The Co-occurrence of Specialty Vape Shops, Social Disadvantage, and Poor Air Quality in the United States: An Assessment of Cumulative Risks to Youth.

Introduction: We conducted a cumulative environmental health risk assessment of whether specialty vape shops and poor air quality are more likely to co-occur in socially disadvantaged neighborhoods where racial/ethnic minority youth live. Methods: We examined the population-adjusted incidence of specialty vape shops in relation to youth race/ethnicity, neighborhood socioeconomic status (SES), and air quality (nitrogen dioxide [NO2]) at the census tract level across the conterminous United States for 2018. Results: We did not find disparity in vape shop incidence related to minority youth race/ethnicity. Vape shop incidence was significantly negatively associated with all the youth race/ethnicities examined. The two lowest SES quintiles had nearly double the rate of specialty vape shop incidence compared with the highest SES quintile. Specialty vape shop incidence increased with NO2 concentration, with more vape shops in poor air quality neighborhoods. Conclusions: Specialty vape shops are disproportionately present in neighborhoods with poor air quality and where socially disadvantaged youth live. The increased incidence of vape shops in poor air quality neighborhoods, particularly in an urban context with increased traffic emissions, further points to potentially disproportionate impacts on disadvantaged populations due to cumulative social and environmental risks. This raises environmental justice and health equity concerns. Retailer-focused strategies aimed at limiting youth exposure to electronic cigarettes' labeling and advertising, preventing sales to minors, and limiting the number of retailers in low-SES neighborhoods may reduce initiation and help prevent tobacco-related health disparities among youth.

Testing of a commercial waterpipe electric heater and a research-grade waterpipe electric heater.

INTRODUCTION: The capability of a commercial waterpipe electric heater to simulate the waterpipe charcoal heating system using waterpipe tobacco consumption as a metric was evaluated, and a research-grade waterpipe electric heater to standardize waterpipe tobacco emission testing was designed. METHODS: The experiment was conducted in two phases. In Phase 1, tobacco was heated using either charcoal or a commercial electric heater. The tobacco temperature was recorded during a 57-minute machine-smoking session and tobacco consumption was measured. In Phase 2, a similar procedure was followed using a novel research-grade electric heater. RESULTS: In Phase 1, tobacco consumption using either charcoal or the commercial electric heater averaged 31.35% and 20.56%, respectively. In Phase 2, tobacco consumption using the research-grade electric heater, set at target temperatures of 470, 430, 400, 380, 370 and 350°C, averaged 55.74, 41.22, 40.18, 39.10, 31.57 and 26.14%, respectively. CONCLUSIONS: The commercial electric heater did not reach consumption levels seen in the charcoal heating system, whereas the research-grade electric heater did and can be used as part of a standardize waterpipe tobacco emission testing regimen.