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Do e-cigarettes contain more nicotine that regular cigarettes? – The Globe and Mail

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‘What we do know is that both smoking and vaping can be addictive,’ says Dr. Peter Selby, chief of medicine and psychiatry at the Centre for Addiction and Mental Health in Toronto. (File Photo).

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The question: I’ve heard that e-cigarettes may contain far more nicotine than regular cigarettes. Does that mean vaping is more addictive than smoking?

The answer: It’s true that some vaping devices can deliver more nicotine than cigarettes. But there are many different types of electronic cigarettes, and how they are used can affect the amount of nicotine that ends up in the bloodstream, and eventually the brain, says Dr. Robert Schwartz, a professor in the Dalla Lana School of Public Health at the University of Toronto.

The battery-powered e-cigarettes heat up a liquid containing nicotine to produce an aerosol, or vapour, which can be inhaled. (Flavourings and other chemicals may also be added to the fluid mixture.)

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A lot depends on the nicotine concentration in the fluid and the power, or heat, generated by the e-cigarette. Other variables include how hard, how long and how often a person inhales. “Unless you know how to puff on the thing properly, and for long enough to heat the liquid sufficiently, you are not going to get huge amounts of nicotine,” says Schwartz.

So, it isn’t clear-cut whether cigarettes or e-cigarettes deliver more nicotine. But one thing is clear:

“What we do know is that both smoking and vaping can be addictive,” says Dr. Peter Selby, chief of medicine and psychiatry at the Centre for Addiction and Mental Health in Toronto

In fact, any amount of inhaled, chewed or snorted nicotine can be problematic – meaning that a person is likely to progress to daily use following a period of experimentation. “Nicotine is one of the most addictive substances we are aware of. It’s as addictive as heroin,” says Schwartz.

Originally, many public health experts looked upon vaping as potentially less harmful than smoking cigarettes, which produce about 7,000 toxic chemicals – including carcinogens – by burning tobacco. Some hope the devices might serve as quitting aids – or, at the very least, help reduce the number of harmful substances that smokers inhale.

But the recent surge in vaping among teens has set off alarm bells in the public-health community. And those concerns are intensified by reports of lung injuries among some vapers.

“My biggest concern is that we have already addicted a whole new generation of people to nicotine,” says Schwartz.

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Teenagers – whose brains are still developing – are especially vulnerable to the addictive powers of nicotine, according to a growing body of research.

Nicotine attaches to receptors in the brain, thereby triggering the release of dopamine – a chemical messenger involved in pleasure and a wide range of other neurological functions. It basically produces a feel-good high.

When teens smoke or vape, it is believed that their brains create more receptors to handle the influx of nicotine. As the number of receptors increases, they need higher levels of nicotine to get the same buzz.

Some researchers have dubbed this effect the “nico-teen” brain. They also speculate that these neurological changes may have long-term consequences for mood and mental focus.

In the debate over vaping, much of the recent attention has been about the spate of serious lung injuries. Many of these cases appear to be linked to the vaping of cannabis oils such as tetrahydrocannabinol or THC. The latest evidence suggests that vitamin E acetate, a filler sometimes added to black-market THC, might be causing the injuries.

But even without THC, routine vaping – and the other chemicals in vaping liquids – may lead to long-term health problems.

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Vaping-related illnesses have been in the spotlight recently amid accusations the makers of the products are targeting them at youth. Dr. James MacKillop outlines some strategies to use at home in conversations with your children about vaping. MacKillop is the director of the Peter Boris Centre For Addictions Research and co-director of the Michael G. Degroote Centre For Medicinal Cannabis Research. The Globe and Mail (staff)

“Kids who vape have almost twice the rate of coughing and wheezing as kids who don’t vape,” says Schwartz. Are these symptoms the early warning signs of chronic respiratory conditions such as asthma? Or, might vaping contribute to the development of cardiovascular disease? “We don’t yet know for sure,” says Schwartz. He adds that it will likely take some time to establish a clear picture of the risks.

Selby is also concerned that young people who have never used tobacco are now being drawn to vaping. He says better government regulations are needed to safeguard adolescents. However, he thinks vaping should not be vilified to the point where the devices are actually banned.

“Some individuals are going to take up tobacco smoking anyway, and they will be better off if they have the option to vape,” says Selby. “It’s all about relative risks between combustible cigarettes and vaping devices that deliver fewer dangerous chemicals.”

Indeed, despite the various problems linked to e-cigarettes, “there is very broad consensus in the scientific community that smoking is the most harmful way to use nicotine and it’s known to cause premature death in at least half of users,” says Schwartz.

According to Selby, “it would be completely ridiculous to ban the sale of vaping devices, while giving free reign to the most dangerous form of nicotine delivery – cigarettes.”

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Whooping cough is at a decade-high level in US

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MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”

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AP data journalist Kasturi Pananjady contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Scientists show how sperm and egg come together like a key in a lock

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How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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Older patients, non-English speakers more likely to be harmed in hospital: report

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Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.

The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.

The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.

The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.

“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.

When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.

“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.

“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.

The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.

Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.

The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.

“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.

They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.

“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”

This report by The Canadian Press was first published Oct. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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