Chronic tobacco smoking is a major cause of preventable morbidity and mortality worldwide. In the lung, tobacco smoking increases the risk of lung cancer, and also causes chronic obstructive pulmonary disease (COPD), which encompasses both emphysema and chronic bronchitis. E-cigarettes (E-Cigs), or electronic nicotine delivery systems, were developed over a decade ago and are designed to deliver nicotine without combusting tobacco. Although tobacco smoking has declined since the 1950s, E-Cig usage has increased, attracting both former tobacco smokers and never smokers. E-Cig liquids (e-liquids) contain nicotine in a glycerol/propylene glycol vehicle with flavorings, which are vaporized and inhaled. To date, neither E-Cig devices, nor e-liquids, are regulated by the Food and Drug Administration (FDA). The FDA has proposed a deeming rule, which aims to initiate legislation to regulate E-Cigs, but the timeline to take effect is uncertain. Proponents of E-Cigs say that they are safe and should not be regulated. Opposition is varied, with some opponents proposing that E-Cig usage will introduce a new generation to nicotine addiction, reversing the decline seen with tobacco smoking, or that E-Cigs generally may not be safe and will trigger diseases like tobacco. In this review, we shall discuss what is known about the effects of E-Cigs on the mammalian lung and isolated lung cells in vitro. We hope that collating this data will help illustrate gaps in the knowledge of this burgeoning field, directing researchers toward answering whether or not E-Cigs are capable of causing disease.

Will chronic e-cigarette use cause lung disease?

Objective: To analyse trial and deposition testimony of tobacco industry executives to determine how they use the concepts of “information” and “choice” and consider how these concepts are related to theoretical models of health behaviour change. Methods: We coded and analysed transcripts of trial and deposition testimony of 14 high-level executives representing six companies plus the Tobacco Institute. We conducted an interpretive analysis of industry executives’ characterisation of the industry’s role as information provider and the agency of tobacco consumers in making “choices”. Results: Tobacco industry executives deployed the concept of “information” as a mechanism that shifted to consumers full moral responsibility for the harms caused by tobacco products. The industry’s role was characterised as that of impartial supplier of value-free “information”, without regard to its quality, accuracy and truthfulness. Tobacco industry legal defences rely on assumptions congruent with and supported by individual rational choice theories, particularly those that emphasise individual, autonomous decision-makers. Conclusions: Tobacco control advocates and health educators must challenge the industry’s preferred framing, pointing out that “information” is not value-free. Multi-level, multi-sectoral interventions are critical to tobacco use prevention. Over-reliance on individual and interpersonal rational choice models may have the effect of validating the industry’s model of smoking and cessation behaviour, absolving it of responsibility and rendering invisible the “choices” the industry has made and continues to make in promoting the most deadly consumer product ever made.

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How the health belief model helps the tobacco industry: individuals, choice, and “information”

In this article we present communication theory as a conceptual framework for conducting documents research on tobacco advertising strategies, and we discuss two methods for analysing advertisements: semiotics and content analysis. We provide concrete examples of how we have used tobacco industry documents archives and tobacco advertisement collections iteratively in our research to yield a synergistic analysis of these two complementary data sources. Tobacco promotion researchers should consider adopting these theoretical and methodological approaches.

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Every document and picture tells a story: using internal corporate document reviews, semiotics, and content analysis to assess tobacco advertising

Tobacco documents research has developed into a thriving academic enterprise since its inception in 1995. The technology supporting tobacco documents archiving, searching and retrieval has improved greatly since that time, and consequently tobacco documents researchers have considerably more access to resources than was the case when researchers had to travel to physical archives and/or electronically search poorly and incompletely indexed documents. The authors of the papers presented in this supplement all followed the same basic research methodology. Rather than leave the reader of the supplement to read the same discussion of methods in each individual paper, presented here is an overview of the methods all authors followed. In the individual articles that follow in this supplement, the authors present the additional methodological information specific to their topics. This brief discussion also highlights technological capabilities in the Legacy Tobacco Documents Library and updates methods for organising internal tobacco documents data and findings.

https://tobaccocontrol.bmj.com/content/tobaccocontrol/20/Suppl_2/ii8.full.pdf

Tobacco documents research methodology

Background Concept of “harm reduction” Methods Data sources Selection criteria Data extraction and synthesis New marketed and test-marketed products and products with emerging use Oral tobacco products Dissolvable tobacco Novel snus products Oral tobacco types resembling snus on the market in the European Union Modified or alternative smoked products Potential reduced exposure cigarettes “Low-tar” cigarettes promoted in some countries as “less harmful” products Reduced-nicotine cigarettes Super-slim cigarettes Little cigars and cigarillos Herbal-tobacco cigarettes Bidis Waterpipes Product description and marketing strategies Consumer awareness, product use and perceptions Constituents, toxicity and disease risk Addictive potential Regulatory considerations Notable alterations to traditional products Swedish snus with reduced tobacco content

WHO Study Group on Tobacco Product Regulation

Nicotine and addiction

El tabaquismo debe ser considerado como una drogodependencia. La nicotina es su principal ingrediente psicoactivo y debe sus propiedades adictivas al aumento de la liberacion de dopamina en los circuitos de recompensa, por su accion agonista sobre receptores colinergicos nicotinicos . La estimulacion indirecta sobre otros sistemas de neurotransmision, como el noradrenergico y el cannabinoide, ha sido implicada en sus propiedades reforzadoras. Exponer este enfoque molecular del tabaquismo, el cual descubre los blancos susceptibles a ser modificados por intervenciones farmacologicas, es el objetivo de este trabajo. Las estrategias actuales incluyen la terapia sustitutiva con nicotina, el uso de farmacos antidepresivos y el desarrollo de vacunas. El tratamiento del tabaquismo implica ademas la consideracion de medidas impositivas, legislativas y laborales y, sobre todo, un cambio de conducta, lo que sumado al apoyo farmacologico constituye un modo eficaz de reducir la morbimortalidad derivada del tabaco a corto y largo plazos.

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Nicotina y Adicción: Un enfoque molecular del tabaquismo

Introduction: there are evidences that the function of health professionals is very important at the moment of social change regarding the smoking and that is own smoke habit has a relevant influence on it. Objective: to determine the smoking behavior in the health staff of a hospitalization area. Methods: a cross-sectional and descriptive study was conducted in the "Dr. Carlos J. Finlay" Central Military Hospital over the first semester of 2010 including 9 smokers including physicians, nurses and service staff. In all the cases a survey was distributed as well as the Fagerström test. Results: there was predominance of female sex (57.8 %) The Fagerström questionnaire showed a low dependence rate (31.1 %). Severity of addiction demonstrated that the 75.5 % was the social group considered as slight or intermittent. The 47.8 % was in training phase for quite the smoking. The 76 % declared had not anti-smoking treatment. Deterioration of personal economy was the more mentioned smoking consequence in all the groups (80 %); whereas among the smoking-provoked diseases, the stomatologic diseases (25.5 %) and the peripheral vascular ones (24.4 %) were fundamental. Conclusions: it is take into account the smoking behavior in health staff of hospitalization area is observed mainly in the service staff, young, female sex, white skin, married, with a low dependence of nicotine, without a prior anti-smoking treatment with consequences for stomatologic and peripheral vascular health and mainly the deterioration of the personal economy.

Comportamiento del tabaquismo en personal sanitario del Hospital Militar Central "Dr. Carlos J. Finlay

Resumen es: La tuberculosis es una de las enfermedades mas terribles que afectan al hombre; su antiguedad se estima entre 15 000 a 20 000 anos. La historia de la luc...

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Historia de la lucha antituberculosa

Objective: describe the results of the use of bronchoscopy to diagnose respiratory diseases. Methods: a descriptive cross-sectional study was conducted with 116 patients who underwent bronchoscopy. The variables studied were age, gender, race, diagnostic indication, radiological findings, positivity of the techniques applied, diagnostic yield and procedural complications. The data obtained were summarized by means of simple frequencies, ranges and percentage. Chi-square tests of statistical significance were applied and the confidence interval was 95 %. The odds ratio was used to determine the association between variables. Results: 73.2 % of the sample were men aged 51-70, and 52.6 % showed elements of radiological suspicion of cancer as diagnostic indication. Hilar widening was the radiological finding most commonly reported (30.1 %), and was associated with a higher diagnostic yield. Cancer was the most commonly diagnosed condition (68.0 %). 70.3 % of cases showed agreement between macroscopic and microscopic diagnoses. Endobronchial biopsy with forceps exhibited a higher diagnostic positivity (66.6 %). Bleeding and hypoxia were reported as minor complications in 10.35 % of cases. Conclusions: bronchoscopy is an important tool for the diagnosis of respiratory diseases. Its highest yield is recorded in the presence of clinical-radiological suspicion of cancer, mainly when findings arouse suspicion of central localizations, which makes endobronchial biopsy with forceps the most useful technique in those cases. The occurrence of infrequent minor complications is associated with the application of techniques.

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Hayvin Pérez Cruz

Papers

Nicotine and addiction

Nicotina y Adicción: Un enfoque molecular del tabaquismo

Comportamiento del tabaquismo en personal sanitario del Hospital Militar Central "Dr. Carlos J. Finlay

Historia de la lucha antituberculosa

Broncoscopia en el diagnóstico de las enfermedades respiratorias