Solicitud de embargo por publicación en revista indexada. / Antecedentes: El uso de cigarrillos electrónicos ha aumentado en los últimos años en el Perú, los cuales en conjunto con el tabaco aumentan la exposición de los jóvenes a nicotina. La marihuana es la droga ilícita mas consumida por los jovenes en el Perú. Objetivo: Identificar la asociación entre uso de cigarrillo electrónico y/o tabaco en la vida con consumo de marihuana en los últimos 12 meses. Material y métodos: Estudio transversal analítico secundario al III Estudio epidemiológico andino sobre consumo de drogas en la población universitaria de Perú, 2016 (EEACDU). Se realizó un análisis multivariado utilizando un modelo lineal generalizado de la familia y opción de enlace log Poisson, presentándose en forma de PR. Participantes: Estudiantes universitarios con criterios de selección (n=3981).Exposición: Consumo de cigarrillo electrónico y/o tabaco sobre la base de preguntas acerca de consumo de tabaco y cigarro electrónico en la vida, categorizándose en solo cigarrillo electrónico, solo tabaco, ambos o ninguno. Variable resultado: Consumo de marihuana en los últimos 12 meses. Resultados: La prevalencia de uso de cigarrillo electrónico y tabaco en la vida fue de 10.1%; de solo cigarrillo electrónico en la vida, de 1.2%, y de consumo de marihuana en los últimos 12 meses, de 5.2%. Aquellos con uso dual tuvieron 40.34 veces la probabilidad de consumir marihuana en los últimos 12 meses (PR 40.34 IC95: 14.76 a 110.25, p <0.001) en comparación con los que no consumieron ninguno. Los que consumieron solo tabaco tuvieron 23 veces la probabilidad de consumir marihuana en los últimos 12 meses (PR 23.12 IC95: 8.43 a 63.35, p <0.001) en comparación con los que no consumieron ninguno. Conclusiones: Se encontró un aumento de probabilidad de consumo de marihuana en los últimos 12 meses en aquellos estudiantes universitarios que reportaron uso de cigarrillo electrónico y tabaco en la vida, así como entre los que reportaron uso exclusivo de tabaco. / Background: The electronic cigarettes use has gained populatiry in the last years, and together with tobacco use, they increase the nicotine exposure. Cannabis is the most consumed illicit drug by the young population in Perú. Objective: To identify the association between the use of electronic cigarettes and/or tobacco in life with the cannabis use in the last 12 months. Methods: An analytical cross-sectional study was developed secondary to the III Andean Epidemiological Study on Drug Consumption in University Students, 2016. A multivariate analysis was performed using a generalized linear model of the family and the log Poisson link option. Participants: University students (n=3981).Exposure: Electronic cigarette and/or tobacco consumption based on questions about consumption of tobacco and electronic cigarette in life, being categorized into only electronic cigarette, only tobacco, both or neither.Outcome: Cannabis use in the last 12 months. Results: Of the total number of university students who met the inclusion criteria (n = 3981), the lifetime prevalence of electronic cigarettes and tobacco (dual) use was 10.1% and 1.2% for electronic cigarettes. Cannabis use in the last 12 months was 5.2%. Those with dual use had forty times the probability of using cannabis in the last 12 months (PR 40.34, CI95: 14.76 to 110.25, p <0.001) compared to those who used none, and those who used only tobacco had twenty-three times the probability of using cannabis in the last 12 months (PR 23.12, CI95: 8.43 to 63.35, p <0.001) compared to those who consumed none. Conclusions: An increase in the probability of cannabis use in the last 12 months was found in those university students who reported dual use of electronic cigarettes and tobacco in life, and also in those who reported exclusive use of tobacco. We didn’t find an increased probability of cannabis use in the last 12 months among the electronic cigarettes only users. / Tesis

Monocytes exhibiting a pro-inflammatory phenotype play a key role in adhesion and development of atherosclerotic plaques. As an alternative to smoking, next-generation tobacco and nicotine products (NGP) are now widely used. However, little is known about their pro-inflammatory effects on monocytes. We investigated cell viability, anti-oxidant and pro-inflammatory gene and protein expression in THP-1 monocytes after exposure to aqueous smoke extracts (AqE) of a heated tobacco product (HTP), an electronic cigarette (e-cig), a conventional cigarette (3R4F) and pure nicotine (nic). Treatment with 3R4F reduced cell viability in a dose-dependent manner, whereas exposure to alternative smoking products showed no difference to control. At the highest non-lethal dose of 3R4F (20%), the following notable mRNA expression changes were observed for 3R4F, HTP, and e-cig respectively, relative to control; HMOX1 (6-fold, < 2-fold, < 2-fold), NQO1 (3.5-fold, < 2-fold, < 2-fold), CCL2 (4-fold, 3.5-fold, 2.5-fold), IL1B (4-fold, 3-fold, < 2-fold), IL8 (5-fold, 2-fold, 2-fold), TNF (2-fold, 2-fold, < 2-fold) and ICAM1 was below the 2-fold threshold for all products. With respect to protein expression, IL1B (3-fold, < 2-fold, < 2-fold) and IL8 (3.5-fold, 2-fold, 2-fold) were elevated over the 2-fold threshold, whereas CCL2, TNF, and ICAM1 were below 2-fold expression for all products. At higher doses, greater inductions were observed with all extracts; however, NGP responses were typically lower than 3R4F. In conclusion, anti-oxidative and pro-inflammatory processes were activated by all products. NGPs overall showed lower responses relative to controls than THP-1 cells exposed to 3R4F AqE.