This study examined oral mucosal lesions in 45 former smokers and 45 electronic cigarette consumers. Oral examinations found lesions in 55 total patients, with 36 lesions in electronic cigarette consumers and 19 in former smokers. Nicotine stomatitis, hairy tongue, and hyperplastic candidiasis were significantly more common among electronic cigarette consumers. The study aims to evaluate differences in oral mucosal lesions between the groups but found no statistically significant difference in total prevalence of lesions.
12 weeks Switch to Vaping: Science of Vaping Fontem Ventures
A randomised, parallel group clinical study was performed to evaluate the safety profile of an e-vapour
product (EVP; 2.0% nicotine) in smokers of conventional cigarettes (CCs) switching to use the EVP for 12
weeks.
Electronic Cigarettes: Evidenced Based Decision Making PresentationKaylaRobinson29
An assignment for Dental Hygiene Theory 1 was to create an annotated bibliography for a research topic of our choice. This project was designed to challenge our critical thinking and decision making skills. I chose to research electronic cigarettes and their effects on oral health. It was interesting to compare different literature on this subject and the validity that they held. Most of the articles were very similar in the information portrayed and were very educational.
Vaping and tobacco: six things you need to know about harm reductionClive Bates
1. Smoking has not gone away
2. Technologies to obsolete cigarettes
3. Risks and risk (mis)perceptions
4. The public health mechanism and the pleasure principle
5. The youth vaping epidemic – a harder look
6. Policymaking and perverse consequences
Abstract— Cigarette smoking is one of the major causes of cancer and cardiovascular diseases leading to millions of premature deaths each year all over the world. Scientists have identified about 4,000 different substances in tobacco all of which have certain degree of toxic effects. At least 43 of them known carcinogens.
Objective: The aim of this study is to assess the extent of adverse effect of cigarette and shisha on haematological parameters in male population of Khartoum State – Sudan.
Subject and Methods: One hundred and fifty male subjects participated in this study, cigarette smoker (n= 50), shisha smoker (n= 50) and non-smoker (n= 50). The smokers were regularly smoking at least for 10 years. Fresh peripheral blood samples from healthy adult non-smokers and smokers (males) were collected and analysed for Red Blood Cells (RBC) count, haemoglobin (Hb) content, packed cell volume (PCV), MCV, MCH and MCHC, total and differential leucocytes (WBC) counts and total platelets count by using fully automatic haematological analyser.
Results: The smokers of cigarette and shisha had significantly higher level of Hb, HCT, RBCs, TWBC count and MCHC. However, platelets counts were significantly lower in cigarette smokers than that of non-smokers. Study shows that the duration of smoking had no significant effect on haematological parameters except Hb.
Conclusion: It concluded that smoking alters haematological parameter that is injurious to health.
Efficacy of Nicotine Replacement Therapy (NRT) to Aid Cigarette Sm.docxtoltonkendal
Efficacy of Nicotine Replacement Therapy (NRT) to Aid Cigarette Smoking Cessation amongst Adults in United Kingdom
Introduction
Tobacco smoking is a major contributor to many serious diseases that eventually lead to death in the United Kingdom (UK). According to Office of National Statistics (ONS) (2017), 7.4 million of United Kingdom’s population are smokers and 19.7 percent of these smokers are adult with age-range of 25 to 34 years. Tobacco cigarettes contain nicotine. Nicotine changes the balance of two chemicals namely noreadrenaline and dopamine which are found in human the brain. The sudden change on the levels of these chemicals after inhalation may result in changes in mood which could result in reduction of stress, anxiety and increase in pleasure (National Health Service (NHS), 2018a). Transmission of nicotine by inhalation of tobacco is the fastest way of distributing nicotine into the bloodstream according to Action on Smoking and Health (ASH) (2019). Therefore, these facts indicate that smoking cigarettes could be profoundly addictive due to the rapid delivery of the desired effects to its users without taking into consideration any adverse effects on the human body and health.
Cigarette smoking harms human health; and stopping has proven hard to do alone. According to Health and Social Care Information Centre (HSCIC) (2017), in 2017 there were 146,234 people who started to try to quit smoking, only 49 percent successfully managed to stay away from using cigarretes and 33 percent of the individuals who successfully managed to stop smoking utilised licensed nicotine containing products. The government came up with tobacco control plan for England to assist its people to stop smoking; the elements of the plan include making tobacco more expensive, restraining tobacco related publicity, efficient control of tobacco products, developing alertness on harm caused by smoking and lowering the instance to be exposed to second-hand smoke (Public Health England, 2015).
Smoking cessation services and interventions are being offered by the NHS. Affirmed by National Institute for Health and Care Excellence (NICE) (2019), there are few evidenced-based interventions for smoking available in the UK for adults which include behavioural support, bupropion, nicotine replacement therapy (NRT), varenicline and very brief advices (VBA). These interventions are available to individuals who seek help through their general practitioner and to those who are being referred to health professionals for assistance; some of the interventions are combined to be able to achieve the desired goal which is to ultimately forgo smoking tobacco.
This paper will discuss the different kinds of NRT available for adults in the United Kingdom. Nicotine replacement therapy (NRT) includes few ways to supplement smoking. It helps to fight the urge to consume or inhale tobacco and also to reduce the effects of withdrawal. In addition, it will help individuals to slowly redu.
12 weeks Switch to Vaping: Science of Vaping Fontem Ventures
A randomised, parallel group clinical study was performed to evaluate the safety profile of an e-vapour
product (EVP; 2.0% nicotine) in smokers of conventional cigarettes (CCs) switching to use the EVP for 12
weeks.
Electronic Cigarettes: Evidenced Based Decision Making PresentationKaylaRobinson29
An assignment for Dental Hygiene Theory 1 was to create an annotated bibliography for a research topic of our choice. This project was designed to challenge our critical thinking and decision making skills. I chose to research electronic cigarettes and their effects on oral health. It was interesting to compare different literature on this subject and the validity that they held. Most of the articles were very similar in the information portrayed and were very educational.
Vaping and tobacco: six things you need to know about harm reductionClive Bates
1. Smoking has not gone away
2. Technologies to obsolete cigarettes
3. Risks and risk (mis)perceptions
4. The public health mechanism and the pleasure principle
5. The youth vaping epidemic – a harder look
6. Policymaking and perverse consequences
Abstract— Cigarette smoking is one of the major causes of cancer and cardiovascular diseases leading to millions of premature deaths each year all over the world. Scientists have identified about 4,000 different substances in tobacco all of which have certain degree of toxic effects. At least 43 of them known carcinogens.
Objective: The aim of this study is to assess the extent of adverse effect of cigarette and shisha on haematological parameters in male population of Khartoum State – Sudan.
Subject and Methods: One hundred and fifty male subjects participated in this study, cigarette smoker (n= 50), shisha smoker (n= 50) and non-smoker (n= 50). The smokers were regularly smoking at least for 10 years. Fresh peripheral blood samples from healthy adult non-smokers and smokers (males) were collected and analysed for Red Blood Cells (RBC) count, haemoglobin (Hb) content, packed cell volume (PCV), MCV, MCH and MCHC, total and differential leucocytes (WBC) counts and total platelets count by using fully automatic haematological analyser.
Results: The smokers of cigarette and shisha had significantly higher level of Hb, HCT, RBCs, TWBC count and MCHC. However, platelets counts were significantly lower in cigarette smokers than that of non-smokers. Study shows that the duration of smoking had no significant effect on haematological parameters except Hb.
Conclusion: It concluded that smoking alters haematological parameter that is injurious to health.
Efficacy of Nicotine Replacement Therapy (NRT) to Aid Cigarette Sm.docxtoltonkendal
Efficacy of Nicotine Replacement Therapy (NRT) to Aid Cigarette Smoking Cessation amongst Adults in United Kingdom
Introduction
Tobacco smoking is a major contributor to many serious diseases that eventually lead to death in the United Kingdom (UK). According to Office of National Statistics (ONS) (2017), 7.4 million of United Kingdom’s population are smokers and 19.7 percent of these smokers are adult with age-range of 25 to 34 years. Tobacco cigarettes contain nicotine. Nicotine changes the balance of two chemicals namely noreadrenaline and dopamine which are found in human the brain. The sudden change on the levels of these chemicals after inhalation may result in changes in mood which could result in reduction of stress, anxiety and increase in pleasure (National Health Service (NHS), 2018a). Transmission of nicotine by inhalation of tobacco is the fastest way of distributing nicotine into the bloodstream according to Action on Smoking and Health (ASH) (2019). Therefore, these facts indicate that smoking cigarettes could be profoundly addictive due to the rapid delivery of the desired effects to its users without taking into consideration any adverse effects on the human body and health.
Cigarette smoking harms human health; and stopping has proven hard to do alone. According to Health and Social Care Information Centre (HSCIC) (2017), in 2017 there were 146,234 people who started to try to quit smoking, only 49 percent successfully managed to stay away from using cigarretes and 33 percent of the individuals who successfully managed to stop smoking utilised licensed nicotine containing products. The government came up with tobacco control plan for England to assist its people to stop smoking; the elements of the plan include making tobacco more expensive, restraining tobacco related publicity, efficient control of tobacco products, developing alertness on harm caused by smoking and lowering the instance to be exposed to second-hand smoke (Public Health England, 2015).
Smoking cessation services and interventions are being offered by the NHS. Affirmed by National Institute for Health and Care Excellence (NICE) (2019), there are few evidenced-based interventions for smoking available in the UK for adults which include behavioural support, bupropion, nicotine replacement therapy (NRT), varenicline and very brief advices (VBA). These interventions are available to individuals who seek help through their general practitioner and to those who are being referred to health professionals for assistance; some of the interventions are combined to be able to achieve the desired goal which is to ultimately forgo smoking tobacco.
This paper will discuss the different kinds of NRT available for adults in the United Kingdom. Nicotine replacement therapy (NRT) includes few ways to supplement smoking. It helps to fight the urge to consume or inhale tobacco and also to reduce the effects of withdrawal. In addition, it will help individuals to slowly redu.
These are the slides for my talk delivered at the Lisbon Addictions conference October 2019 as part of the FuturiZe round table on safer drugs.
A recording of the presentation can be found on my YouTube channel 'Lynne Talks Vape': https://youtu.be/8jTQvoWu1Pk
The relative risk of cancer from smoking and vaping nicotine yfzsc5g7nm
Switching from smoking to vaping nicotine reduces your lifetime risk of cancer by over 99%.
Most of the carcinogens in smoke are absent in vapour. Those present are at very low doses.
Presentation at Prince of Wales Hospital, Medical Ground Rounds
Dr Colin Mendelsohn
22 November 2023
Innovation for Consumers: E-cigarettes and novel tobacco products - Part of t...Clive Bates
Clive Bates presentation at a seminar in the European Parliament organised by Monika Beňová MEP
European Commission DG SANTE - Matus Ferech
Patient Access Partnership - Dr. Stanimir Hasurdjiev
Effects of substituting cigarettes with e-cigarettes in adult smokers Fontem Ventures
Measurement of cardiovascular and pulmonary function endpoints
and other physiological effects following partial or complete
substitution of cigarettes with electronic cigarettes in adult smokers
Smoking kills. The prevalence of smokers is increasing especially among young groups. Other than Cigarette, there is the Electronic formate which is increasing among the population
Little over a decade since their launch, electronic cigarettes (ECs) today represent a global
industry with sales exceeding US$6 billion last year. Yet the devices have increasingly
generated heated debate surrounding their safety, efficacy and regulatory control, while
advocates of the immediate formal use of ECs opine their usefulness in reducing the
burden of smoking-related disease – other experts urge caution until more information
and better evidence become available. Dr Robert Combes reports.
NUR 315 Milestone One Selection of Case Guidelines and Rubr.docxvannagoforth
NUR 315 Milestone One: Selection of Case Guidelines and Rubric
For Milestone One of the final project, you will choose a well-known individual from history or current popular literature who has a known physiological—as
opposed to psychiatric or psychological—disease or illness of interest for instructor approval. You will introduce your chosen individual, describe the
pathophysiology for your selected disease or illness, and explain the clinical manifestations.
Prompt: Identify your selected case describing how the normal physiology is changed by the disease state. In addition, define pathophysiology, the clinical
manifestations (i.e., signs and symptoms), and how each of these can be explained by alteration in physiology. Finally, a discussion of the extent to which the
clinical manifestations affect multiple body systems for the case should be included in this first milestone for the final project in this course.
Guidelines for Submission: Your paper must be submitted as a 2-page Microsoft Word document with double spacing, 12-point Times New Roman font, one-inch
margins, and any sources cited in APA format.
Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value
Introduction of
Individual
Introduces the reader to the
individual and his or her
background, including time and
location
Introduces the reader to the
individual, but does not explain
his or her background
Does not clearly introduce or
identify the chosen individual or
chooses an inappropriate
individual for the focus of the
final project
20
Identification of
Pathophysiology
Accurately identifies the
pathophysiology afflicting the
individual and explains how it
changes the normal physiology
Identifies the pathophysiology
and briefly explains how it
changes the normal physiology,
but with gaps in knowledge
Does not identify the
pathophysiology or
misidentifies the
pathophysiology
35
Explanation of
Clinical
Manifestations
Accurately identifies and
explains the clinical
manifestations of the
pathophysiology
Identifies and explains the
clinical manifestations, but with
gaps in knowledge
Does not identify or explain or
incorrectly identifies clinical
manifestations
35
Articulation of
Response
(APA/Mechanics)
Submission has no major errors
related to citations, grammar,
spelling, syntax, or organization
Submission has major errors
related to citations, grammar,
spelling, syntax, or organization
that negatively impact
readability and articulation of
main ideas
Submission has critical errors
related to citations, grammar,
spelling, syntax, or organization
that obstruct understanding
10
Total 100%
Med Pregl 2018; LXXI (11-12): 349-354. Novi Sad: novembar-decembar. 349
Introduction
Tobacco addiction is considered to be the most
common and problematic form of addiction world-
Summary
Introduction. Smoking is the leading preventable cause of
mortality ...
A.What is the sensitivity of self-reported smoking statusSolut.pdfnobel25
A.What is the sensitivity of self-reported smoking status?
Solution
Assessment of validity of self-reported smoking status by Suzy L. Wong, Margot
Shields, Scott Leatherdale, Eric Malaison and David Hammond The health risks associated with
cigarette smoking are well-documented and widely recognized—cancer, respiratory illness, heart
disease, and stroke.1-3 In Canada, smoking contributes to more than 37,000 deaths a year.4
Tobacco-related health care expenditures amount to billions of dollars annually, with additional
indirect costs such as lost productivity, longer-term disability and premature death.4 Self-
reported data are typically used to monitor trends in cigarette smoking.5-7 However, estimates
based on self-report, particularly of socially undesirable behaviours, are subject to reporting
biases.8 The widespread implementation of legislation prohibiting smoking in workplaces and
public areas9 and prominent health warnings on cigarette packages may reinforce the perception
of smoking as socially undesirable, and thereby increased the tendency to underreport over time.
To validate self-reported smoking status, the urinary concentration of cotinine, a widely accepted
objective measure of exposure to tobacco smoke,10 has been used. Cotinine is the major
metabolite of nicotine, with a half-life of about 16 to 20 hours.11 Because of its high sensitivity
and specificity, cotinine is considered to be an accurate quantitative measure of recent exposure
to tobacco smoke.12 Compared with estimates based on cotinine concentration, smoking
prevalence based on self-report, is generally lower,13 although the extent of the difference varies
by country.14 The validity of self-reported cigarette smoking data have yet to be determined for
Canada. Thus, this study compares estimates of the prevalence of cigarette smoking based on
self-report with estimates based on urinary cotinine concentrations. The data are from the 2007
to 2009 Canadian Health Measures Survey, which included self-reported smoking status and the
first nationally representative measures of urinary cotinine. Methods Data source The Canadian
Health Measures Survey (CHMS) is a nationally representative survey of the household
population. Data for cycle 1 were collected from March 2007 through February 2009 at 15 sites
across the country for respondents aged 6 to 79. Full-time members of the Canadian Forces and
residents of Crown lands, Indian reserves, institutions and certain remote regions were excluded.
The sample represented approximately 96% of the population.15 The CHMS consisted of a
household interview during which information about socio- demographic characteristics, health
and lifestyle was gathered. This was followed by a visit to a mobile examination centre where
direct measurements, including the collection of urine samples, were taken. Of the households
selected for the survey, 69.6% agreed to participate. One or two members of each responding
household were invited to take p.
Articles/Carcinogen+Exposure.pdf
Carcinogen Exposure during Short-term Switching
from Regular to ‘‘Light’’ Cigarettes
Neal L. Benowitz,1 Peyton Jacob III,1 John T. Bernert,2 Margaret Wilson,1 Langing Wang,2
Faith Allen,1 and Delia Dempsey1
1Division of Clinical Pharmacology and Experimental Therapeutics, Departments of Medicine, Psychiatry, and Biopharmaceutical Sciences,
University of California, San Francisco and 2Biomarkers Laboratory, Emergency Response and Air Toxicants Branch, Division of Laboratory
Science, National Center for Environmental Health, Centers for Disease Control, Atlanta, Georgia
Abstract
Objectives: ‘‘Light’’ cigarettes are extremely popular and
are perceived by many smokers as less hazardous than
higher-yield cigarettes. The objectives of this study were
(a) to assess a battery of biomarkers of tobacco smoke
exposure that includes tobacco smoke carcinogens, (b) to
examine the behavioral nature of compensation, and (c) to
examine the consistency of an individual’s tobacco smoke
exposure when smoking the same cigarette at different
times.
Methods: The study was a 3-week crossover study in which
smokers smoked their usual cigarettes during weeks 1 and 3,
and a light cigarette, with a machine-determined nicotine
yield of about 50% of the usual cigarette, during week 2.
Blood and urine biomarkers of exposure and subjective
questionnaires were collected weekly.
Results: Based on cotinine and carboxyhemoglobin levels,
compensation averaged 78% and 83%, respectively. Urinary
excretion of 4-(methylnitrosamino)-1-(3-pyridyl)-butanol, a
metabolite of the tobacco specific carcinogen 4-(methylnitro-
samino)-1-(3-pyridyl)-butanone, and a number of polycyclic
aromatic hydrocarbon metabolites was similar in all con-
ditions. Compensation was accomplished both by smoking
cigarettes more intensively and by smoking more cigarettes
per day. Exposures to various tobacco smoke constituents
while smoking the usual brand of cigarette in weeks 1 and 3
were highly correlated.
Conclusion: Our findings support the idea that smokers
compensate to a high degree when switched from their usual
brand to a light cigarette. Short-term switching resulted in no
significant reduction in carcinogen exposure. Our assess-
ment, based on measures of biochemical exposures, supports
the idea that switching to light cigarettes is unlikely to
reduce the health risks of cigarette smoking. (Cancer
Epidemiol Biomarkers Prev 2005;14(6):1376 – 83)
Introduction
Cigarette smoking is sustained by addiction to nicotine (1).
Dependent smokers tend to regulate their intake of nicotine
from day to day. When switched to cigarettes of lower
machine-determined yield, smokers on average increase their
intake of nicotine beyond that which would be expected based
on the stated (machine tested) yield (2, 3). The process of
smoking lower-yield cigarettes more intensively than higher-
yield cigarettes is termed compensation. When compensating
for lower nicotine yields, smoker ...
A public lecture on Electronic Cigarettes delivered by Dr Lynne Dawkins of the Centre for Addictive Behaviours Research, London South Bank University on 14th November 2018.
A recording of the talk can be found here: https://youtu.be/VpetvlAmIaU
Following her successful public lecture on E-Cigarettes in 2013, Dr Dawkins re-visits the subject of e-cigarettes and vaping, drawing on the most recent evidence and updates since 2013. She describes the development in e-cigarette technology and current regulation and then brings the audience up to date with the latest research on usage patterns, smoking cessation and safety issues, addressing some of the common myths held around e-cigarettes and vaping.
Deep Behavioral Phenotyping in Systems Neuroscience for Functional Atlasing a...Ana Luísa Pinho
Functional Magnetic Resonance Imaging (fMRI) provides means to characterize brain activations in response to behavior. However, cognitive neuroscience has been limited to group-level effects referring to the performance of specific tasks. To obtain the functional profile of elementary cognitive mechanisms, the combination of brain responses to many tasks is required. Yet, to date, both structural atlases and parcellation-based activations do not fully account for cognitive function and still present several limitations. Further, they do not adapt overall to individual characteristics. In this talk, I will give an account of deep-behavioral phenotyping strategies, namely data-driven methods in large task-fMRI datasets, to optimize functional brain-data collection and improve inference of effects-of-interest related to mental processes. Key to this approach is the employment of fast multi-functional paradigms rich on features that can be well parametrized and, consequently, facilitate the creation of psycho-physiological constructs to be modelled with imaging data. Particular emphasis will be given to music stimuli when studying high-order cognitive mechanisms, due to their ecological nature and quality to enable complex behavior compounded by discrete entities. I will also discuss how deep-behavioral phenotyping and individualized models applied to neuroimaging data can better account for the subject-specific organization of domain-general cognitive systems in the human brain. Finally, the accumulation of functional brain signatures brings the possibility to clarify relationships among tasks and create a univocal link between brain systems and mental functions through: (1) the development of ontologies proposing an organization of cognitive processes; and (2) brain-network taxonomies describing functional specialization. To this end, tools to improve commensurability in cognitive science are necessary, such as public repositories, ontology-based platforms and automated meta-analysis tools. I will thus discuss some brain-atlasing resources currently under development, and their applicability in cognitive as well as clinical neuroscience.
These are the slides for my talk delivered at the Lisbon Addictions conference October 2019 as part of the FuturiZe round table on safer drugs.
A recording of the presentation can be found on my YouTube channel 'Lynne Talks Vape': https://youtu.be/8jTQvoWu1Pk
The relative risk of cancer from smoking and vaping nicotine yfzsc5g7nm
Switching from smoking to vaping nicotine reduces your lifetime risk of cancer by over 99%.
Most of the carcinogens in smoke are absent in vapour. Those present are at very low doses.
Presentation at Prince of Wales Hospital, Medical Ground Rounds
Dr Colin Mendelsohn
22 November 2023
Innovation for Consumers: E-cigarettes and novel tobacco products - Part of t...Clive Bates
Clive Bates presentation at a seminar in the European Parliament organised by Monika Beňová MEP
European Commission DG SANTE - Matus Ferech
Patient Access Partnership - Dr. Stanimir Hasurdjiev
Effects of substituting cigarettes with e-cigarettes in adult smokers Fontem Ventures
Measurement of cardiovascular and pulmonary function endpoints
and other physiological effects following partial or complete
substitution of cigarettes with electronic cigarettes in adult smokers
Smoking kills. The prevalence of smokers is increasing especially among young groups. Other than Cigarette, there is the Electronic formate which is increasing among the population
Little over a decade since their launch, electronic cigarettes (ECs) today represent a global
industry with sales exceeding US$6 billion last year. Yet the devices have increasingly
generated heated debate surrounding their safety, efficacy and regulatory control, while
advocates of the immediate formal use of ECs opine their usefulness in reducing the
burden of smoking-related disease – other experts urge caution until more information
and better evidence become available. Dr Robert Combes reports.
NUR 315 Milestone One Selection of Case Guidelines and Rubr.docxvannagoforth
NUR 315 Milestone One: Selection of Case Guidelines and Rubric
For Milestone One of the final project, you will choose a well-known individual from history or current popular literature who has a known physiological—as
opposed to psychiatric or psychological—disease or illness of interest for instructor approval. You will introduce your chosen individual, describe the
pathophysiology for your selected disease or illness, and explain the clinical manifestations.
Prompt: Identify your selected case describing how the normal physiology is changed by the disease state. In addition, define pathophysiology, the clinical
manifestations (i.e., signs and symptoms), and how each of these can be explained by alteration in physiology. Finally, a discussion of the extent to which the
clinical manifestations affect multiple body systems for the case should be included in this first milestone for the final project in this course.
Guidelines for Submission: Your paper must be submitted as a 2-page Microsoft Word document with double spacing, 12-point Times New Roman font, one-inch
margins, and any sources cited in APA format.
Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value
Introduction of
Individual
Introduces the reader to the
individual and his or her
background, including time and
location
Introduces the reader to the
individual, but does not explain
his or her background
Does not clearly introduce or
identify the chosen individual or
chooses an inappropriate
individual for the focus of the
final project
20
Identification of
Pathophysiology
Accurately identifies the
pathophysiology afflicting the
individual and explains how it
changes the normal physiology
Identifies the pathophysiology
and briefly explains how it
changes the normal physiology,
but with gaps in knowledge
Does not identify the
pathophysiology or
misidentifies the
pathophysiology
35
Explanation of
Clinical
Manifestations
Accurately identifies and
explains the clinical
manifestations of the
pathophysiology
Identifies and explains the
clinical manifestations, but with
gaps in knowledge
Does not identify or explain or
incorrectly identifies clinical
manifestations
35
Articulation of
Response
(APA/Mechanics)
Submission has no major errors
related to citations, grammar,
spelling, syntax, or organization
Submission has major errors
related to citations, grammar,
spelling, syntax, or organization
that negatively impact
readability and articulation of
main ideas
Submission has critical errors
related to citations, grammar,
spelling, syntax, or organization
that obstruct understanding
10
Total 100%
Med Pregl 2018; LXXI (11-12): 349-354. Novi Sad: novembar-decembar. 349
Introduction
Tobacco addiction is considered to be the most
common and problematic form of addiction world-
Summary
Introduction. Smoking is the leading preventable cause of
mortality ...
A.What is the sensitivity of self-reported smoking statusSolut.pdfnobel25
A.What is the sensitivity of self-reported smoking status?
Solution
Assessment of validity of self-reported smoking status by Suzy L. Wong, Margot
Shields, Scott Leatherdale, Eric Malaison and David Hammond The health risks associated with
cigarette smoking are well-documented and widely recognized—cancer, respiratory illness, heart
disease, and stroke.1-3 In Canada, smoking contributes to more than 37,000 deaths a year.4
Tobacco-related health care expenditures amount to billions of dollars annually, with additional
indirect costs such as lost productivity, longer-term disability and premature death.4 Self-
reported data are typically used to monitor trends in cigarette smoking.5-7 However, estimates
based on self-report, particularly of socially undesirable behaviours, are subject to reporting
biases.8 The widespread implementation of legislation prohibiting smoking in workplaces and
public areas9 and prominent health warnings on cigarette packages may reinforce the perception
of smoking as socially undesirable, and thereby increased the tendency to underreport over time.
To validate self-reported smoking status, the urinary concentration of cotinine, a widely accepted
objective measure of exposure to tobacco smoke,10 has been used. Cotinine is the major
metabolite of nicotine, with a half-life of about 16 to 20 hours.11 Because of its high sensitivity
and specificity, cotinine is considered to be an accurate quantitative measure of recent exposure
to tobacco smoke.12 Compared with estimates based on cotinine concentration, smoking
prevalence based on self-report, is generally lower,13 although the extent of the difference varies
by country.14 The validity of self-reported cigarette smoking data have yet to be determined for
Canada. Thus, this study compares estimates of the prevalence of cigarette smoking based on
self-report with estimates based on urinary cotinine concentrations. The data are from the 2007
to 2009 Canadian Health Measures Survey, which included self-reported smoking status and the
first nationally representative measures of urinary cotinine. Methods Data source The Canadian
Health Measures Survey (CHMS) is a nationally representative survey of the household
population. Data for cycle 1 were collected from March 2007 through February 2009 at 15 sites
across the country for respondents aged 6 to 79. Full-time members of the Canadian Forces and
residents of Crown lands, Indian reserves, institutions and certain remote regions were excluded.
The sample represented approximately 96% of the population.15 The CHMS consisted of a
household interview during which information about socio- demographic characteristics, health
and lifestyle was gathered. This was followed by a visit to a mobile examination centre where
direct measurements, including the collection of urine samples, were taken. Of the households
selected for the survey, 69.6% agreed to participate. One or two members of each responding
household were invited to take p.
Articles/Carcinogen+Exposure.pdf
Carcinogen Exposure during Short-term Switching
from Regular to ‘‘Light’’ Cigarettes
Neal L. Benowitz,1 Peyton Jacob III,1 John T. Bernert,2 Margaret Wilson,1 Langing Wang,2
Faith Allen,1 and Delia Dempsey1
1Division of Clinical Pharmacology and Experimental Therapeutics, Departments of Medicine, Psychiatry, and Biopharmaceutical Sciences,
University of California, San Francisco and 2Biomarkers Laboratory, Emergency Response and Air Toxicants Branch, Division of Laboratory
Science, National Center for Environmental Health, Centers for Disease Control, Atlanta, Georgia
Abstract
Objectives: ‘‘Light’’ cigarettes are extremely popular and
are perceived by many smokers as less hazardous than
higher-yield cigarettes. The objectives of this study were
(a) to assess a battery of biomarkers of tobacco smoke
exposure that includes tobacco smoke carcinogens, (b) to
examine the behavioral nature of compensation, and (c) to
examine the consistency of an individual’s tobacco smoke
exposure when smoking the same cigarette at different
times.
Methods: The study was a 3-week crossover study in which
smokers smoked their usual cigarettes during weeks 1 and 3,
and a light cigarette, with a machine-determined nicotine
yield of about 50% of the usual cigarette, during week 2.
Blood and urine biomarkers of exposure and subjective
questionnaires were collected weekly.
Results: Based on cotinine and carboxyhemoglobin levels,
compensation averaged 78% and 83%, respectively. Urinary
excretion of 4-(methylnitrosamino)-1-(3-pyridyl)-butanol, a
metabolite of the tobacco specific carcinogen 4-(methylnitro-
samino)-1-(3-pyridyl)-butanone, and a number of polycyclic
aromatic hydrocarbon metabolites was similar in all con-
ditions. Compensation was accomplished both by smoking
cigarettes more intensively and by smoking more cigarettes
per day. Exposures to various tobacco smoke constituents
while smoking the usual brand of cigarette in weeks 1 and 3
were highly correlated.
Conclusion: Our findings support the idea that smokers
compensate to a high degree when switched from their usual
brand to a light cigarette. Short-term switching resulted in no
significant reduction in carcinogen exposure. Our assess-
ment, based on measures of biochemical exposures, supports
the idea that switching to light cigarettes is unlikely to
reduce the health risks of cigarette smoking. (Cancer
Epidemiol Biomarkers Prev 2005;14(6):1376 – 83)
Introduction
Cigarette smoking is sustained by addiction to nicotine (1).
Dependent smokers tend to regulate their intake of nicotine
from day to day. When switched to cigarettes of lower
machine-determined yield, smokers on average increase their
intake of nicotine beyond that which would be expected based
on the stated (machine tested) yield (2, 3). The process of
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Acta Odontologica Scandinavica
ISSN: 0001-6357 (Print) 1502-3850 (Online) Journal homepage: http://www.tandfonline.com/loi/iode20
Oral mucosal lesions in electronic cigarettes
consumers versus former smokers
Elena Bardellini, Francesca Amadori, Giulio Conti & Alessandra Majorana
To cite this article: Elena Bardellini, Francesca Amadori, Giulio Conti & Alessandra Majorana
(2018) Oral mucosal lesions in electronic cigarettes consumers versus former smokers, Acta
Odontologica Scandinavica, 76:3, 226-228, DOI: 10.1080/00016357.2017.1406613
To link to this article: https://doi.org/10.1080/00016357.2017.1406613
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2. ORIGINAL ARTICLE
Oral mucosal lesions in electronic cigarettes consumers versus former smokers
Elena Bardellinia
, Francesca Amadoria
, Giulio Contib
and Alessandra Majoranaa
a
Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy;
b
Department of Oral Surgery, University Vita-Salute San Raffaele, Milan, Italy
ABSTRACT
Objectives: Electronic cigarettes (ECs) have become very popular in recent years. However, many
uncertainties remain about their side effects. This study aims to evaluate the prevalence and character-
istics of oral mucosal lesions (OMLs) in former smokers compared to ECs consumers.
Methods: A prospective case-control study was carried out. Outpatients for dental consultation were
consecutively enrolled into two groups based on their habits, i.e. former smokers and ECs consumers.
Each patient was examined to detect possible oral lesions and, if needed, a swab or biopsy of the
lesion was taken for diagnosis. Data was entered into a spreadsheet and analyzed.
Results: A total of 90 patients were examined, 45 were former smokers (group A) and 45 were ECs
consumers (group B). OMLs were detected in 55 cases, of which 19/55 (34.6%) belonged to group A
and 36/55 (65.4%) to group B. Nicotine stomatitis, a hairy tongue and angular cheilitis resulted to be
significantly more common among EC consumers.
Conclusions: We found no statistically significant differences in terms of total prevalence of OMLs
between former smokers and ECs consumers. An increased prevalence of three specific types of OMLs
was detected among ECs consumers.
ARTICLE HISTORY
Received 1 June 2017
Revised 17 October 2017
Accepted 6 November 2017
KEYWORDS
Smoking; oral lesion;
electronic cigarette
Introduction
Electronic cigarettes (ECs) are battery-powered, nicotine-deliv-
ery devices marketed as safe substitutes for traditional ciga-
rettes [1]. In recent years, ECs have rapidly gained popularity.
Although ECs were developed as a safer alternative to smok-
ing tobacco products, there is a growing body of evidence to
substantiate that their produced aerosols contain low levels
of toxicants and carcinogens, though generally lower than
the quantities found in conventional tobacco cigarettes [2,3].
The few existing toxicological studies investigating the cel-
lular effects of exposure to ECs’ aerosol in human bronchial
cells have produced conflicting results. Some studies seem to
indicate either no or very little toxicity from ECs in vitro [4],
while others suggest potential oxidative stress and inflamma-
tory response [5,6].
Relatively little is known about the clinical effects of the
ECs on the oral mucosa, especially on a long-term basis. This
study aims to investigate the oral mucosal lesions (OMLs) in
ECs consumers.
Materials and methods
Study population
This case-control study was performed at the Dental Clinic
of the University of Brescia, within a 2-year period, from
January 2015 to December 2016 on consecutively enrolled
patients.
The study was undertaken on former cigarettes smokers
and current EC users. Former smokers were defined as daily
or almost daily smokers, who had smoked at least 100 ciga-
rettes in their lifetime and who had quit smoking from at
least 6 months to a maximum of 2 years prior to their
involvement in the study. EC consumers considered were
those who had been smoking ECs for at least 6 months.
Inclusion criteria were: age older than 18 years, no dental
procedures in the last six months, no chronic alcoholism,
no occupational exposure to carcinogens, no history of
malignancy.
OMLs were classified following the WHO criteria [7].
Patients were examined by two calibrated clinicians (EB, FA)
under standardized conditions, with artificial lighting and
with a mouth mirror. If needed, the clinical diagnosis was
confirmed by a swab or biopsy of the lesion. Carious lesions,
endodontic lesions and periodontal lesions were excluded
from the oral lesions studied.
The following data was recorded from each patient: age,
gender, systemic chronic diseases, clinical aspects of the
OMLs and eventual histological diagnosis.
Data analysis
The data was put on a spreadsheet. A 5% level of signifi-
cance was used and the data was analyzed using RV
R
software
for Mac. Descriptive analysis, bivariate analysis and Fisher’s
test were used.
CONTACT Elena Bardellini elena.bardellini@unibs.it Dental Clinic, P.le Spedali Civili 1, 25123 Brescia, Italy
ß 2017 Acta Odontologica Scandinavica Society
ACTA ODONTOLOGICA SCANDINAVICA, 2018
VOL. 76, NO. 3, 226–228
https://doi.org/10.1080/00016357.2017.1406613
3. Ethical considerations
The research was conducted in accordance with the princi-
ples of the Declaration of Helsinki. All subjects gave a written
informed consent indicating their voluntary and anonymous
participation in the study. They completed a questionnaire
that collected demographic data and information on the con-
sumption of cigarettes/e-cigarettes, use of alcohol, exposure
to occupational carcinogens and the presence of concomi-
tant or previous systemic diseases.
Results
During the 2-year period, we consecutively enrolled former
smokers and EC consumers in order to have two numerically
similar groups. Ninety patients met the inclusion criteria, 45
were former smokers (group A) and 45 were EC consumers
(group B). Group A was composed of 23 females and 22
males (mean age 47 ± 11) while group B contained four
females and 41 males (mean age 47 ± 10). About 43.3% of
the patients (n ¼ 39) had some form of the systemic disease,
which included diabetes (n ¼ 8), hypertension (n ¼ 16), heart
disease (n ¼ 8) or HCV (n ¼ 5). The sociodemographic data is
shown in Table 1.
OMLs were detected in 55 cases, of which 34.6% (n¼ 19/55)
belonged to group A and 65.4% (n ¼ 36/55) to group B. Nine
different types of OMLs were detected. The type and distribu-
tion of the lesions are shown in Table 2.
Discussion
E-cigarettes are currently used to stop smoking or at least
reduce the consumption of traditional cigarettes. However,
the Food and Drug Administration has yet to fully regulate
the composition or given approval of the e-liquid contained
by ECs, although it has provided information about the
known side effects of such usage (e.g. congestive heart fail-
ure, cough, hypotension, and mental confusion) and defined
the common components found in these liquids [8].
There have been few studies that address the direct
health effect of EC smoking, especially regarding the oral
mucosa. A recent study [9] based on cytological examination
of scrapings from the oral mucosa in three groups of patients
(smokers, ECs smokers, and non-smokers) demonstrated that
there were no statistically significant differences in the micro-
nuclei distribution, suggesting that the use of ECs seems to
be safe for oral cells. On the other hand, Reuther et al. [10]
found that ECs may have an effect on the blood flow (meas-
ured using a laser Doppler) of the oral mucosa. The laser
Doppler measurements were expressed as arbitrary perfusion
units: a significant difference in the arbitrary perfusion units
was found with respect to the baseline capillary blood flow
after vaping with both nicotine and nicotine-free ECs.
However, the Doppler measurements were not performed in
smokers.
The pathologic effects on the oral mucosa in terms of clin-
ical OMLs have yet to be thoroughly evaluated and therefore,
to our knowledge; this is the first report describing OMLs in
ECs consumers. Before discussing the results of this study, it
should be emphasized that the study was carried out on a
small sample of patients, so the findings must be considered
preliminary.
From our results, the prevalence of total OMLs was higher
among ECs consumers, but the difference between the two
groups was not statistically significant. One of the most com-
mon lesions in both groups was smoker’s melanosis and this
was consistent with the observations made by Saraswathi
et al. [11] and Hedin et al. [12]. Polycyclic amines such as
nicotine and benzopyrenes, present in tobacco, can activate
the production of melanin by melanocytes, perhaps as a pro-
tective mechanism of the oral mucosa against tobacco
agents. Tobacco-associated melanin pigmentation has been
reported in about 22% of smokers and is dose-dependent. In
our study, the prevalence of such pigmentation was we
found no difference between the former tobacco smokers
and the EC consumers, confirming that former smokers have
a lower incidence of melanosis [13], as the cessation of
tobacco usage can be sufficient in reducing or eliminating
the pigmentation.
Table 1. Demographic characteristics of the group A (former smokers) and of
the group B (EC consumers).
Group A (n ¼ 45) Group B (n ¼ 45)
Gender
Male 22 41
Female 23 4
Mean age 47 þ 11 47 þ 10
Systemic diseases 16 23
Diabetes 3 5
Hypertension 9 7
Heart disease 2 6
HCV 2 5
Table 2. Distribution of OMLs in the group A (former smokers) and in the group B (EC consumers).
Oral mucosal lesions Group A (45) n (%) Group B (45) n (%) OR (95% CI) p Value
Melanosis 5 (11.1) 6 (13.3) 1.23 .74
Nicotine stomatitis 1 (2.2) 6 (13.3) 6.77 .04
Hairy tongue 1 (2.2) 7 (15.5) 8.11 .02
Hyperplastic candidiasis 2 (4.4) 8 (17.7) 4.65 .04
Median rhomboid glossitis 3 (6.6) 4 (8.8) 1.37 .69
Lichen planus 2 (4.4) 0 0 .15
Erythematous candidiasis 2 (4.4) 4 (8.8) 2.1 .39
Leukoplakia 2 (4.4) 1 (2.2) 2.05 .55
Hyperkeratosis 2 1
Dysplasia 0 0
Squamous cell carcinoma 1 (2.2) 0 (0) 0 .31
Total 19 36 0.42 .28
Significant, p value .05.
ACTA ODONTOLOGICA SCANDINAVICA 227
4. Regarding other OMLs, nicotine stomatitis occurred more
frequently in 6/45 EC consumers and only in 1/45 former
smokers (p ¼ .04). The many irritants, toxins and carcinogens,
found naturally in tobacco, cause the typical opacification or
keratinization of the palate seen as red dots surrounded by
white keratotic rings [14]. Although ECs do not contain as
many ingredients as conventional tobacco, they are vapor-
ized by heat starting from a liquid solution (a mixture of pro-
pylene glycol, glycerine, nicotine and flavouring) [15]. The
nicotine content in ECs varies widely among brands, typically
ranging from 0 to 34 mg/ml [16]. Emissions from ECs may
also contain fine particles of flavours, aroma transporters, gly-
cerol, propylene glycol, nicotine, trace amounts of carcino-
gens, heavy metals and other chemicals [1].
We can speculate that nicotine stomatitis in ECs consum-
ers may depend not only on the exposure of the palatal
mucosa to nicotine but also to some of these chemical com-
pounds. For instance, a recent study found that the product
characteristics of electronic nicotine delivery systems, includ-
ing flavouring, might induce inhalation toxicity, with a straw-
berry-flavoured product being the most cytotoxic [17].
Likewise, we can also interpret the high percentage of
hyperplastic candidiasis in the retrocommissural area (17.8%)
found in the group of ECs consumers (p ¼ .04). Many cross-
sectional studies show a higher prevalence of hyperplastic
candidasis among smokers while there are no data about ECs
consumers. Candidal ability to invade superficial layers of the
epithelium, aided by their hyphal appendages with tips con-
taining concentrated amounts of candidal proteinases
(secreted aspartyl proteinases [SAP]) and lipases – is optimal
at acidic pH. Several studies have shown that many protect-
ive salivary proteins such as lactoferrin, lactoperoxidase, and
immunoglobulins, especially IgA1 and IgA2, are susceptible
to degradation by candidal SAPs. We can presume that
hyperplastic candidiasis in ECs consumers could be favoured
by a pH alteration induced by the aforementioned chemical
compounds [18].
Hairy tongue resulted in a statistically greater prevalence
among EC consumers than in former smokers. There are
numerous initiating or predisposing factors for the abnormal
coating on the dorsal surface of the tongue, particularly with
smoking-associated pH changes [14]. We can speculate that
the mucosal changes may also arise from other factors, i.e.
the mucosal drying effects, the high intraoral temperatures,
intraoral pH changes, local alteration of membrane barriers
and immune responses, or altered resistance to fungal and
viral infections.
No differences in terms of precancerous OMLs (lichen pla-
nus, leukoplakia) were found between the two groups. Only
one case of squamous cell carcinoma was found on the lat-
eral surface of the tongue in a 52-year-old former smoker.
Our results show that e-cigarettes are linked to three
types of inflammatory lesions in the oral cavity. Future case-
control or cohort studies for individual lesions with larger
sample sizes are necessary to evaluate the risk for OMLs
resulting from EC habits.
Disclosure statement
No potential conflict of interest was reported by the authors.
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