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Nicotine Addiction

E-cigarette exposure in children rises 1400% in pediatrics study, vaping industry feels the FDA heat

E-cigarette exposure in children rises 1400 percent in pediatrics study, even as vaping industry feels the heat from the FDA. There has been a long-running debate on whether vaping and the use of e-cigarettes is a safer alternative to traditional tobacco cigarettes. Unfortunately, the answer is yet to be known, as e-cigarettes are still a new phenomenon and research is lagging behind the instant craze of vaping. Between 2011 and 2012, the number of teens and tweens using these products has doubled, so there has been a strong push to obtain as much information as possible regarding this style of smoking.

E-cigarettes mimic traditional cigarettes as their end glows on the inhale and a cloud of smoke follows on the exhale. Inside an e-cigarette, there is a battery, a heating element, and a cartridge that holds nicotine and other liquids and flavorings.

If nicotine is used, then e-cigarettes are still addicting, and quitting e-cigarettes with nicotine can yield similar withdrawal symptoms. Some evidence supports the argument that e-cigarettes may be safer than traditional cigarettes, but other research shows they pose a risk, especially in those with heart problems. Although research suggests that e-cigarettes are less harmful than traditional cigarettes, they carry their own risk.

E-cigarettes raise the risk of nicotine poisoning in children

There is a raised risk of nicotine poisoning in children associated with e-cigarettes, according to a new study. Researcher Alisha Kamboj wrote, “The frequency of exposures to e-cigarettes and nicotine liquid among young children reported to US [Poison Control Centers] is rising rapidly. Children exposed to e-cigarette devices and nicotine liquid are 2.5 times more likely to have a severe outcome than children exposed to cigarettes, and lethal exposure has occurred.”

The researchers examined the data from the National Poison Data System (NPDS) on single exposures involving nicotine and tobacco products from January 2012 through April 2015 among children under the age of six.

During that time period, the NPDS received 29,141 calls related to exposure. E-cigarette exposure accounted for 14.2 percent of these exposures, cigarettes accounted for 60.1 percent, and other tobacco products accounted for 16.4 percent.

The researchers noted that exposure to e-cigarettes had increased by 1492.9 percent during the study period, while exposure to traditional tobacco remained the same.

Common routes of exposure as noted by the authors were ingestion, dermal, and inhalation/nasal. Children in particular may be specifically vulnerable due to their curiosity and the enticing packaging of e-cigarettes.

FDA extends regulations on all tobacco products including e-cigarettes, cigars, and hookah

The FDA has extended regulations on all tobacco products including e-cigarettes, cigars, and hookah. In the next year or so, minors will not be allowed to purchase e-cigarettes and all ingredients will have to pass FDA approval. Some vaping liquids, although they don’t contain typical cancer-causing ingredients seen in traditional tobacco products, still contain harmful chemicals.

Shop owners will now have to send applications to the FDA to have their product approved, which is not only timely but costly as well. Application estimates can range from several hundreds of dollars to the millions.

The new FDA guidelines include:

Registering manufacturing establishments and providing product listings to the FDA
Reporting ingredients, as well as harmful and potentially harmful constituents
Requiring premarket review and authorization of new tobacco products by the FDA
Placing health warnings on product packages and advertisements
Not selling modified risk tobacco products (including those described as light, low, or mild) unless authorized by the FDA
Not allowing products to be sold to persons under the age of 18 years (both in-person and online)
Requiring age verification by photo ID
Not allowing the selling of tobacco products in vending machines (unless in an adult-only facility)
Not allowing the distribution of free samples.

On the other hand, in the U.K., the e-cigarettes are deemed safe, because – unlike in America – teenagers in the U.K. have not jumped ship on them.

The new FDA rules will be implemented by August.


The fight against tobacco is not over

The Boston Globe presents the Harvard Kennedy School PolicyCast, a weekly podcast on public policy, politics, and global issues. HKS PolicyCast is hosted by Matt Cadwallader.

At this point, efforts to end tobacco use seem almost passe.

While it wasn’t so long ago that smoking was ubiquitous, most millennials, the largest generation in the country, have never been able to smoke in a Massachusetts bar or restaurant, much less in an office or on an airplane.

For many of us, the fight against tobacco has fallen off the radar. But that doesn’t mean the problem has been solved.

“Tobacco’s going to kill 1 billion people in the 21st century,” says Dr. Howard Koh on this week’s Harvard Kennedy School PolicyCast podcast. “There’s no other condition that reaches those extraordinary figures.”

Dr. Koh, a professor at the Harvard TH Chan School of Public Health and former assistant secretary for health at the US Department of Health and Human Services, says that it’s not yet time to declare mission accomplished.

“We have to keep talking about this huge issue because so many people are suffering and dying preventable deaths due to tobacco dependence. . . . We still have young people trying cigarettes every day. Several thousand a day, in fact, start for the first time.”

Efforts to curb nicotine addiction have taken on new dimensions in recent years, and in several ways Massachusetts has been at the forefront.

The national movement to raise the minimum age to buy tobacco from 18 to 21 began in Needham back in 2005, and has been picking up steam. Earlier this year Boston followed suit.

Just recently, the Massachusetts State Senate passed a bill that would raise the age statewide, and Governor Baker has indicated that he supports the idea “conceptually.”

Passing such a law would make Massachusetts just the thirdstate to do so after Hawaii enacted the change in January and California passed its law in May.

This year another big change came on opening day at Fenway Park. While smoking has been banned in the park for many years, the use of smokeless tobacco, nicknamed spit or chew, has long been a part of baseball culture.

Now due to new regulations enacted by the city of Boston, Fenway is one of a handful of Major League Baseball stadiums where even smokeless tobacco is unwelcome. This was in response to a study released last year by the US Centers for Disease Control and Prevention, which found that the use of chew among baseball players has a significant impact on whether high school athletes pick up the same habit.

Perhaps the most intriguing issue in tobacco control has been the rising popularity of e-cigarettes.

Koh describes e-cigarettes as a “double-edged sword” that have added an unexpected twist to public health officials’ efforts. Two camps have emerged, one arguing that e-cigarettes can be a useful tool in helping smokers quit, and the other taking a more cautious approach, worried that they may be used by teenagers as a stepping stone into further tobacco use.

So far the data have been inconclusive. A recent study found that 16 percent of US high schoolers had tried e-cigarettes, a more-than tenfold increase over the last five years, but it also came at a time when cigarette use among the same group had dropped significantly.

Tobacco control isn’t a new topic, but in the effort to stop 1 billion preventable deaths, we still have a long way to go.

Can e-cigarette makers stub out addiction concerns?

As vaping culture grows and big tobacco piles in with huge ad budgets, worry over nicotine use lingers

The medical report published this week which finds that vaping could save millions of lives and should be encouraged could be read as a victory for the Marlboro Man of our times, who has swapped his horse for a helicopter and become a woman.

Perhaps you’ve seen the glossy new TV ad, below, and its evocation of an age when cowboys sold a deadly lifestyle. In summary: helicopter corrals cows under big skies, lands next to massive rock; pilot wearing stetson gets out, pulls down bandana and puts an electronic cigarette in her mouth. Its tip glows blue before the setting sun catches the vapour cloud as she exhales.

It’s big-budget and kind of beautiful. But the ad, for Blu eCigs, part of Imperial Tobacco, comes at a tricky time in the rise of an awkward object. Conceived as a nicotine vehicle to deliver the physical, social and chemical appeal of smoking without the aftertaste of death, the electronic cigarette, used by an estimated 2.6 million people in Britain, has rapidly spawned a sub-industry and vaping culture.

But like a curious teenager clutching an Embassy behind a bike shed, we don’t quite seem to know what to do with these new sticks, or what the risks might be. Just as the the Royal College of Physicians (RCP) called on Thursday for the promotion of vaping in the biggest report of its kind, new rules are about to make e-cigarettes harder to buy – and kill off the Blu Woman before she’s even got going.

The EU Tobacco Products Directive, which comes into force on 20 May, will, among other things, outlaw the advertising of electronic cigarettes on TV, radio and in newspapers. It will also set a limit on the nicotine content of the liquid used in the devices, which use a small, battery powered heating element to create the inhalable vapour (the “e-liquid” or “juice” is a blend of organic compounds, natural or synthetic flavourings and nicotine).

The directive follows years of conflicting advice and regulation. There is no public ban on e-cigarettes but local policy varies. You can vape to your lungs’ content inside a Westfield shopping centre, but stray over the carpet into a Starbucks and you’re banned. Doctors haven’t been able to agree either. In 2014, the World Health Organisation said vaping could be dangerous. A year later, Public Health England said it was 95% less harmful than smoking, but its evidence was subsequently doubted in the Lancet.

Perhaps Prof John Britton, chair of the RCP’s tobacco advisory group, which produced the new report, can help navigate this fug of confusion. “A lot of it is psychological,” he says. “There are people who feel sustaining nicotine addiction is wrong. I’ve had those conversations at conferences over coffee, and nobody has seen the irony in it.”

Nicotine isn’t something to seek out but “like caffeine, if it is used in the doses in which smokers use it, it is not significantly hazardous,” Britton adds. “The important thing is to separate it from the smoke, which is what electronic cigarettes do.”

The RCP report “lays to rest almost all of the concerns over these products”, including any suggestion that secondhand vapour can be harmful. But it will be harder to stub out the connotations of smoking. Almost 10 years after the public smoking ban, and more than half a century after the RCP’s pivotal 1962 report, Smoking and Health, which changed our relationship with cigarettes for ever, we are bound to doubt a solution that looks like the problem. Moreover, as the tobacco multinationals catch up with a runaway trend, and sell that solution as a lifestyle, we are understandably wary of the motivations of an industry which has not always welcomed the advice of doctors.

“There’s a suspicion of a commercial, consumer-led rather than medical response,” Britton accepts. “And there are arguments that these products are being used to promote smoking subconsciously … and that the tobacco industry will exploit them to sell more tobacco, particularly in countries with poorer governance.” The professor of epidemiology welcomes proportionate regulation, including the ad ban, as well as theforthcoming move to allow doctors to prescribe licensed vape kits. But while 200,000 children still take up smoking every year in Britain, he believes the participation even of public health villains is a price worth paying if it reduces illness and about 100,000 deaths a year (that’s about one every five minutes).

“We still have nearly 9 million people smoking tobacco every day when we’ve known what to do about it pretty much since 1962,” Britton says. “That’s a reflection of an abject failure of health policy. We’re reducing the number of young people taking up smoking, but we’re not that much better at helping them quit. That’s why the e-cigarette is such a powerful new tool.”

Marc Michelsen is, unsurprisingly, inclined to agree. “We have had an issue with public trust,” admits the public affairs executive at Fontem Ventures, the Dutch firm which owns Blu, and is an “arms-length subsidiary” of Imperial, the British tobacco company. “But a lot of that comes from a lack of scientific understanding.” Blu is delighted with the RCP report, but less keen on the advertising ban. “If you inhibit advertising, fewer people will buy the product and that can’t be good,” adds Michelsen, who denies that Blu’s commerical is a barely veiled Marlboro reboot. “I think it’s pure Mad Max,” he suggests (I must have missed the pastoral scenes in Fury Road). “This campaign is not about the past, we’re looking forward.”

What do vapers think, and who are they anyway? The majority of electronic smokers buy mass-produced products in supermarkets or online, and don’t think a great deal about them beyond their health and financial savings (£200 a month for a 20-a-day smoker, according to vape sites). But a vaping scene has unexpectedly mushroomed to the extent that, for many vapers, nicotine has become a secondary interest.

At the Vape Emporium, a London-based online store with boutiques at Hampstead and Richmond, a vape consultant will talk you through a menu of handcrafted e-pipes and more than 200 flavoured e-liquids. Perhaps you’d like to try the VG by Simple Chocolaccino, which “blends caramel, chocolate, coffee and biscuit for a divine morning vape”. “We now have juices that only contain 1.5mg of nicotine, which is tiny,” says Andy Logan, the emporium’s co-founder. A 24mg/ml mix compares to a strong cigarette, he explains (the new rules will set the maximum at 20mg). “And some people are taking zero nicotine now because they just don’t need it but still enjoy vaping.”

Logan, who set up as an online store in 2013 and is looking for new shopfronts, says vapers follow a familiar path. “At the start they’re adamant they don’t want any funny flavoured rubbish and go for a strong, tobacco-style vape. But after a few weeks they’re trying some crazy flavours and dropping the nicotine because they’ve got their tastebuds back.” Flavour seekers tend to favour fruit, pudding (doughnuts and cakes are popular) or mint and vanilla perfumes, he adds. Some go further, vaping socially in cafes and clubs and discussing equipment and blends. Logan has just exhibited at the second Vape Jam UK, a three-day expo at London’s ExCel centre attended by 300 companies and clubs. “I took my fiancee on the Sunday,” he says. “She had no idea this subculture exists. It’s quite amazing.”

Logan says his customers range from an insanely knowledgable 94-year-old woman to a businessman who comes in for a puff while his driver idles outside in a Bentley.

Vaping is increasingly popular among young people (it is illegal to sell to under-18s), he adds. Meanwhile, the public response to vaping – while still generally somewhere between curious and hostile – is catching up with its rise in popularity. “I still can’t go to a party without facing a barrage of questions, but it is changing,” Logan says.

As a culture emerges and big tobacco piles in with huge advertising budgets, do we risk discouraging nicotine quitting, or even drawing non-smokers into addiction? “Our annual survey of 12,000 adults suggests the level of vaping among non-smokers is steady at about 0.2%, says Hazel Cheeseman, director of policy at Ash, the smoking health charity.

“It’s extremely rare and I don’t think that will ever change,” Logan adds, rejecting the gateway hypothesis. And he doesn’t need it to. “If there are nearly 10 million smokers and only 2 million vapers, we’ve still got a massive, long journey to convert the rest,” he says.

Early symptoms of nicotine dependence among adolescent waterpipe smokers



Although waterpipe smoking is increasingly popular among youth and can lead to nicotine dependence (ND), no studies have documented how ND develops in waterpipe smokers. We examined the emerging symptoms of ND among adolescent waterpipe smokers in Lebanon.


Individual confidential interviews were used to evaluate ND in 160 waterpipe smokers and 24 cigarette smokers from a sample of 498 students enrolled in 8th and 9th grades in Lebanon.


Among waterpipe smokers, 71.3% endorsed at least one Hooked on Nicotine Checklist (HONC) symptom and 38.1% developed the full syndrome of ND (≥3 criteria using the International Classification of Diseases, 10th revision). The early symptoms of ND among waterpipe smokers were craving (25%), feeling addicted (22.5%), and failed quit attempts (14.3%). Among those who reached the respective milestones, median tobacco use when the first HONC symptom emerged was 7.5 waterpipes/month with smoking frequency of 6 days/month; the median tobacco use for the full syndrome of ND was 15 waterpipes/month with smoking frequency of 15 days/month. Among those who had already reached these milestones, the first HONC symptom appeared 10.9 months after the initiation of waterpipe smoking, and the full syndrome of ND was reached at 13.9 months. In addition, cues such as seeing or smelling waterpipe, and the café environment triggered craving in most waterpipe smokers with symptoms of ND.


Symptoms of ND develop among adolescent waterpipe smokers at low levels of consumption and frequency of use. Craving for nicotine triggered by waterpipe-specific cues is reported even at this young age. Waterpipe-specific ND prevention and intervention programmes for youth are needed.

How To Quit Smoking? Science Unravels Best Strategy For Smokers

Many smokers have grappled with one rather perturbing question for years: How to call it quits once and for all? Finally, a new study on smoking habits seems to have addressed the question compellingly. The study published in the journal Annals of Internal Medicine has brought to light some revealing findings in this regard.

Smokers are usually quite happy to contend that gradually cutting down the number of sticks each day over a period of time as opposed to quitting instantly or using the so-called “cold turkey” approach is perhaps the most effective strategy for quitting the habit. New findings from the Oxford University study based on a compelling survey of smokers has suggested that the latter could, in fact, be the best possible way to purge away the habit.

The study observed nearly 700 regular smokers in the UK who had demonstrated the inclination to quit the habit over the subsequent two weeks. Fifty percent of these smokers were encouraged to continue smoking the usual way until the end of the two-week period followed by a period of immediate abstinence. The other 50 percent were asked to gradually curb their number of cigarettes each day over the same period until the quitting day. Subsequently, smoking habits of both the groups were examined a month after quitting followed by another six-month follow-up survey.

The results revealed that the success rates after four weeks for smokers who had refrained from smoking altogether had been up to 25 percent higher than those using a gradual cessation approach. An almost similar success rate was documented between the two groups after the designated six months as well.

According to contributing researcher Nicola Lindson-Hawley, although these findings contradict the long-held common-sense way thought by many smokers as the best strategy to curb the tendency, attempting to quit gradually is still better than making no attempt at all.

“Health care workers should offer abrupt quitting first, but if that is not an option, gradual quitting can be a second-line approach. We understand that people might be dead set against quitting abruptly so if the only way they would consider quitting is gradually then the results of this trial suggest it shouldn’t be ruled out.”

Many smokers experience continuous cycles of recurring abstinence and relapse time and again. For most, quitting smoking can become an excruciatingly lengthy battle owing to the many nicotine withdrawal symptoms that follow within days and sometimes even hours after the last cigarette. However, studies have shown that these symptoms are most agonizing during the first three to five days and are likely to subside and even vanish after two to three weeks.

According to the Centers For Disease Control and Prevention, many smokers are tempted to resort to smoking once again owing to the highly unpleasant nicotine withdrawal symptoms oftentimes leading to stress and weight gain. These symptoms are known to include irritability, anger, anxiety, distraction, and sometimes erratic appetite.

The success rate of smokers who choose to cease the habit abruptly compared to those who prefer the gradual cessation approach may be explained by the first group’s early exposure to and, more importantly, success during the withdrawal phase. Similarly, the reduced success rate documented in the smoking habits of the second group in the study may be attributed to a delay in the onset of the same symptoms.

According to experts, few population-based studies have comprehensively studied relapse among former smokers. Researchers have historically maintained that the quantification of the relationship between the duration of abstinence and the likelihood of continued abstinence is critical for the understanding of ongoing public health interventions and the formulation of smoking-cessation initiatives

‘Brain movies’ show nicotine affects men and women differently

Innovative research being done in Israel demonstrates, on film, how short-term bursts of brain activity are prompted by stimulants

A 'dopamine movie' (screenshot)

A ‘dopamine movie’ (screenshot)

Addictions are hard to kick. Just ask all cigarette smokers who keep puffing away despite the boatload of evidence that they are killing themselves.

Now, new research being conducted in Israel shows that addictions work differently in women and men. A study being conducted largely in Israel by Evan Morris, an associate professor of Radiology, Biomedical Engineering, and Psychiatry at Yale University, shows this clearly. In fact, Morris and his students have even made a movie out of it.

“Our dopamine movies show the effect of nicotine on the dopamine levels in the body, and those movies – which essentially show how the brain reacts when the chemical is released – shows clearly that there is a difference in brain activity for men and women who smoke.”

Those findings are interesting, Morris told The Times of Israel, but the real point is to show “how short-term bursts of brain activity are prompted by chemical changes. This could have all sorts of implications for treating symptoms like PTSD and other stress-induced conditions, where there can be radical changes in brain activity for short periods of time.”

Morris is a world-renowned expert on Positron Emission Tomography (PET) imaging using tracer kinetic modeling to create functional images of the brain.

“With PET, you can see in how the brain changes – based on mathematical formulas – in response to induced changes,” said Morris. “One of the most difficult challenges facing researchers is developing models of short-term changes – changes in the brain that pass quickly, perhaps in just a few minutes or so.”

It’s clear that with a supercharged emotion taking over the body – anger, ecstasy, or anything in between – there are changes to the brain, “but generally researchers have been able to capture only changes that linger, with the imaging of the short-term changes unattainable.”

That’s what makes a study of smoking so attractive. “When a person smokes, the chemicals they inhale – especially nicotine – engender a response that releases dopamine, the brain’s primary motivation neurotransmitter.”

Dopamine is released in response to environmental and internal stimuli – food, sex, or pleasurable events – as well as in response to chemicals that stimulate the central nervous system, like nicotine.

The sensation involved with nicotine – as with other drugs – is fleeting, with dopamine levels rising sharply but briefly. PET scans, said Morris, provide an opportunity to see how this fleeting sensation physically affects the brain.

“We are able to scan the brain’s reaction using a tracer that mimics dopamine. With our method, we are able to see how brains react to the chemically induced changes associated with addiction over time, creating a movie which shows the changes – and that is where we noticed how male and female brains differ when it comes to smoking.”

The results of the study, which was largely carried out at Hadassah Ein Kerem Hospital in Jerusalem with Dr. Nanette Freedman of the Nuclear Medicine Dept., were published in a recent edition of the Journal of Neuroscience.

The findings, according to the report, show that “male smokers smoking in the PET scanner activate dopamine in the right ventral striatum during smoking but female smokers do not. This finding—men activating more ventrally than women—is consistent with the established notion that men smoke for the reinforcing drug effect of cigarettes whereas women smoke for other reasons, such as mood regulation and cue reactivity.”

Based on these results, said Morris, who collaborated on developing the method with Yale co-researcher Prof. Kelly Cosgrove, researchers will be better able to understand what makes smokers tick – and develop more effective ways to get them to kick the habit. “It could be, for example, that you need different kinds of nicotine patches designed for men and women, since they react differently to nicotine.”

But besides what the study means for smokers, it also has implications far beyond nicotine addiction.

“Any short-term event that affects the brain could be ‘filmed’ for analysis, to see which part of the brain is affected, and how,” added Morris.

Just like adrenaline flows in a moment of danger providing extra strength in a moment of need, brain changes in response to those dangers could teach researchers about how people think and react – and how to “turn on” parts of the brain that can enhance thinking, among other things.

“PTSD, ADHD, and other conditions in which an individual’s mood and actions change depending on stimuli could be better understood using this method,” said Morris.

Morris, an associate professor of diagnostic radiology, biomedical engineering and psychiatry at Yale University, is in Israel on a Fulbright exchange program scholarship, which each years brings dozens of American researchers to Israel to work on innovative medical and technology projects in the start-up nation for a year, while sending Israeli researchers to work in the US for the same amount of time.

One reason Morris chose Israel is that he needed a young adult population that had recently taken up smoking in order to find recently addicted people.

“Part of what we are trying to determine is the development of addiction. Are there people more prone to addiction?” he said. “To see that kind of progression, you want people who are recent smokers so you can see over time what their brain patterns are, and how they change the more they are exposed to the cause of their addiction.

“In the US, most of these early stage smokers are kids – under 18 years of age, study of which entails all sorts of legal and disclosure issues. In Israel, many of the young smokers pick up the habit in the army – so they are already over 18, and it is much easier legally to recruit them for studies like these, that entail using the radioactive material we need for the PET tracer,” he added.

Morris will be discussing this and other findings of his research, along with other uses and research being conducted with PET, at a special event at Hadassah Ein Kerem Hospital on February 29, in a one-day symposium on Advances in Brain Imaging. The symposium is funded by Fulbright, Yale, Hadassah, and the US National Institutes of Health, which is also helping to fund Morris’s Hadassah research.

“Smoking was a good place to start, but we certainly don’t intend to stop there. The movies we created showing brain changes induced by stimuli can ‘star’ many more chemicals besides dopamine, giving us more insight into how the brain works.”

Vaping linked to host of new health risks

Potential effects span immunity to mental health and sperm to heart

RISKY PUFFS Many people assume e-cigarettes are a healthier alternative to smoking. But new animal data suggest vaping may pose immune risks — and possibly behavioral and reproductive risks for the children of women who vape during pregnancy.

WASHINGTON — Many people have turned to electronic cigarettes in hopes of avoiding the heart and cancer risks associated with smoking conventional tobacco products. But vaping appears far from benign, a trio of toxicologists reported February 11 and 12 at the American Association for the Advancement of Science annual meeting.

If used as a means to totally wean people off of tobacco products, then e-cigarettes might have value, concedes Ilona Jaspers of the University of North Carolina at Chapel Hill. But she’s not sure.

Unpublished data that she and the others presented at the meeting link e-cig products to a host of new risks. So vaping may not eliminate risks associated with conventional smoking, Jaspers maintains — “and may actually be introducing new ones.”

Her group examined scraped cells from the noses of otherwise healthy people who had a history of smoking, vaping or doing neither. The researchers then measured the activity levels in these cells of 594 genes associated with the body’s ability to fight infections. Among smokers, the activity of 53 genes was substantially diminished, compared with people who neither smoked nor vaped.

Among vapers, those same 53 genes showed significantly diminished activity, Jaspers reported, as did 305 more.

The normal role of these genes would suggest that the lung tissue as well as nasal tissue of smokers — and especially vapers — “may be more susceptible to any kind of infection.”

To test that possibility, Jaspers’ team collected immune cells from healthy human volunteers, then exposed them to flavored liquids used in e-cigarettes. Tested cells included blood neutrophils and lung macrophages, both normally tasked with gobbling up and killing bacteria. Some of the liquids proved disturbingly effective at suppressing the ability of those immune cells to do their job, Jaspers reported.

One compound with a particularly suppressive effect on immune-gene activity was the cinnamon-flavored cinnamaldehyde. Jaspers said she was surprised to find cinnamaldehyde in some of the liquids, including the cola-flavored one.

Judy Zelikoff of New York University’s Langone Medical Center in Tuxedo looked at genes affected by e-cigarette vapors. Her group exposed mice developing in the womb, and for a month after birth, to vapors at concentrations calculated to be comparable to what a vaping person might encounter. Then she tracked the activity of genes in the animals’ frontal cortex, a brain region associated with planning and integrating the senses to understand the environment.

Whether the e-cig vapors contained nicotine made a big difference.

Males exposed to nicotine-laced vapors showed no gene-activity changes. Among females, vapors laced with nicotine appeared to alter the activity levels of 148 genes in the brain’s frontal cortex.

But among rodents exposed to nicotine-free vapors, a whopping 830 or more genes in the frontal cortex showed substantially altered activity — either much higher or lower than in unexposed mice. Here, both males and females were about equally affected.

“Was I surprised” by this exaggerated effect of the no-nicotine group? “We were so surprised,” Zelikoff said, “that we repeated the [experiment] two more times.”

The nature of the gene changes would suggest affected animals would exhibit behavioral changes, including ones associated with mental illness, she said. To probe that a bit further, her group teamed up with researchers at the University of Rochester in New York. Both mice in the nicotine and no-nicotine group showed behavioral changes. When adult mice that had been exposed to e-cig vapors in the womb moved, they tended to do so at almost twice the pace as unexposed mice if the vapors had no nicotine. They moved faster still if they had been exposed to nicotine. Both groups of mice also jumped more. And mice exposed to vapors also stood on their hind legs more than those that had not been exposed. All of these “are behaviors that are reflective of increased — or hyper — activity,” Zelikoff reported, “and possibly agitation.” Her group is now exploring possible effects on memory and mental disorders.

Her group also uncovered reproductive problems in young-adult males exposed to e-cig vapors in the womb. Their sperm concentrations were roughly half the value as those in unexposed mice.

And the motility of their sperm was only a fifth as high as in unexposed males.

Finally, exposing mice to e-cig vapors increased plaque buildup, which is a sign of emerging atherosclerosis, reported Daniel Conklin of the University of Louisville in Kentucky. Cigarette smoke did too. In both cases, he noted, it appears that toxic aldehydes, such as acrolein, formaldehyde and acetaldehyde, are contributors. As such, he concluded, it appears electronic cigarette vapors “could adversely impact the cardiovascular health of users.”

“We’re really at the beginning of understanding the toxicity of emerging products,” says Neal Benowitz of the University of California, San Francisco. But as presentations at the science meeting illustrated, he says, there is a lot of complexity to understanding what goes into the vapors and the tissues that may be at risk. Certainly, he says, there has been a general perception that vaping is safer than smoking. “The challenge to science,” he says, will be to tease out: “Is this really true?” For now, he says, “We really don’t know.”

Perhaps it’s true, Zelikoff says. “But I’m a firm believer in the precautionary principle.” If she were pregnant, she says, “I would look at these animal data with a great deal of respect.”

Neanderthal DNA may account for nicotine addiction and depression

Matching modern genetic profiles against genes known to have been inherited from Neanderthals has shown links to a wide range of current disorders

Modern European and Asian people may owe more than skin or hair colour to Neanderthal ancestry. Interbreeding 50,000 years ago between two species of human may also have bequeathed a sunburn hazard called keratosis, addiction to nicotine, and a greater risk of depression.

That the forebears of modern Homo sapiens and the long-extinct Neanderthals lived side by side is well known: that they interbred, and that up to 4% of modern human DNA is inherited from the first Europeans, was confirmed only in 2010.

US researchers examined a database of 28,000 patients whose biological samples had been linked to versions of their medical records. Identities remained anonymous but the researchers could see how inheritance linked to medical history.

Then, they report in the journal Science, they matched the modern human database against a map of those groups of genes known to have been inherited from the big-boned, heavy-browed, red-haired humans whose ancestors had moved out of Africa long before Homo sapiens, and colonised Ice Age Europe.

“Our main finding is that Neanderthal DNA does influence clinical traits in modern humans,” said John Capra, an evolutionary geneticist at Vanderbilt University in Nashville, Tennessee. “We discovered associations between Neanderthal DNA and a wide range of traits, including immunological, dermatological, neurological, psychiatric and reproductive diseases.”

Sub-Saharan African peoples do not inherit Neanderthal DNA. The assumption is that the Neanderthals left Africa first, had time to adapt to a colder, darker and more difficult world, evolved paler skin colour to take advantage of less certain sunlight, and developed other traits that might have helped them survive changing conditions.

Early modern humans – more gracile, and perhaps quicker to adapt and take advantage of their environment – then migrated north from Africa to outpace and outlive the first Europeans. But, during the thousands of years the two species coexisted, they also interbred.

And these encounters passed on traits that might have been of some evolutionary advantage in an Ice Age world. But in changing conditions, the same lengths of inherited DNA contained greater health liabilities as well.

One of these, the researchers think, was a Neanderthal gene variant that increases blood-clotting. This would have sealed wounds more quickly, and prevented infection more easily. But in a modern western society, hyper-coagulation brings other problems, including greater risk for stroke, pulmonary embolism and pregnancy complications.

One length of Neanderthal DNA is now linked to increased risk of nicotine addiction, and several variants influence the risk of mood disorders, including depression. As tobacco was introduced into widespread use in Europe only 400 years ago, the researchers were surprised at the number of Neanderthal genetic variants now associated with modern psychiatric and neurological disorders.

“The brain is incredibly complex, so it is reasonable to expect that introducing changes from a different evolutionary path might have negative consequences,” said Corinne Simonti, a Vanderbilt doctoral student and the study’s first author.

Judge Slams Big Tobacco’s Do-Over Request

(CN) – Philip Morris and other cigarette makers will soon be required to make public statements about the health effects of smoking, after a federal judge called the companies’ rewrite request “ridiculous.”

Monday’s ruling stems from a case the U.S. brought 15 years ago against the nine companies under federal anti-racketeering law. A judge concluded at the end of a nine-month trial that the defendants had engaged in a “pervasive scheme to defraud customers and potential customers of cigarettes” for more than 50 years.

The judgment found that the cigarette makers joined together to “maximize their profits” by misleading the public about the “devastating health effects of smoking.”

Despite that court’s finding that it had the authority to order disgorgement of fraudulently gained profits, the D.C. Circuit barred that damages route “because disgorgement is aimed at past violations,” and the RICO Act permits damages only to prevent future violations.

The government instead sought and won a judgment ordering the cigarette manufacturers to make corrective disclosures on cigarette packaging, in advertising and on their websites.

Affirming this remedy in 2009, the D.C. Circuit found that exposing “the previously hidden truth about their products [will] prevent and restrain” future RICO violations.

On remand, a federal judge approved a draft of the disclosures that the tobacco companies were required to make.

The draft required the cigarette makers to declare that they “intentionally designed cigarettes to make them more addictive,” to “maximize the ingestion of nicotine, adding ammonia to make the cigarette taste less harsh, and controlling the physical and chemical make-up of the tobacco blend.”

It also required that they include a preamble admitting that a federal court found they “deliberately deceived the American public” about the adverse health effects of smoking and second-hand smoke, the addictiveness of nicotine, the manipulation of cigarette design, and the lack of a significant difference between regular and “light” cigarettes.

R.J. Reynolds and the others appealed, however, saying such backward-looking corrective disclosures “force defendants to vilify and shame themselves for past wrongdoing” rather than “reveal the previously hidden truth.”

A three-judge panel of the D.C. Circuit upheld the corrective statements last year, insofar as they correct possible misinformation about tobacco products, but said the tobacco companies cannot be forced to admit their past acts of deliberate deception.

After this ruling, parties went to mediation, but failed to agree on new preamble language.

And back in court, the tobacco companies filed a 40-page brief seeking to rewrite all five of the statements approved by the appeals court, even though the appellate panel rejected only one sentence in the preamble.

“That is ridiculous – a waste of precious time, energy, and money for all concerned – and a loss of information for the public,” U.S. District Judge Gladys Kessler wrote in a Feb. 8 ruling. “The court has no intention of following that path, although it is obvious that defendants are, once again, attempting to stall any final outcome to this long-standing litigation.”

The government proposed a shortened preamble that eliminated the reference to the tobacco companies’ prior bad acts, and simply states, “A federal court has ordered Altria, R.J. Reynolds Tobacco, Lorillard, and Philip Morris USA to make this statement about [particular topic].”

Kessler rejected the cigarette makers’ proposal that the preamble should use the word “determined” instead of “ordered,” as well as their proposal to remove a separate line stating, “Here is the truth.” In addition, the tobacco companies sought to completely remove their names from the statements.

The judge also rejected the government’s proposed modifications to the parties’ Consent Order regarding the requiring date for publishing the notices.

“In accordance with the remand of the Court of Appeals, this court adopts the corrective statements submitted by the government,” the 11-page opinion concluded.

Time to take tobacco dependence treatment seriously

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