messages in 2011, and the associations between message exposure and ever use of these products in 2011. Results: Regarding snus, 8% and 7% of the participants had received advertisements and coupons for non-tobacco products in the mail, respectively; <1% had seen snus Facebook
pages/groups. Regarding e-cigarettes, 14% of the participants had seen kiosk at shopping malls promoting e-cigarettes; 7% and 1% had seen e-cigarettes advertisements and pages/groups on Facebook, respectively. Male, less educated participants, those who had friends who smoke, tobacco users were more likely to have received advertisements and coupons for non-cigarette products in the
mail (p<.05). For every additional type of exposure to pro-snus and pro-e-cigarette messages, there was a 79% and 96% higher odds that participants had used snus and e-cigarettes, respectively, adjusted for demographics, peer smoking and tobacco use behaviors (p<.05). Conclusions: Exposure to pro-snus and pro-ecigarette messages were associated with experimenting with these products in our sample. Longitudinal studies are needed to confirm our findings.
This research was funded by the National Cancer Institute (R01 CA86191; J. Forster - PI).
CORRESPONDING AUTHOR: Kelvin Choi, M.P.H., Ph.D., Research Associate, University of Minnesota, Division of Epidemiology and Community Health, 1300 South Second Street, Minneapolis, MN 55454, United States, Phone: 612-626- 1799, Email: choix137@umn.edu

Tobias Rüther, M.D., Ph.D.*, Franziska Wissen, Andrea Linhardt, M.D., Désirée Aichert, Oliver Pogarell, M.D., Ph.D., and Hein de Vries, Ph.D.
Introduction: The use of an electronic-cigarette (e-cigarette) resulted in some previous studies in reduction and cessation of conventional cigarette smoking.
Therefore, this study aims to examine the reasons of using e-cigarettes instead of and in addition to conventional cigarettes in Germany. Furthermore it is determined to what extent e-cigarettes are used as a smoking cessation tool. Method: A cross-sectional study was conducted in April � May 2012 in Munich, Germany. The I-Change Model was used as theoretical framework and existing questionnaires were used to build up the present questionnaire. 320 Smokers participated
in the study, divided in three groups: E-cigarette smokers (e-smokers) (33%), conventional cigarette smokers (c-smokers) (37%) and smokers of both cigarettes (b-smokers) (30%). Pearson Chi Square tests and analyses of variance were used to assess differences among the group of smokers on demographic variables, smoking behaviour and the constructs of the I-Change Model. Results: About half of the e-cigarette users used the e-cigarette in addition to c. cigarettes and the
other half instead of c. cigarettes. It seemed that e-smokers and b-smokers had the same reasons for using e-cigarettes overall. E-cigarette users were most often men, were less addicted to nicotine and had a higher motivation to stop smoking than c-smokers. In addition, e-smokers reported a more positive health and had a lower carbon monoxide concentration compared to c-smokers. Furthermore,
e-smokers had a more positive attitude towards e-cigarettes, a higher self-efficacy in terms of being abstinent from c. cigarettes in certain situations and a higher self-efficacy of using an e-cigarette instead of c. cigarettes. E-cigarettes were used more frequently if the social environment of a person vaporized as well or preferred the respondent to vaporize e-cigarettes instead of c. cigarettes. Discussion: The results confirmed most of the hypotheses and also important results of previous
studies. In addition, a well-conducted randomized-control trial is needed to confirm the efficacy of e-cigarettes as a smoking cessation aid.
No funding.
CORRESPONDING AUTHOR: Tobias Rüther, MD PhD, Physician, University of Munich Department of Psychiatry, Tobacco Dependence Outpatient Clinic, Nussbaumstr.7, Munich, 80336, Germany, Phone: +49-89-5160-5707, Email: tobias.ruether@med.uni-muenchen.de

Jill Murphy*1, Sarah Beshers1, Brian Fix2, and Martin Mahoney2, 1State University of New York at Cortland, Cortland, NY; 2Roswell Park Cancer Institute, Buffalo, NY Electronic cigarettes (e-cigarettes) have been available in the United States for about five years. Recent studies have found that awareness and ever use of e-cigarettes among adults is increasing. To our knowledge, to date there are no published reports of e-cigarette awareness and use among college students
in the United States. Some tobacco control advocates express concerns with e-cigarettes, including that e-cigarettes could be used as a starter product for younger or never smokers or they could delay cessation and result in a pattern of dual use of tobacco products. The objective of this study was to assess college students’ awareness, use, and perceptions of e-cigarettes. In October
and November of 2011, we conducted a cross-sectional survey among 1,187 undergraduate students attending two public universities in New York State.
Participants completed an online survey that included questions on demographics, cigarette smoking behavior, smokeless tobacco use, awareness and use of e-cigarettes, beliefs about the harmfulness of e-cigarettes, and interest in using an e-cigarette. The prevalence of current cigarette smoking was 10.5%, and the prevalence of smokeless tobacco use (including chewing tobacco, snuff, or snus)
was 2.7%. Current cigarette smokers were more likely than non-smokers to have heard of e-cigarettes (86% vs. 71%, p<0.01), ever try an e-cigarette (47% vs. 5%, p<0.01), and use an e-cigarette in the past month (4% vs. 0.1%, p<0.01), respectively. Only one participant reporting daily use of the e-cigarette. The vast majority (97%) of college students perceived that e-cigarettes were either less harmful or no different in terms of harm when compared to regular cigarettes.
Among participants who had not tried an e-cigarette, cigarette smokers were more likely than non-smokers to report they would be interested in trying an electronic cigarette (39% vs. 5%, p < 0.01). We found the majority of college students were aware of e-cigarettes. While ever use of e-cigarettes was much more common in current cigarette smokers than non-smokers, past month use was much less common in the sample overall, and daily use was rare.
No funding.
CORRESPONDING AUTHOR: Jill Murphy, PhD, Associate Professor, SUNY Cortland, Health, PO Box 2000 Graham Ave, Cortland, NY 13045, United States, Phone: 6077535613, Email: murphyj@cortland.edu


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Re: 2013 SRNT Conference
« Responder #1 em: 2013.03.11 | 16:01:53 »

Pasquale Caponnetto, Ph.D.1,2, Davide Campagna, M.D.1,2, Fabio Cibella, Ph.D.3, Jaymin B. Morjaria, M.D.4, Cristina Russo, M.D.1,2, and Riccardo Polosa, M.D., Ph.D.*1,2, 1Centro per la Prevenzione e Cura del Tabagismo, Azienda Ospedaliero- Universitaria “Policlinico-V. Emanuele”, Università di Catania, Catania, Italy;
2Institute of Internal Medicine, S. Marta Hospital, Azienda Ospedaliero-Universitaria “Policlinico-V. Emanuele”, Università di Catania, Catania, Italy; 3Istituto di Biomedicina e Immunologia Molecolare del Consiglio Nazionale delle Ricerche, Palermo, Italy; 4IIR Division, School of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
E-cigarettes are becoming increasingly popular with smokers worldwide.
Carefully conducted research on e-cigarettes is urgently needed in order to ensure that the decisions of regulators, healthcare providers and consumers are based on science. We designed a prospective 12-month double-blind, randomized, controlled trial to evaluate smoking reduction, smoking abstinence and adverse events in 300 smokers not intending to quit experimenting 2 different nicotine
strengths of a very popular brand compared to the non nicotine alternative from the same brand. Study Group A (n =100) used 7.2 mg nicotine cartridges, Group B (n =100) used 5.4 mg nicotine cartridges and Group C (n =100) was given no-nicotine cartridges. Study participants were invited to attend a total of 9 study visits during which number of cigarettes smoked, and eCO levels were measured.
Smoking reduction and abstinence rates were calculated. Adverse events and product preferences were also reviewed. Lastly, classic and novel static and dynamic factors predicting abstinence and reduction rates will be investigated.
A significant reduction (p<0.001) cig/day use and eCO levels from baseline was observed at each study visits in all 3 study groups. By and large, no difference between study groups was observed in terms of changes in cig/day use and in eCO levels. A mean of 2.0 cartridges/day was used in each study group up to the 3-month time point, but falling thereafter. Smoking reduction was shown in 21% and 9% participants in group A, in 16% and 8% in group B and in 19% and 10% in
group C, at 3- and 12-months respectively. Smoking abstinence was observed in 11 % and 13% participants in group A, in 17% and 9% in group B and in 4% and 4% in group C, at 3- and 12-months respectively. Only minor and transient adverse were reported, including mouth and throat irritation, and dry cough. They seem to attenuate over time. By and large, participants’ perception and acceptance of the product was positive. In smokers not intending to quit, the use of e-Cigarette
decreased cigarette consumption and elicited enduring tobacco abstinence at 1-yr without causing significant side effects.
No funding.
CORRESPONDING AUTHOR: Pasquale Caponnetto, University of Catania, c/o Policlinico Vittorio Emanuele, Catania, 95123, Italy, Phone: 0039 7436413, Email: p.caponnetto@unict.it

Randolph C. Grace, Ph.D.1, Aimee Richardson, B.Sc.(Hons)1, Donna Ritchie, B.A.1, Murray Laugesen, FNZCPHM*2, Bronwyn Kivell, Ph.D.3, and Nathan Cowie, M.P.H.4, 1University of Canterbury NZ; 2Health New Zealand Ltd; 3Victoria University of Wellington; 4University of Auckland
BACKGROUND: Nicotine electronic cigarettes (NECs) were illegal to sell or advertise in New Zealand during 2012, where 17% of adults smoke tobacco cigarettes daily. METHODS: Smokers age 18 and over who purchased their own cigarettes were recruited on worksites and by newspaper publicity; 343 were interviewed face to face in four cities and rewarded with a voucher for $15 (NZ$; 1
NZ$ = 0.85 USD) and a chance to win an electronic tablet. Participants completed the Cigarette Purchase Task (CPT; MacKillop et al., 2008) in which they reported how many cigarettes per day they would smoke at various price points. Then they sampled an NEC and rated preference for it against their own brand on a 10-point scale. The NEC used was SafeCig 18mg (SafeCig LLC. Los Angeles), notionally priced at $5 per day. RESULTS: Participants smoked a mean 14.9 cigarettes per
day (cpd) and spent $8.72 daily on cigarettes, 33% paying $0.38 per roll-your-own (RYO) tobacco cigarette, 67% paying $0.72 per factory-made (FM) cigarette. After 3 puffs from the NEC, smokers liked it 83% as much as their own brand: average preference ratings for NEC and own brand were 6.26 and 7.51, respectively. If cigarettes cost $0.70 each, smokers estimated they would smoke 14.5 cpd, but only 7.08 cpd if they could buy NECs (t[312] = 15.39, p < .001). Using NECs,
31.6% said they would quit smoking their own brand completely. If cigarette price doubled to $1.40, 59.5% of smokers estimated they would quit, and a further 11.1% would quit by using NECs if NECs were on sale. Those continuing to smoke at this price would smoke 10.63 cpd; but if NECs were on sale, would smoke 6.34 cpd (t[125] = 4.29, p < .001). CONCLUSIONS: If cigarettes cost $0.70 each (20% above the mean 2012 price), and NECs cost 36% of this ($5 a day), three in ten
smokers would use NECs to switch off tobacco smoking entirely. If the price of cigarettes doubled, price would be the main motivator of quitting, but even more intended to quit if NECs were on sale. Most smokers liked the NEC and given its price advantage, especially as tobacco excise increases, many would switch to NECs and stop smoking tobacco, if NECs were available.
Funding: End Smoking NZ from Canterbury Community Trust; Univ. of Canterbury, Tobacco Control Research Turanga Fund, University of Auckland.
CORRESPONDING AUTHOR: Murray Laugesen, FNZCPHM, Public Health Medicine Specialist, Health New Zealand Ltd, 36 Winchester St Lyttelton, Christchurch, 8082, New Zealand, Phone: +64 3 3288 688, Email: hnz@healthnz.

Vikram Kumar1, Jay Kumar1, Joseph McClernon*2, and Thangaraju Murugesan2, 1Siva Scientific, Inc., Yorba Linda, CA; 2NeuroAnalytics, LLC, Durham, NC
Aims: We report on the chemical testing and analysis of a prototype of a novel heated tobacco cigarette system (HTCS). The HTCS works by heating tobacco at temperatures below the point at which pyrolysis occurs, thereby producing a vapor potentially devoid of many of the constituents found in the smoke of conventional cigarettes (CCs). Methods: Evaluation of a number of the physical (e.g., particle size) and chemical (e.g. nicotine content) characteristics of a novel HTCS was
made using a standard puffing regimen and chemical analysis techniques. The HTCS was tested by heating tobacco rods from four commercially available cigarettes, and comparing to values obtained by conventionally burning those same cigarettes.
Results: Assessment of heating element and surrounding tobacco
temperatures indicated stable attainment of temperatures of approximately 400 ?C and 200 ?C in the heating element and tobacco respectively. The heating of four different commercial cigarettes with the HTCS resulted in mean nicotine levels in a range between 18.77 and 42.8 μg/puff (conventional burning = 131.73 to 342.88 μg/puff). The results of gas chromatography with nitrogen phosphorous
detection (GC-NPD) revealed substantial reduction in total ion chromatography peaks for the HTCS versus CC. Finally, the mass median aerodynamic diameter (MMAD) of vaporized particulate matter from the HTCS was calculated as 0.55μM.
Conclusion: The results of this initial assessment of a novel heated tobacco cigarette system indicate delivery of an aerosol achieving significant levels of nicotine at particle sizes similar to CC, but substantially reduced levels of nonnicotine constituents as indicated by GC. Future in vivo and in vitro is warranted to assess the biological activity of this novel HTCS and it’s potential to reduce harm
from smoking in humans.
This research was funded by Siva Scientific, Inc.
CORRESPONDING AUTHOR: Francis McClernon, 26 Oak Drive, Durham, NC
27707, United States, Phone: 919-260-0586, Email: joe.mcclernon@gmail.com