Short-term respiratory effects of e-cigarettes in healthy individuals and smokers with asthma.

BACKGROUND AND OBJECTIVE: This study investigated the duration of immediate respiratory effects of e-cigarette smoking (ECS) and tested the hypothesis that ECS has more prominent effects in asthmatics compared with healthy smokers (HS). METHODS: Fifty-four smokers, 27 healthy (HS group) and 27 with intermittent asthma (mild asthma (MA) group) underwent a control session (no liquid, no resistor coil inside e-cigarette cartridge) and an experimental session of ECS using standardized puffing settings. Impulse oscillometry impedance (Z), resistance (R), reactance (X) and fractional exhaled nitric oxide (FeNO) were measured before and 0, 15 and 30 min after control and experimental sessions. RESULTS: Control session revealed no significant changes. In the experimental session, immediately post-ECS, both groups exhibited a significant increase in respiratory system total impedance at 5 Hz (Z5) (P < 0.001), respiratory system resistance at 5 Hz (R5) (P < 0.001), respiratory system resistance at 10 Hz (R10) (P < 0.001), respiratory system resistance at 20 Hz (R20) (P < 0.05), resonant frequency (P < 0.001) and reactance area (P < 0.05). MA exhibited higher baseline values and a more prominent effect immediately after ECS compared with HS for Z5 (P = 0.022), R5 (P = 0.010) and R10 (P = 0.013). FeNO decreased significantly in both groups (P < 0.001); HS returned to baseline values in ≤15 min while the MA maintained significantly lower values for an additional 15 min (P < 0.05) and returned to baseline values at 30 min post-ECS. CONCLUSION: A single session of ECS had respiratory mechanical and inflammatory effects, which were more prominent in smokers with asthma.

Passive exposure to e-cigarette emissions: Immediate respiratory effects.

INTRODUCTION: The present work examined the effect of passive exposure to electronic-cigarette (e-cigarette) emissions on respiratory mechanics and exhaled inflammatory biomarkers. METHODS: A cross-over experimental study was conducted with 40 healthy nonsmokers, 18-35 years old with normal physical examination and spirometry, with body mass index <30 kg/m2, who were exposed to e-cigarette emissions produced by a smoker, according to a standardized protocol based on two resistance settings, 0.5 ohm and 1.5 ohm, for e-cigarette use. All participants underwent a 30-minute control (no emissions) and two experimental sessions (0.5 and 1.5 ohm exposure) in a 35 m3 room. The following Impulse Oscillometry (IOS) parameters were measured at pre and post sessions: impedance, resistance, reactance, resonant frequency (fres), frequency dependence of resistance (fdr=R5-R20), reactance area (AX), and fractional exhaled nitric oxide (FeNO). Differences between pre and post measurements were compared using t-tests and Wilcoxon signed rank tests, while analysis of variance (ANOVA) was used for comparisons between experimental sessions (registered under ClinicalTrials.gov ID: NCT03102684). RESULTS: IOS and FeNO parameters showed no significant changes during the control session. For IOS during the 1.5 ohm exposure session, fres increased significantly from 11.38 Hz at baseline to 12.16 Hz post exposure (p=0.047). FeNO decreased significantly from 24.16 ppb at baseline to 22.35 ppb post exposure in the 0.5 ohm session (p=0.006). CONCLUSIONS: A 30-minute passive exposure to e-cigarette emissions revealed immediate alterations in respiratory mechanics and exhaled biomarkers, expressed as increased fres and reduced FeNO.

Relation between individual factors and support for smoking bans in bars in Greece: A cross-sectional study of the 2013 Global Adult Tobacco Survey (GATS).

INTRODUCTION: Smoking rates among the general population and among youth are decreasing in Greece. Low compliance with smoke-free legislation in indoor places in Greece renders non-smokers exposed to secondhand smoke, especially when frequenting bars. The aim of the current study was to identify the factors related to support for smoking bans in bars in Greece. METHODS: A cross-sectional secondary data analysis was conducted on the 2013 Greek Global Adult Tobacco Survey. Multivariate regression was used to analyze individual factors and their relation to support for the smoking ban in bars. The total sample was nationally representative of the Greek population and included 3961 residents over the age of 15 with 2061 supporting a ban in bars. RESULTS: Overall, 50.5% (95% CI: 46.5-54.4) of Greeks supported the smoking ban in bars. Among them, 1,832 (74.9%, 95% CI=70.1-79.1) were non-smokers and 229 (13.7%, 95% CI=10.6-17.5) were smokers. Age over 65 years was significantly related to increased support for the smoking ban in bars compared to those aged 15-24 years (p<0.05). Belief that secondhand smoke causes lung cancer was significantly related (p<0.001) to having increased support for the ban. Increased knowledge of smoking-related harm was significantly related to increased support for the ban in bars (p<0.001). Male non-smokers were significantly less likely to support the ban in bars than females (p<0.05). CONCLUSIONS: Increasing knowledge and awareness of smoking-related harm will enhance smoking ban support and compliance, improving tobacco prevention and cessation, especially among the youth and young adults.