Electronic Nicotine Delivery Systems (ENDS) are methods of delivering nicotine without combustion, which happens in cigarettes. These devices consist of a heating element, a battery, and a tank which stores eliquid. Over the years these devices have become more powerful, and capable of increased delivery of nicotine. There is a large variety of flavors and devices, which causes trouble for standardized studies. These devices were created to help cigarette users quit smoking; however, they are associated with significant dual use. ENDS produce lower levels of most toxic chemicals when compared to cigarettes, and significantly increased levels when compared to not smoking. Newer generation ENDS have capabilities of producing levels of reactive oxygen species and carbonyl compounds at levels similar to cigarettes. ENDS use has detrimental effects on the genome, immune system, and lung function due to exposure from these chemicals. These effects are at lower levels when compared to cigarette use. Chronic ENDS use has been associated with chronic obstructive pulmonary disorder (COPD), with an even higher association with dual use. ENDS use also causes DNA adduct formation, and activates protein kinases, nicotine acetylcholine receptors and other pathways for lung cancer as cigarette use. The full health effects of ENDS use are still unknown, from the currents studies it is clear that its use is not without harm.

Electronic cigarette (ECIG) users can manipulate several device features including liquid nicotine concentration (mg/ml) and heating coil resistance (Ohms). One class of ECIG models, called “sub-Ohm” devices, use coils with a resistance of < 1 Ohms, lower than those observed in conventional ECIGs (e.g., ≥ 1.5 Ohms). Increasing voltage or decreasing coil resistance increases device power. Given that ECIG coil resistance and liquid nicotine concentration have not been manipulated systematically and simultaneously in clinical laboratory studies, the influence of these factors on ECIG acute effects remain unclear. The primary purpose of this study was to examine the influence of coil resistance and liquid nicotine concentration on nicotine delivery, heart rate (HR), subjective effects, puff topography, and liquid consumption. Thirty-two experienced ECIG users completed four independent laboratory sessions that differed by coil resistance (0.5Ohm or 1.5Ohm ) and liquid nicotine concentration (3 or 8 mg/ml). In each session, participants used a 4.5 V “Kanger SUBOX” loaded with 3.5 ml ECIG liquid in a 10-puff directed and 60-minute ad libitum bout. Nicotine delivery was greatest when using 8 mg+0.5Ohm combination and lowest when using the 3 mg/ml+1.5Ohm combination and HR followed a similar pattern. Abstinence symptom suppression was most pronounced for the 8 mg+0.5Ohm combination and least pronounced for the 3 mg/ml+1.5Ohm combination. Participants provided the highest ratings for pleasantness, satisfaction, and liking of harshness/irritancy and throat hit sensations for the 3 mg+0.5Ohm combination. Overall, use of ECIGs filled with 3 mg/ml nicotine concentration resulted in longer/larger puffs, increased puff frequency, and greater consumption of ECIG liquid. ECIG coil resistance, liquid nicotine concentration, and user puff topography, all of which influence ECIG nicotine delivery, should be considered together when making regulatory decisions aimed at protecting public health.

Introduction As e-cigarette use increases, questions about individual and public health effects remain unanswered (e.g. cessation tool, addiction path). Despite increasing use, few studies have focused on vape shop patrons. This study examined whether vape shop patrons believe their health is affected by the use of e-cigs; more specifically, the aim was to evaluate the association between e-cig use, change in tobacco use, and perception of health. Methods A survey of e-cig users (N=78) was conducted in vape shops. Questions included e-cig and traditional tobacco use, health perceptions, and demographics. Descriptive techniques were used to characterize participants as either those who perceived e-cig use improved their health or those who perceived their health unaffected. Logistic regression assessed the association between change in tobacco use, e-cig use, and perception of health effects. Results Most reported daily e-cig (91%) and current (11.5%) or former (78.2%) combustible cigarette use. Approximately, three-fourths (76.9%) perceived better health; the remainder (23.1%) perceived unaffected health. Change in cigarette use was significantly associated with perceptions that health is better with e-cig use. Participants who decreased cigarette use by 2-3 cartons/month and more than 3 cartons/month were significantly more likely to indicate that e-cig use has improved their health compared to those who decreased tobacco use by 1.5 cartons or fewer per month (OR=4.35, 95% CI: 1.13-16.9; OR=25.67, 95% CI: 2.97-221.7, respectively). Conclusions The majority of e-cig users perceived better health. Our findings suggest that health campaign designers should carefully assess the scientific uncertainty surrounding the use of these devices and consider means to clearly convey this information. Given the lack of scientific agreement on the health effects of e-cigs and the important role that perceptions play in behavior, health campaign designers, health education practitioners, policy makers, and health care providers should err on the side of caution when advising individuals about e-cig use.

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ABSTRACT Background: Electronic cigarettes are used to deliver nicotine to consumers. E-cigarettes are claimed to be an alternative method for smoking cessation. The use of electronic cigarettes is increasing among young people, especially current and former smokers. It is unknown what the harm or benefit that result from e-cigarettes’ use of the individuals on the well-being. Purpose: This study was conducted to explore the prevalence of e-cigarettes use and exposure among college-based health care students. Also to assess the awareness level and beliefs in regard to electronic cigarettes use among the college-based health care students. Methods: 217 college-based health care undergraduate students from nursing, nutrition and respiratory therapy programs were surveyed in this study. The survey was composed of 17 questions in regards to the awareness, prevalence of e-cigarettes use and beliefs about e-cigarettes use. The data analysis included descriptive statistics, independent sample t-test and one-way ANOVA. A significance level was set at 0.05. Results: The response rate was 98.1%, 87% of the respondents were female and 70% were between the ages of 19-25 years. Most of the respondents were nursing students (47.5%); followed by nutrition students (29.5%); and respiratory therapy students (23%). Most of the respondents were non-smokers (83.4%); former smokers were 13.8%; and smokers were 2.8%. Almost all the respondents had heard of e-cigarettes (99.5%), and 21.2% had tried e-cigarettes at least once in their lifetime. The mean awareness score was 5.1 (SD 0.11); smokers showed the highest mean awareness score of 6.0±2.28. The majority of the participants disagreed that e-cigarettes are less dangerous than traditional cigarettes or can help smokers to quit; and more than half of the participants disagreed that e-cigarettes are used only by smokers. There was a significant difference among male (5.71±1.51) and female (5.03±1.71) in regards to the e-cigarettes awareness level (p=0.047). The awareness level was significantly different among respondents who had previously used e-cigarettes (5.63±1.49) than participants who have not tried e-cigarettes at least once during their lifetime (4.98±1.72) (p=0.021) Conclusion: This study found that most of the students in the college of nursing and health professions were not e-cigarettes’ users. People who have tried e-cigarettes, have friends who have tried e-cigarettes as well. Furthermore, curiosity is the major reason that led them to try e-cigarettes. E-cigarettes’ awareness is high among smokers and e-cigarettes’ users; older students seem to have higher awareness than younger students. There were general disagreements on the use of e-cigarettes as a less dangerous alternative to tobacco cigarettes to help smokers to quit. Finally, male and female participants showed significant differences in their awareness of e-cigarettes.

Anotation The Master's degree thesis Trends in the use of electronic cigarette in the population of smokers of tobacco products provides a pilot research and analysis of the use of electronic cigarette in the current population of smokers in the Czech Republic. Furthermore, it presents the most common motivation patterns of its consumption among tobacco smokers. To this purpose, the author developped her own questionnaire addressed to a predefined sample of respondents. The first, theoretical part of the thesis is dedicated to analysis of tobacco and nicotine and their effects on human health. Further, the thesis focuses entirely on the analysis of electronic cigarette. The practical part is based on a questionnaire designed and distributed by the author herself directly or through the internet among 105 respondents. The target group are smokers of tobacco products between 25 and 55 years old living in the Czech Republic who have pasively or actively had a contact with electronic cigarette. This is to determine the common attitudes towards the electronic cigarette and analyse the current trends in its use in the population of smokers. The second part of the thesis offers a detailed evaluation of the results of the questionnaire obtained through the answers of 105 respondents, their motivations for its use...

Electronic cigarettes have grown in popularity across the U.S. and concerns have been raised about their abuse liability. The purpose of the current study was to evaluate and compare the abuse liability of an electronic cigarette with and without nicotine to a nicotine inhaler (the Nicotrol inhaler) and participants’ own brand of cigarettes. A total of 24 smokers attended four sessions in which the abuse liability of each product was examined using the Multiple-Choice Procedure (MCP), nicotine delivery, nicotine abstinence symptom suppression, and subjective reinforcing effects. Results revealed that the nicotine containing and non-nicotine containing electronic cigarette had a higher reinforcing efficacy on the MCP than the nicotine inhaler, but on average had a lower reinforcing efficacy than participants own brand of cigarettes. The nicotine containing electronic cigarette delivered nicotine to participants in amounts that did not differ significantly from participants’ own brand of cigarettes. The electronic cigarette with nicotine reduced nicotine abstinence symptoms to a greater degree than the electronic cigarette without nicotine, and both electronic cigarettes were rated as subjectively more reinforcing than the inhaler but less reinforcing than participants’ own brand of cigarettes. In sum, the results from this study suggest that the electronic cigarette examined had a moderate level of abuse liability that was higher than an FDA-approved nicotine inhaler but lower than traditional cigarettes. Furthermore, findings also suggest that electronic cigarette abuse liability may extend beyond factors related to nicotine delivery.

The thesis topic bears the name: "Aspect of smoking among students of high medical schools". Smoking is one the most often appearing drug addictions nowadays in Europe. With reference to the World Health Organization, there are 1.3 billion of smoking people in the world today whereas consequences of smoking kill approximately 4.8 million of people every year, which are 560 people each hour. If the current trend continues, then in the current pace 10 million of people will die of the consequences of cigarette smoking during the year of 2020. Smoking invokes an enormous addiction to nicotine which bears itself considerable economic, social and health problems. There were some students from 1st and 4th grade of the present form of studies of all high medical schools selected. Those were students particularly from the schools: SZŠ and VOŠZ České Budějovice, SOŠZ and SOU Český Krumlov, SZŠ Jindřichův Hradec, SZŠ Tábor and SZŠ Písek. In total, 591 of students were responded whereas most of them were girls (87%). The average age of the responded ones was 17 years. The thesis consists of theoretical and empirical parts. The theoretical part deals with history of cigarette smoking, a definition of drug addiction, chemical composition of cigarette smoke and malignity of individual toxic elements. Further, there is a chapter concerning problem issues of electronic cigarette smoking in the theoretical part. In the conclusion of this part of the thesis, there are some statistical data referring to cigarette smoking stated. There are some findings of quite a few of authors dealing with problem issues of cigarette smoking and addiction to nicotine summarized here. The empirical part consists of findings from my own research analysis which was done with the intention to map the prevalence of smoking among future health workers and their opinion to cigarette smoking among healthcare staff and people preparing for their healthcare career. There are also the respondents' opinions and attitudes included. The aim of the thesis was: 1.: To find the prevalence of smoking of 1st and 4th grade of high medical schools students. 2.: To find what influence the respondents' surroundings have on the fact of their smoking. 3.: To find what attitude high medical school students have to healthcare staff smoking cigarettes. To reach the above mentioned aims, there were three hypotheses determined: H1: There is a statistically significant difference existing in the prevalence of smoking at 1st and 4th grade of high medical school students. H2: There is a statistically significant difference existing in the prevalence of cigarette smoking among students coming from families where at least one member smokes. H3: There are statistically significant differences in the attitude of 1st and 4th grade students to cigarette smoking among healthcare workers. To prove or disprove the mentioned hypotheses there is a method of quantitative research selected. A questionnaire was used to collect the data. The questionnaires including 23 questions were distributed among 591 students of high medical schools of the South Bohemia Region. Their rate of return was 85%. The collected data were processed in the form of transparent graphs and the hypotheses were statistically tested. Pursuant to the evaluation of respondents' answers including the statistical data testing were proved by the hypothesis which presumed that there were statistically significant differences in the prevalence of cigarette smoking 1st and 4th grade students. The difference really exists that the 4th grade students smoke more often. It is interesting that the most considerable difference is between the schools of SZŠ and VOŠZ České Budějovice. On the contrary, the percentage of smoking students of SOŠZ Český Krumlov in the 1st grade is considerably high. Hypothesis no. 2 was statistically proved as well. There is a real significant difference exist

The increase in use of e-cigarettes in adolescents is a major public health concern that must be addressed. Research studies showed some e-cigarettes contained varying amounts of nicotine and sever cancer-causing chemicals. The purpose of this quantitative, cross-sectional study was to assess the perception of harm (dependent variable) from using e-cigarettes and being exposed to state and school-based antitobacco programs (independent variable) and to determine if the association was modified by socioeconomic status or area of residence. Attitude-social influence-self-efficacy theory was the chosen theory for research and suggests that attitude, social influence, and self-efficacy variables can be persuaded via specific health promotion activities. Texas students enrolled in 6th to 12th grade of an eligible school who voluntarily consented to participate and received written authorization from a parent were included. Nearly half of participants out of N=9,239 adolescents considered e-cigarettes very dangerous, yet more than half reported using the device. Ordinal logistic regression was used to determine the relationship between the independent and dependent variables. The results concluded that though majority of adolescents perceived e-cigarettes as harmful, exposure to state and school antitobacco programs are not completely effective at discouraging use. The findings of the study may provide potential impact for positive social change for adolescents and tobacco cessation by increasing understanding of what factors are associated with increased/decreased perception of harm. Results of the study may encourage public health professionals to create and disseminate tailored antitobacco educational information including school and state activities and resources.

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