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Local Anti Tobacco Advocate Busts E-cigarette Myths

http://www.caledonianrecord.com/features/health/local-anti-tobacco-advocate-busts-e-cigarette-myths/article_65ee5497-ed23-5131-b69d-a503312368c3.html

According to a recently released report by the US Surgeon General, research has confirmed that there has been a significant increase in electronic cigarette (e-cigarette) use in recent years. Just last year alone, in 2015, the increase of electronic cigarette use has more than doubled particularly among our youth (ages 11 – 14), adolescents (ages 15 – 17) and in our young adults (ages 18 – 25) with more than 3 million youth in middle and high school using electronic cigarettes within the past 30 days. A cash cow for the tobacco industry, these numbers are increasing daily. More than 85 percent of electronic cigarette users ages 12 – 17 use flavored e-liquids, which come in a large variety of flavors, and are especially appealing to youth. And the flavors are the leading reason for youth use, according to the Surgeon General’s report.

Tobacco companies have been ramping up their marketing strategies to attract and cause young people to start using electronic cigarettes. In the United States, $3.5 billion dollars in sales is big business for the industry. Electronic cigarette manufacturers spent $125 million dollars in advertising their products with retail stores becoming the most frequent source of youth exposure to the tobacco industry’s advertising approaches. The tobacco industry has gone back to its old tactics that are much the same as the ones used to promote the conventional tobacco products.

Unlike the marketing campaigns of yesteryear, advertising approaches and themes today have a significant advantage with the use of internet and social media creating a more effective and wider outreach to attract youth and young adults, causing them to start using tobacco products at a much earlier age. In 2014, more than 7 out of 10 middle and high school students stated that they have been exposed to tobacco advertising. Research has shown that youth who use tobacco products like electronic cigarettes or chew, are most likely to go on to use other tobacco products like the traditional tobacco cigarette. In 2015, nearly 6 out of 10 high school cigarette smokers were also using electronic cigarettes.

The tobacco industry has claimed that electronic cigarettes are safer than the traditional tobacco cigarette. The tobacco industry has also claimed that the chemicals in e-liquids are not harmful to the user. The tobacco industry has suggested that electronic cigarettes can and may be used as a cessation tool to quit smoking. On the contrary, the newly released US Surgeon General’s report has confirmed these claims to be myths. The US Surgeon General’s report has busted these myths by saying;

The use of products containing nicotine poses dangers to youth, pregnant women, and fetuses. The use of products containing nicotine in any form among youth, including electronic cigarettes, is unsafe.

The liquid usually has nicotine, which comes from tobacco, flavoring; and other additives. Many electronic cigarettes contain nicotine, which is highly addictive. The nicotine in electronic cigarettes and other tobacco products can prime young brains for addiction to other drugs, such as cocaine and methamphetamine. Electronic aerosol is not harmless. The aerosol or vapor created by electronic cigarettes can contain ingredients harmful and potentially harmful to the public’s health.

There have been no conclusive study results or evidence to confirm that electronic cigarettes are a possible cessation tool for those who want to quit smoking. On the contrary, there is sufficient evidence to substantiate that the use of electronic cigarettes promotes users to use both electronic cigarettes along with smoking the conventional tobacco cigarette and that can potentially place the user at risk for exposure to higher levels of nicotine in the body that may ultimately lead to acute toxicity and possible death from over-exposure to nicotine.

The US Surgeon General’s full report titled: E-Cigarette Use Among Youth and Young Adults, can be found on the Surgeon General’s official website: https://e-cigarettes.surgeongeneral.gov.

Brand Loyalty Low Among Teen E-Cig Users

Half of surveyed users did not know which brand they used

Half of teens who use e-cigarettes reported vaping no particular brand, and about a third reported using e-cigarette devices for substances other than nicotine, according to an analysis of recent survey data by researchers from the CDC.

The most commonly reported e-cigarette used by the middle school and high school students participating in the 2015 National Youth Tobacco Survey (NYTS) was the heavily promoted brand ‘blu’, manufactured by Fontem Ventures-Imperial Brands (formerly Imperial Tobacco Group).

Roughly one in four surveyed teen e-cigarette users (26.4%) reported using that brand, while 12.2% reported using the next most popular brand, ‘VUSE’, manufactured by R.J. Reynolds.

The survey results were reported Thursday in the CDC’s Morbidity and Mortality Weekly Report.

“Electronic cigarettes are now the most commonly used tobacco product among U.S. youths; in 2015, 5.3% of middle school students and 16% of high school students reported using e-cigarettes in the past 30 days,” CDC researcher Tushar Singh, MD, PhD, and colleagues wrote, adding that not much has been known about the brands preferred by teens and the substances used in e-cigarette devices.

The analytic sample of the 2015 NYTS included 4,021 students who reported ever using e-cigarettes, “even once or twice.” Respondents were asked what brands of e-cigarettes they had used, with eight specific brands listed, and whether they had ever used an e-cigarette device for vaping a substance other than nicotine.

Data were weighted to account for the complex survey design and to adjust for nonresponse. Prevalence estimates were also reported for the type of e-cigarette ever used, brands, and whether e-cigarettes were used for substances other than nicotine.

A total of 13.5% of sixth through eighth graders and 37.7% of ninth through 12th graders reported ever-use of e-cigarettes.

Among the adolescents reporting ever having used an e-cigarette, 14.5% used only disposable e-cigarettes, 53.4% used only rechargeable/refillable e-cigarettes, and 32.1% used both types.

Half of the student respondents (50.7%, representing 3.18 million teens) did not know the brand of the e-cigarette they had used.

Use of e-cigarettes for a substance other than nicotine was similar among middle school (33.7%) and high school (32.2%) users, and it was higher among males than females (37.3% of high school male e-cigarette users versus 26.2% of high school female respondents).

In a separate survey of high school age e-cigarette users in Connecticut, reported last year in Pediatrics, 18% of respondents reported using cannabis in an e-cigarette device.

“In the present analysis, it is unknown whether students who had used an e-cigarette for a non-nicotine substance had also used an e-cigarette for nicotine, which might underestimate nicotine use,” Singh and colleagues wrote.

“Nicotine content in e-cigarettes is of public health concern because exposure to nicotine is the main cause of tobacco product dependence, and nicotine exposure during adolescence, a critical period for brain development, can cause addiction, can harm brain development, and could lead to sustained tobacco product use among youths.”

Study limitations cited by the researchers included the self-reported nature of the survey, the limited number of specific e-cigarette brands included in the survey, and the lack of data on which substances other than nicotine were being used.

The researchers concluded that increased monitoring of product types, brands, and ingredients preferred by adolescent e-cigarette users is warranted, “to guide measures to prevent and reduce use of e-cigarettes among youths.”

Big Tobacco wins big with vaping

http://www.heraldnet.com/opinion/big-tobacco-wins-big-with-vaping/

Big Tobacco, with its legion of lobbyists, and evil geniuses, is almost always a step ahead of regulators and health officials. It wasn’t until May of this year that the FDA finally finalized a rule extending its authority to all nicotine products — including e-cigarettes, cigars, hookah and pipe tobacco, among others. The lack of such authority is why we saw ads for nicotine vaping products on TV, and such products sold legally to teens and kids.

When cigarette smoking rates among teens hit historic lows in the past decade, flavored products (from cigars to vaping) filled the void. When the FDA announced the oversight change, it cited research by the agency and the CDC showing current e-cigarette use among high school students has skyrocketed from 1.5 percent in 2011 to 16 percent in 2015 (an over 900 percent increase) and hookah use has risen significantly. In 2015, 3 million middle and high school students were current e-cigarette users, and data showed high school boys smoked cigars at about the same rate as cigarettes.

A separate study by the FDA and the National Institutes of Health shows that in 2013-2014, nearly 80 percent of current youth tobacco users reported using a flavored tobacco product in the past 30 days – with the availability of appealing flavors consistently cited as a reason for use, the FDA reported.

And now, a new, disturbing study shows just how successfully Big Tobacco is cultivating more nicotine addicts, and how belated the FDA was to take action to oversee the new products. The research, published in the Journal of the American Medical Association, found that teenagers with a regular vaping habit aren’t just more likely to take up smoking — they have higher odds of developing a heavy cigarette habit, Reuters reported.

Vaping devices have been advertised as way to help smokers quit, but the lead author of the study says his findings call that cessation claim into question.

“Our most recent study is the first to show that teenagers who vape not only experiment with cigarettes, but are also more likely to become regular smokers,” said Adam Leventhal, director of the University of Southern California’s Emotion and Addiction Laboratory in Los Angeles.

Rather than keeping kids and teens from smoking, the flavored nicotine products can act as bridge to smoking, said Dr. Brian Primack, a University of Pittsburgh researcher who wasn’t involved in the study.

“… young people who may not have otherwise ended up smoking started with palatable, flavored e-cigarettes — and then after they became accustomed to e-cigarette use, many transitioned to traditional cigarette smoking,” Primack told Reuters. Which is exactly what is happening.

Hazardous chemicals discovered in flavored e-cigarette vapor

Building on more than 30 years of air quality research in some of the most polluted urban environments on Earth, a team of atmospheric scientists has turned their attention toward the growing e-cigarette industry and the unidentified effects of vaping on human health.

https://www.sciencedaily.com/releases/2016/11/161110085644.htm

Building on more than 30 years of air quality research in some of the most polluted urban environments on Earth, a team of atmospheric scientists at the Desert Research Institute (DRI) has turned their attention toward the growing e-cigarette industry and the unidentified effects of vaping on human health.

New research published this week in Environmental Science & Technology (ES&T), a journal of the American Chemical Society, reports that the aerosols (commonly called vapors) produced by flavored e-cigarettes liquids contain dangerous levels of hazardous chemicals known to cause cancer in humans.

The study “Flavoring compounds dominate toxic aldehyde production during e-cigarette vaping” confirms that these toxic aldehydes, such as formaldehyde, are formed not by evaporation, but rather during the chemical breakdown of the flavored e-liquid during the rapid heating process (pyrolysis) that occurs inside e-cigarettes or electronic nicotine delivery systems (ENDS).

“How these flavoring compounds in e-cigarette liquids affect the chemical composition and toxicity of the vapor that e-cigarettes produce is practically unknown,” explained Andrey Khylstov, Ph.D., an associate research professor of atmospheric sciences at DRI. “Our results show that production of toxic aldehydes is exponentially dependent on the concentration of flavoring compounds.”

E-cigarette liquids have been marketed in nearly 8,000 different flavors, according to a 2014 report from the World Health Organization. Recent reports have shown that many flavors, such as Gummy Bear, Tutti Fruitty, Bubble Gum, etc., were found to be especially appealing to adolescents and young adults.

The U.S. Food and Drug Administration (FDA) reports that 16-percent of high school and 5.3-percent of middle school students were current users of e-cigarettes in 2015, making e-cigarettes the most commonly used tobacco product among youth for the second consecutive year. In 2014, 12.6-percent of U.S. adults had ever tried an e-cigarette, and about 3.7-percent of adults used e-cigarettes daily or some days.

Khylstov and his colleagues measured concentrations of 12 aldehydes in aerosols produced by three common e-cigarette devices. To determine whether the flavoring additives affected aldehyde production during vaping, five flavored e-liquids were tested in each device. In addition, two unflavored e-liquids were also tested.

“To determine the specific role of the flavoring compounds we fixed all important parameters that could affect aldehyde production and varied only the type and concentration of flavors,” explained Vera Samburova, Ph.D., an assistant research professor of chemistry at DRI.

Samburova added that the devices used in the study represented three of the most common types of e-cigarettes — bottom and top coil clearomizers, and a cartomizer.

The study avoided any variation in puff topography (e.g., puff volume, puff velocity, interval between puffs) by utilizing a controlled sampling system that simulated the most common vaping conditions. E-cigarette vapor was produced from each device by a four-second, 40-ml controlled puff, with 30-second resting periods between puffs. The e-cigarette devices were manually operated to replicate real-life conditions and all samples were collected in triplicate to verify and confirm results. Specific care was taken to avoid “dry puff” conditions.

To provide further proof that the flavoring compounds, not the carrier e-liquid solvents (most commonly propylene glycol and/or vegetable glycerin) dominated production of aldehydes during vaping, the authors performed a series of experiments in which a test flavored e-liquid was diluted with different amounts of the unflavored e-liquid. Liquids with higher flavor content produced larger amounts of aldehydes due to pyrolysis of the flavoring compounds.

In all experiments, the amount of aldehydes produced by the flavored e-cigarette liquids exceeded the American Conference of Governmental Industrial Hygienists Threshold Limit Values (TLVs) for hazardous chemical exposure.

“One puff of any of the flavored e-liquids that we tested exposes the smoker to unacceptably dangerous levels of these aldehydes, most of which originates from thermal decomposition of the flavoring compounds,” said Khylstov. “These results demonstrate the need for further, thorough investigations of the effects of flavoring additives on the formation of aldehydes and other toxic compounds in e-cigarette vapors.”

Boom year in Italy as vaping population triples

http://ecigintelligence.com/boom-year-in-italy-as-vaping-population-triples/

Italy’s vaping population has more than tripled in the past year, bringing the number of e-cigarette users back to the levels of 2013, before the 2014 crash. The Italian market is estimated for 2016 at €295m, a growth of 300% over the previous year. And the trend, according to the latest ECigIntelligence market report, is set to continue with still greater numbers of users in 2017.

One reason for this could be the decrease in prices of several e-cigs products this year – in some categories, a drop of between 24% and 44%. At the same time, the price of traditional tobacco cigarettes has risen.

The industry is optimistic too about future regulation and the implementation of the EU Tobacco Products Directive (TDP). There are currently 1,107 vape stores in Italy and EcigIntelligence expects more to be opened in large urban areas.

Minimal restrictions after TPD

The TDP came into force in Italy in May 2016. Rome imposed minimum restrictions on the industry and the country is one of the most permissive in or outside Europe, according to the most recent ECigIntelligence regulatory report.

Although restrictions have been placed on packaging, and cross-border distance sales – since May it is prohibited to buy e-cig products from companies not established in Italy – advertising is permitted, with certain stipulations, such as the requirement to state that nicotine is addictive.

What This Means: The e-cig industry in Italy has reacted extremely positively to the new TPD regime, with a boom in the number of vapers and vape stores matching the increased visibility of the sector. Though recent rises in tax on traditional tobacco products provide an incentive for smokers to switch to vaping, taxation remains a major concern for the e-cig industry.

Nearly two-thirds of smokers also use e-cigarettes, CDC says

http://www.omaha.com/livewellnebraska/health/nearly-two-thirds-of-smokers-also-use-e-cigarettes-cdc/article_bfd5256e-a2d8-11e6-a78c-5323b0e6b11c.html

Many American adults who use electronic cigarettes also smoke tobacco cigarettes, a U.S. Centers for Disease Control and Prevention survey reveals.

The survey found that in 2015, 59 percent of all adult e-cigarette users were also current cigarette smokers. The survey also showed that 30 percent of e-cigarette users were former smokers and 11 percent using the devices had never smoked.

Among young adults ages 18 to 24, 40 percent of e-cigarette users were never smokers, 43 percent were current smokers and 17 percent were former smokers.

“If there is a public health benefit to the emergence of e-cigarettes, it will come only if they are effective at helping smokers stop using cigarettes completely, responsibly marketed to adult smokers and properly regulated to achieve these goals,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids.

Altogether, 3.5 percent of all U.S. adults were e-cigarette users in 2015, down slightly from 3.7 percent in 2014, the CDC survey found.

Myers said these findings raise concerns that many adults using e-cigarettes are using the devices in addition to tobacco cigarettes, rather than in place of them.

Myers’ organization also said the finding that 40 percent of young adults who use e-cigarettes have never been smokers raises concerns that e-cigarettes may be introducing young nonsmokers to tobacco use and nicotine addiction.

There has been a sharp increase in use of e-cigarettes by youth. In 2015, 24 percent of high school students were current users of e-cigarettes, compared to 11 percent who smoked cigarettes, a previous CDC survey found.

E-cigarettes “will not benefit public health if smokers use them in addition to cigarettes instead of quitting or if they re-glamorize tobacco use among young people and attract nonsmokers,” Myers said in a Campaign for Tobacco-Free Kids statement.

Current evidence on whether e-cigarettes help smokers quit is limited and inconclusive, he said.

E-cig studies provide more conflicting outcomes on potential harm

http://www.journalnow.com/news/local/e-cig-studies-provide-more-conflicting-outcomes-on-potential-harm/article_f1bf6e4b-90e8-5c52-86c5-f845e4808150.html

Another week, another release of studies that have conflicting outcomes on the attractiveness and potential risk of electronic cigarettes, particularly to young adults.

One report, from researchers at Georgia State University’s School of Public Health, determined that government agencies and public-health advocates may be providing an incomplete assessment of smoking e-cigs and vaporizers.

“The proportion of American adults who perceive e-cigarettes to be equally or more harmful than traditional cigarettes has tripled over the last few years (from 12 percent to 35 percent), highlighting the need for more accurate public-health messaging,” according to the researchers. Their study was published in the American Journal of Preventive Medicine.

The other report, from the federal Centers for Disease Control and Prevention, found that 40 percent of current e-cigs smokers ages 18 to 24 had never tried traditional cigarettes before consuming e-cigs and vaporizers, while 43 percent were current traditional cigarette smokers.

By comparison, nearly all adults at least 45 years old were listed as a current or former traditional cigarette consumer.

The CDC report determined that 3.5 percent of adult Americans, or about 8.7 million, were current e-cig users in 2015. The report did not provide how many young adults were current e-cig users.

E-cigs, such as the top-selling Vuse brand by R.J. Reynolds Vapor Co., typically are battery-powered devices that heat a liquid nicotine solution in a disposable cartridge and create a vapor that is inhaled. Vaporizers can be supplied and reused through the insertion of a liquid capsule.

Neither report broke new ground per se.

But until a universally accepted definitive study is released, the two reports add more evidence to support either anti-tobacco advocates, who promote a “quit or die” approach to tobacco products, or anti-smoking advocates, who believe reduced-risk tobacco and nicotine products can play a pivotal role in decreasing the number of traditional cigarette consumers.

For example, anti-smoking advocates have explained the increase in young adults consuming e-cigs as experimentation typical of individuals their age, and a better alternative than traditional cigarettes.

The Georgia State researchers based their report on data from the Tobacco Products and Risk Perception surveys from 2012 through 2015. Nearly 16,000 adults completed the surveys.

Researchers said the proportion of adult smokers who thought e-cigs were addictive more than doubled from 25 percent in 2012 to nearly 57 percent in 2015. Similar trends were seen in non-smoking adults.

“Although the impact of long-term use of e-cigarettes on health is still unknown, the available scientific evidence indicates that e-cigarettes are less harmful than combustible cigarettes,” the researchers said.

Some studies, including from the Royal College of Physicians, have claimed that e-cigs and vaporizers are up to 95 percent less harmful than traditional cigarettes.

However, a pivotal component of the Food and Drug Administration’s tighter e-cig and vaporizer regulations was that they were necessary to limit or thwart the use of nicotine and tobacco products by youth. The regulations, which went into effect Aug. 8, ban the sale nationwide of those products to anyone under age 18.

Mitch Zeller, director of the FDA’s Center for Tobacco Products, said May 5 that “there are still many open questions about are e-cigarettes a gateway to smoking more harmful products.”

However, most recent federal reports have shown a significant decline in youth smoking of traditional cigarettes in the past 10 years.

Interestingly, among the sponsors of the Georgia State study is the FDA’s Center for Tobacco Products.

“Our public health messages should accurately convey to cigarette smokers that switching completely to e-cigarettes would reduce their risks even if e-cigarettes are addictive and not risk-free,” said Dr. Michael Eriksen, dean of Georgia State’s School of Public Health.

Matt Myers, president of the Campaign for Tobacco-Free Kids, responded to the CDC data by saying it “raises fresh concerns that a large majority of adult e-cigarette users are using e-cigarettes in addition to regular cigarettes rather than in place of them.”

“If there is a public health benefit to the emergence of e-cigarettes, it will come only if they are effective at helping smokers stop using cigarettes completely, responsibly marketed to adult smokers and properly regulated to achieve these goals.”

In August, a national study on youth vaporizer use determined that up to 65 percent of students consume the products for flavor, compared with 20 percent for nicotine.

University of Michigan researchers said the results “challenge the common assumption that all vaporizer users inhale nicotine.” The results were published in the publication Tobacco Control.

Patrick Miech, the lead Michigan researcher, said in an email to the Journal that “vaping is a case where the science has yet to catch up with policy, which seems to be guided more by emotion and anecdote than hard facts.”

Scott Ballin, past chairman of the Coalition on Smoking or Health, has called for “all stakeholders to curtail their public relations efforts and call for scientific cooperation, monitoring and surveillance.”

Scientists stunned by new report about smoking

http://www.morningticker.com/2016/10/scientists-stunned-by-new-report-about-smoking/

A new report about smoking suggests that the effects of vaping on the habit may be completely misunderstood.

An alarming new report from the Centers for Disease Control and Prevention indicates that vaping might not be the easy cure to smoking that we thought it was, because many adults who use e-cigarettes also smoke tobacco cigarettes.

A total of 59 percent of all adult e-cigarette users also smoke cigarettes, and just 30 percent of e-cigarette users were former smokers, with the remaining 11 percent made up of people who had never smoked before.

A total of 40 percent of e-cig users between the ages of 18-24 were never-smokers, indicating this actually may be a new way to get people hooked on smoking or vaping, especially for young people. About 43 percent were current smokers and 17 percent were former smokers in that age group.

The new report follows a September statement from the CDC showing a rise in vaping in teens.

“The increased use of e-cigarettes by teens is deeply troubling,” said CDC Director Tom Frieden, M.D., M.P.H., in the statement. “Nicotine is a highly addictive drug. Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes.”

“About 90 percent of all smokers begin smoking as teenagers,” said Tim McAfee, M.D., M.P.H., director of the CDC Office on Smoking and Health. “We must keep our youth from experimenting or using any tobacco product. These dramatic increases suggest that developing strategies to prevent marketing, sales, and use of e-cigarettes among youth is critical.”

QuickStats: Cigarette Smoking Status Among Current Adult E-cigarette Users, by Age Group

Download (PDF, 177KB)

Nicotine and Carbonyl Emissions From Popular Electronic Cigarette Products

Nicotine and Carbonyl Emissions From Popular Electronic Cigarette Products: Correlation to Liquid Composition and Design Characteristics

Ahmad EL-Hellani, PhD Rola Salman, BS Rachel El-Hage, MS Soha Talih, PhD Nathalie Malek, MS Rima Baalbaki, MS Nareg Karaoghlanian, BE Rima Nakkash, PhD Alan Shihadeh, ScD Najat A. Saliba, PhD

https://academic.oup.com/ntr/article-abstract/doi/10.1093/ntr/ntw280/2282864/Nicotine-and-Carbonyl-Emissions-From-Popular

Abstract

Introduction:

Available in hundreds of device designs and thousands of flavors, electronic cigarette (ECIG) may have differing toxicant emission characteristics. This study assesses nicotine and carbonyl yields in the most popular brands in the U.S. market. These products included disposable, prefilled cartridge, and tank-based ECIGs.

Methods:

Twenty-seven ECIG products of 10 brands were procured and their power outputs were measured. The e-liquids were characterized for pH, nicotine concentration, propylene glycol/vegetable glycerin (PG/VG) ratio, and water content. Aerosols were generated using a puffing machine and nicotine and carbonyls were, respectively, quantified using gas chromatograph and high-performance liquid chromatography. A multiregression model was used to interpret the data.

Results:

Nicotine yields varied from 0.27 to 2.91 mg/15 puffs, a range corresponding to the nicotine yield of less than 1 to more than 3 combustible cigarettes. Nicotine yield was highly correlated with ECIG type and brand, liquid nicotine concentration, and PG/VG ratio, and to a lower significance with electrical power, but not with pH and water content. Carbonyls, including the carcinogen formaldehyde, were detected in all ECIG aerosols, with total carbonyl concentrations ranging from 3.72 to 48.85 µg/15 puffs.

Unlike nicotine, carbonyl concentrations were mainly correlated with power.

Conclusion:

In 15 puffs, some ECIG devices emit nicotine quantities that exceed those of tobacco cigarettes. Nicotine emissions vary widely across products but carbonyl emissions showed little variations. In spite of that ECIG users are exposed to toxicologically significant levels of carbonyl compounds, especially formaldehyde. Regression analysis showed the importance of design and e-liquid characteristics as determinants of nicotine and carbonyl emissions.

Implications.

Periodic surveying of characteristics of ECIG products available in the marketplace is valuable for understanding population-wide changes in ECIG use patterns over time.