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1.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-47962

RESUMEN

A venda, importação e propaganda de cigarros eletrônicos no Brasil são proibidas no Brasil por uma resolução da Anvisa, de 2009


Asunto(s)
Jurisprudencia , Sistemas Electrónicos de Liberación de Nicotina
2.
JAMA ; 324(18): 1844-1854, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33170240

RESUMEN

Importance: Electronic cigarettes (e-cigarettes) for smoking cessation remain controversial. Objective: To evaluate e-cigarettes with individual counseling for smoking cessation. Design, Setting, and Participants: A randomized clinical trial enrolled adults motivated to quit smoking from November 2016 to September 2019 at 17 Canadian sites (801 individuals screened; 274 ineligible and 151 declined). Manufacturing delays resulted in early termination (376/486 participants, 77% of target). Outcomes through 24 weeks (March 2020) are reported. Interventions: Randomization to nicotine e-cigarettes (n = 128), nonnicotine e-cigarettes (n = 127), or no e-cigarettes (n = 121) for 12 weeks. All groups received individual counseling. Main Outcomes and Measures: The primary end point was point prevalence abstinence (7-day recall, biochemically validated using expired carbon monoxide) at 12 weeks, changed from 52 weeks following early termination. Participants missing data were assumed to be smoking. The 7 secondary end points, examined at multiple follow-ups, were point prevalence abstinence at other follow-ups, continuous abstinence, daily cigarette consumption change, serious adverse events, adverse events, dropouts due to adverse effects, and treatment adherence. Results: Among 376 randomized participants (mean age, 52 years; 178 women [47%]), 299 (80%) and 278 (74%) self-reported smoking status at 12 and 24 weeks, respectively. Point prevalence abstinence was significantly greater for nicotine e-cigarettes plus counseling vs counseling alone at 12 weeks (21.9% vs 9.1%; risk difference [RD], 12.8 [95% CI, 4.0 to 21.6]) but not 24 weeks (17.2% vs 9.9%; RD, 7.3 [95% CI, -1.2 to 15.7]). Point prevalence abstinence for nonnicotine e-cigarettes plus counseling was not significantly different from counseling alone at 12 weeks (17.3% vs 9.1%; RD, 8.2 [95% CI, -0.1 to 16.6]), but was significantly greater at 24 weeks (20.5% vs 9.9%; RD, 10.6 [95% CI, 1.8 to 19.4]). Adverse events were common (nicotine e-cigarette with counseling: 120 [94%]; nonnicotine e-cigarette with counseling: 118 [93%]; counseling only: 88 [73%]), with the most common being cough (64%) and dry mouth (53%). Conclusions and Relevance: Among adults motivated to quit smoking, nicotine e-cigarettes plus counseling vs counseling alone significantly increased point prevalence abstinence at 12 weeks. However, the difference was no longer significant at 24 weeks, and trial interpretation is limited by early termination and inconsistent findings for nicotine and nonnicotine e-cigarettes, suggesting further research is needed. Trial Registration: ClinicalTrials.gov Identifier: NCT02417467.


Asunto(s)
Consejo , Sistemas Electrónicos de Liberación de Nicotina , Cese del Hábito de Fumar/métodos , Reducción del Consumo de Tabaco/estadística & datos numéricos , Tabaquismo/terapia , Adulto , Terapia Combinada , Terminación Anticipada de los Ensayos Clínicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Autoinforme , Dispositivos para Dejar de Fumar Tabaco
3.
Oral Health Prev Dent ; 18(1): 991-998, 2020 11 20.
Artículo en Inglés | MEDLINE | ID: mdl-33215490

RESUMEN

PURPOSE: This study aimed to explore self-reported oral hygiene practices (OHPs) among Hungarian adult e-cigarette-only (former smokers who switched completely to e-cigarette use or vaping) and dual users (smokers who use e-cigarettes and combustible tobacco cigarettes concomitantly). MATERIALS AND METHODS: A cross-sectional, web-based survey of 930 adult Hungarian e-cigarette users was conducted in 2015. Participants reported 10 OHPs, which were included in analyses as separate binary variables and as a composite variable of the 10 OHP items (inadequate/adequate). Chi-square test was used to explore whether separate OHPs differ by vaping status, and to examine the relationship between inadequate OHPs and past combustible or e-cigarette use characteristics. Associations between separate OHPs and vaping status, and between inadequate OHPs and vaping status were tested by multiple logistic regression analyses. RESULTS: More dual users reported toothbrushing twice a day or more than e-cigarette-only users (73.6% vs 65.3%, respectively, p = 0.041) and using sugar-free chewing gum (57.7% vs 45.8%, respectively, p = 0.006) while adequacy of other OHPs did not differ statistically significantly by vaping status. Inadequate OHPs were more typical in the sample (63.7%) than adequate OHPs, however, inadequate OHPs did not differ statistically significantly among dual users and e-cigarette-only users (62.0% vs 64.0%, respectively, OR = 1.20, p = 0.400), controlling for age, gender, education, past combustible and current e-cigarette use characteristics. CONCLUSION: In this study, both e-cigarette-only and dual users demonstrated similarly high prevalence of inadequate OHPs. Therefore dentists should educate them about effective OHPs and the role of tobacco and e-cigarette use in the development of oral diseases.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Productos de Tabaco , Adulto , Estudios Transversales , Humanos , Hungría/epidemiología , Higiene Bucal
10.
Cochrane Database Syst Rev ; 10: CD010216, 2020 10 14.
Artículo en Inglés | MEDLINE | ID: mdl-33052602

RESUMEN

BACKGROUND: Electronic cigarettes (ECs) are handheld electronic vaping devices which produce an aerosol formed by heating an e-liquid. People who smoke report using ECs to stop or reduce smoking, but some organisations, advocacy groups and policymakers have discouraged this, citing lack of evidence of efficacy and safety. People who smoke, healthcare providers and regulators want to know if ECs can help people quit and if they are safe to use for this purpose. This review is an update of a review first published in 2014. OBJECTIVES: To evaluate the effect and safety of using electronic cigarettes (ECs) to help people who smoke achieve long-term smoking abstinence. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group's Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO for relevant records to January 2020, together with reference-checking and contact with study authors. SELECTION CRITERIA: We included randomized controlled trials (RCTs) and randomized cross-over trials in which people who smoke were randomized to an EC or control condition. We also included uncontrolled intervention studies in which all participants received an EC intervention. To be included, studies had to report abstinence from cigarettes at six months or longer and/or data on adverse events (AEs) or other markers of safety at one week or longer. DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methods for screening and data extraction. Our primary outcome measures were abstinence from smoking after at least six months follow-up, AEs, and serious adverse events (SAEs). Secondary outcomes included changes in carbon monoxide, blood pressure, heart rate, blood oxygen saturation, lung function, and levels of known carcinogens/toxicants. We used a fixed-effect Mantel-Haenszel model to calculate the risk ratio (RR) with a 95% confidence interval (CI) for dichotomous outcomes. For continuous outcomes, we calculated mean differences. Where appropriate, we pooled data from these studies in meta-analyses. MAIN RESULTS: We include 50 completed studies, representing 12,430 participants, of which 26 are RCTs. Thirty-five of the 50 included studies are new to this review update. Of the included studies, we rated four (all which contribute to our main comparisons) at low risk of bias overall, 37 at high risk overall (including the 24 non-randomized studies), and the remainder at unclear risk. There was moderate-certainty evidence, limited by imprecision, that quit rates were higher in people randomized to nicotine EC than in those randomized to nicotine replacement therapy (NRT) (risk ratio (RR) 1.69, 95% confidence interval (CI) 1.25 to 2.27; I2 = 0%; 3 studies, 1498 participants). In absolute terms, this might translate to an additional four successful quitters per 100 (95% CI 2 to 8). There was low-certainty evidence (limited by very serious imprecision) of no difference in the rate of adverse events (AEs) (RR 0.98, 95% CI 0.80 to 1.19; I2 = 0%; 2 studies, 485 participants). SAEs occurred rarely, with no evidence that their frequency differed between nicotine EC and NRT, but very serious imprecision led to low certainty in this finding (RR 1.37, 95% CI 0.77 to 2.41: I2 = n/a; 2 studies, 727 participants). There was moderate-certainty evidence, again limited by imprecision, that quit rates were higher in people randomized to nicotine EC than to non-nicotine EC (RR 1.71, 95% CI 1.00 to 2.92; I2 = 0%; 3 studies, 802 participants). In absolute terms, this might again lead to an additional four successful quitters per 100 (95% CI 0 to 12). These trials used EC with relatively low nicotine delivery. There was low-certainty evidence, limited by very serious imprecision, that there was no difference in the rate of AEs between these groups (RR 1.00, 95% CI 0.73 to 1.36; I2 = 0%; 2 studies, 346 participants). There was insufficient evidence to determine whether rates of SAEs differed between groups, due to very serious imprecision (RR 0.25, 95% CI 0.03 to 2.19; I2 = n/a; 4 studies, 494 participants). Compared to behavioural support only/no support, quit rates were higher for participants randomized to nicotine EC (RR 2.50, 95% CI 1.24 to 5.04; I2 = 0%; 4 studies, 2312 participants). In absolute terms this represents an increase of six per 100 (95% CI 1 to 14). However, this finding was very low-certainty, due to issues with imprecision and risk of bias. There was no evidence that the rate of SAEs varied, but some evidence that non-serious AEs were more common in people randomized to nicotine EC (AEs: RR 1.17, 95% CI 1.04 to 1.31; I2 = 28%; 3 studies, 516 participants; SAEs: RR 1.33, 95% CI 0.25 to 6.96; I2 = 17%; 5 studies, 842 participants). Data from non-randomized studies were consistent with RCT data. The most commonly reported AEs were throat/mouth irritation, headache, cough, and nausea, which tended to dissipate over time with continued use. Very few studies reported data on other outcomes or comparisons and hence evidence for these is limited, with confidence intervals often encompassing clinically significant harm and benefit. AUTHORS' CONCLUSIONS: There is moderate-certainty evidence that ECs with nicotine increase quit rates compared to ECs without nicotine and compared to NRT. Evidence comparing nicotine EC with usual care/no treatment also suggests benefit, but is less certain. More studies are needed to confirm the degree of effect, particularly when using modern EC products. Confidence intervals were wide for data on AEs, SAEs and other safety markers. Overall incidence of SAEs was low across all study arms. We did not detect any clear evidence of harm from nicotine EC, but longest follow-up was two years and the overall number of studies was small. The main limitation of the evidence base remains imprecision due to the small number of RCTs, often with low event rates. Further RCTs are underway. To ensure the review continues to provide up-to-date information for decision-makers, this review is now a living systematic review. We will run searches monthly from December 2020, with the review updated as relevant new evidence becomes available. Please refer to the Cochrane Database of Systematic Reviews for the review's current status.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Nicotina , Agonistas Nicotínicos , Cese del Hábito de Fumar/métodos , Prevención del Hábito de Fumar , Sesgo , Estudios de Cohortes , Humanos , Persona de Mediana Edad , Nicotina/administración & dosificación , Agonistas Nicotínicos/administración & dosificación , Sesgo de Publicación , Ensayos Clínicos Controlados Aleatorios como Asunto , Fumar/epidemiología , Cese del Hábito de Fumar/estadística & datos numéricos , Dispositivos para Dejar de Fumar Tabaco , Vapeo
11.
Praxis (Bern 1994) ; 109(13): 1063-1069, 2020.
Artículo en Alemán | MEDLINE | ID: mdl-33050810

RESUMEN

Vaping-Associated Pulmonary Illness Abstract. Electronic cigarettes are hand-held devices used to vaporize liquids by heating and thus allowing inhalation of aerosols. Recently, cases of patients have been published which presented with a syndrome associated with e-cigarette consumption, also known as vaping. The syndrome designated 'vaping-associated pulmonary illness' (VAPI) features either isolated respiratory, or combined respiratory gastro-intestinal or constitutional symptoms. VAPI can be rapidly progressive and lead to severe respiratory failure requiring intensive care treatment. Despite the as yet very incomplete understanding of the causative agents and pathogenesis we review the current knowledge of the clinical, pathological and radiological aspects in VAPI and summarise the current therapeutic strategies.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Enfermedades Pulmonares , Vapeo , Humanos , Pulmón , Enfermedades Pulmonares/etiología , Vapeo/efectos adversos
12.
Medicine (Baltimore) ; 99(40): e22514, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33019453

RESUMEN

Despite the controversy surrounding electronic cigarette (e-cigarette) safety, global consumption has been rapidly increasing. We investigated the relationship between e-cigarette use and mental health conditions in adults of various ages.We conducted a secondary data analysis of adults aged 19 to 80 who participated in the first year of the 7th Korea National Health and Nutrition Examination Survey (2016). The total number of participants was 5469, including 3398 non-smokers, 1700 smokers who had never used e-cigarettes, and 371 smokers who had previously used e-cigarettes, selected based on self-report questionnaires. Mental health factors including stress status, depressive mood, suicide plan, and suicide attempt were assessed by self-reported questionnaire. The Patient Health Questionnaire (PHQ-9) was used to assess depressive mood, with a cut-off value of 10. The relationship between e-cigarette use and stress status with depressive mood were analyzed with adjustment for potential confounders.Both male and female smokers who previously used e-cigarettes showed higher levels of stress than non-smokers or smokers who had never used e-cigarettes. The average PHQ-9 score was higher among previous e-cigarette-using smokers relative to non-smokers and smokers who had never used e-cigarettes, regardless of gender. The number of participants with depressive mood was significantly higher in the group of smokers who previously used e-cigarettes. In multivariable-adjusted logistic regression analyses, there was a significantly higher odds ratio for higher stress in male smokers who had previously used e-cigarettes and for depressive mood in female smokers who had previously used e-cigarettes, compared with non-smokers.This study analyzed the association between adult e-cigarette use and mental health conditions, including stress and depressive mood, and showed that e-cigarette use was significantly related to both conditions in men and women.


Asunto(s)
Depresión/epidemiología , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Salud Mental/estadística & datos numéricos , Estrés Psicológico/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , República de Corea/epidemiología , Intento de Suicidio/estadística & datos numéricos , Adulto Joven
13.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-47895

RESUMEN

Desde o começo da pandemia da Covid-19, médicos e especialistas da área da saúde vêm alertando para o fato de que pessoas que fumam – tanto cigarros convencionais quanto eletrônicos – provavelmente estariam mais suscetíveis a complicações da doença


Asunto(s)
Tabaquismo , Sistemas Electrónicos de Liberación de Nicotina , Infecciones por Coronavirus
14.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-47846

RESUMEN

Dois estudos, publicados nesta quarta pela Escola de Medicina da Universidade da Califórnia, em San Diego (EUA), questionam a prática de vaping (hábito de fumar cigarros eletrônicos) como estratégia eficaz para que fumantes deixem o vício


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Tabaco , Vapeo
15.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-47853

RESUMEN

Estudo da Universidade Stanford feito com mais de 4 mil norte-americanos com idades entre 13 e 24 anos alerta para os perigos do vape em tempos de pandemia


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Infecciones por Coronavirus , Adolescente
16.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-47855

RESUMEN

Cigarros eletrônicos e tabaco aquecido são produtos de tabaco e devem obedecer às mesmas regras


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Tabaco , Organización Mundial de la Salud
17.
Mutat Res ; 856-857: 503230, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32928375

RESUMEN

This work investigates a completely novel and experimental concept of exposing L5178Y cells at the air-agar-interface to mainstream cigarette smoke aerosol (Kentucky reference 3R4F). This study highlights the associated challenges of combining a suspension cell line alongside an in vitro aerosol exposure system. To achieve a monolayer, cells were 'seeded' in a concentrated cell super-mix suspension onto an RPMI/agar-matrix -base. The resulting cell suspension media was adsorbed into the agar base leaving the L5178Y cells lightly suspended on the agar surface, approximating a monolayer. Cells were deemed supportable on the agar-matrix, viable and recoverable. Using Vitrocell VC 10 exposure system and the Ames 4 exposure module, L5178Y cells were successfully exposed to a dynamic cigarette smoke aerosol, recovered and assessed for mutant frequencies, using standard assay procedures. Method development included assessment of flowing air conditions, plating efficiency and recovery of L5178Y cells from the agar-matrix surface. Positive controls MMS and B[a]P were successfully incorporated into the agar-matrix and metabolic activation was achieved by S-9 incorporation into the same agar-base-matrix. B[a]P demonstrated metabolic activation and positive response, suggesting a clear cellular interaction with the agar-matrix. Whole smoke exposed cells in the presence of metabolic activation showed a clear dose response and increasing mutant frequencies, well in excess of the controls (air and incubator) and the global evaluation factor following a 2 or 3 day expression period. This experimental concept demonstrates that L5178Y cells can be exposed to cigarette smoke aerosol, using a completely novel and a previously untested approach. Although this work successfully demonstrates the approach is viable and cells can be plated and maintained on an agar-matrix, more optimisation and robustness assessment is required before it can be considered fully adapted and used alongside other whole aerosol methodologies for the assessment of cigarette smoke and other inhaled aerosols.


Asunto(s)
Linfoma/patología , Pruebas de Mutagenicidad , Mutágenos/toxicidad , Humo/efectos adversos , Aerosoles/farmacología , Aerosoles/toxicidad , Agar/química , Aire , Animales , Línea Celular/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Sistemas Electrónicos de Liberación de Nicotina , Humanos , Linfoma/inducido químicamente , Ratones , Mutágenos/farmacología
18.
Artículo en Inglés | MEDLINE | ID: mdl-32882887

RESUMEN

The growth of the fitness industry observed in the last decade has been accompanied by the emergence of an occupation as a social media fitness influencer. The most popular are able to accumulate millions of followers. The marketing potential of fitness influencers is a subject of interest, not only for the fitness industry but also for other sectors offering products related to health, wellness, or healthy nutrition. However, the activities of fitness influencers related to the promotion of physical activity and healthy lifestyle converge with the aims of those promoting public health. The main objective of this study was to make an assessment of the determinants of regular access to fitness influencers' sites (FIS) and their relationship with the health behaviors of young adult women. It was based on the data originating from an online survey on a representative sample of Polish women aged 18-35 years. Chi2 test, univariate, and multiply logistic regression models were used to determine the relationships between FIS and the variables related to the respondents' characteristics of and their health behaviors. FIS were accessed by 29.3% of respondents (n = 1030) at least once a week. It was found that those living in cities with a population ranging from 20,000 to 100,000 were more likely to access FIS than those living in rural areas. Similarly, greater access was made by those in a high-income household rather than those with the lowest income, by those with inadequate rather than those with problematic health literacy and by those with high rather than low e-health literacy. The use of FIS was significantly associated with the consumptions of fruit and vegetables (OR, 95%CI: 2.77, 2.01-3.82), physical activity (1.74, 1.27-2.38), breast self-examination (1.54, 1.11-2.13), and also with the greater use of e-cigarettes (1.63, 1.09-2.43) and increased consumption of alcohol (1.37, 1.01-1.88). In conclusion, as access to Internet resources run by fitness influencers was a prevailing predictor of young adult Polish women's health behaviors, FIS may play a potentially important role in promoting a healthy lifestyle in this population. However, it should be remembered that there are complex patterns of associations with specific behaviors, e.g., the use of e-cigarettes or alcohol consumption.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Conductas Relacionadas con la Salud , Medios de Comunicación Sociales , Adolescente , Adulto , Consumo de Bebidas Alcohólicas , Estudios Transversales , Ejercicio Físico , Femenino , Humanos , Relaciones Interpersonales , Polonia , Adulto Joven
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