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Background: The use of electronic (e)-cigarettes in the long term has been associated with an increased risk of respiratory diseases. Dual use of e-cigarettes and traditional cigarettes may increase these risks even more due to the combined exposure effects of these products. The aim of this study was to investigate the local and systemic effects of e-cigarette use for more than one year and compare them with healthy non-smokers, cigarette smokers, and dual users.
Methods: The clinical study was conducted among 22 healthy non-smokers, 20 e-cigarette users, 20 cigarette smokers, and 20 dual users. Participants were matched with age and BMI, had normal baseline lung function, and had no allergies. Exhaled FeNO and bronchial responsiveness were assessed along with reactive oxygen species (ROS), toll-like receptor (TLR) expression, and inflammatory cytokines in blood and sputum.
Results: Exhaled FeNO was higher in e-cigarette users (14 ppb, p = 0.04) and lower in cigarette smokers (9 ppb, p = 0.04) compared to healthy non-smokers (11 ppb). Bronchial responsiveness was increased in e-cigarette users (1.9 mg, p = 0.01) and cigarette smokers (1.9 mg, p = 0.01) compared to healthy non-smokers (2.9 mg). ROS in blood and sputum in e-cigarette users (p = 0.005 and p = 0.04) and dual users (p = 0.003 and p = 0.04) were increased. Also, TLR2 expression in blood granulocytes in all exposed groups (p = 0.001), TLR2 and TLR4 expression in sputum in e-cigarette users (p = 0.04 and p = 0.03) and dual users (p < 0.0001 and p = 0.004) were increased. Moreover, the percentage of IL13 and IFNγ cytokine-producing T cells in blood were increased in e-cigarette users (p = 0.0001 and p < 0.0001) and dual users (p = 0.001 and p < 0.0001).
Conclusion: Our research indicates that both local and systemic inflammatory responses, along with innate immune receptor activity, were significantly altered in e-cigarette users and dual users. Notably, these alterations were detected in e-cigarette users within a short timeframe of just 1 to 3 years of use.
Clinical Trial Number: Not applicable.
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http://dx.doi.org/10.1186/s12931-025-03289-4 | DOI Listing |
Nicotine Tob Res
September 2025
College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States.
Introduction: Nicotine pouches (NPs) are an emerging nicotine delivery system. Understanding nicotine and toxicant exposure among NP users compared with users of other tobacco products and non-users is critical for informing public health strategies.
Methods: Data (n = 4527) were drawn from the Population Assessment of Tobacco and Health Study Wave 7 (2022-2023).
BMJ Public Health
September 2025
School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Introduction: Curbing adolescent vaping is a public health priority and little evidence exists examining protective factors. Using a strength-based approach, this study explored the relationship between adolescent vaping health perceptions and vaping use.
Methods: Cross-sectional data from 9000 Australian adolescents aged 14-17 years recruited via multiple online panels as part of the Generation Vape Study were used.
Cureus
August 2025
Community Medicine, Jazan University, Riyadh, SAU.
Vaping product use-associated lung injury is a recently recognized respiratory illness that can occur in users of e-cigarettes or vaping products, including those marketed as nicotine‑free. We describe a previously healthy, 22‑year‑old male, non‑smoker who presented with progressive shortness of breath, non‑productive cough, pleuritic chest pain, low‑grade fever, and fatigue. He reported daily use of a flavored nicotine‑free vaping device for eight months, with increased use in the preceding month, including cartridges purchased from unregulated online sources.
View Article and Find Full Text PDFCureus
August 2025
Institute of Endocrine and Metabolic Sciences, Institute of Endocrine and Metabolic Sciences, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, ITA.
Introduction Graves' orbitopathy (GO) is a significant complication of Graves' disease (GD), often exacerbated by cigarette smoking. While smoking is a well-established risk factor, it remains unclear whether nicotine itself or toxic combustion byproducts are primarily responsible. Here, we present preliminary results from our study, which investigates the impact of different nicotine delivery systems on GO features and clinical outcomes.
View Article and Find Full Text PDFFront Public Health
September 2025
Clinical Pharmacy Department, College of Pharmacy, Taif University, Taif, Saudi Arabia.
Background: Electronic cigarette (e-cigarette) use has become increasingly popular worldwide, including in Saudi Arabia, especially among younger individuals. This study investigates the patterns, motivations, and perceptions of e-cigarette use to inform public health interventions and policy.
Methods: This descriptive cross-sectional study surveyed traditional cigarette smokers and ex-smokers above 18 in Saudi Arabia using an online questionnaire distributed via social media with convenience and snowball sampling.