The nicotine and tobacco epidemic among adolescents: new products are addicting our youth.

Purpose Of Review: New nicotine and tobacco products such as electronic cigarettes and oral nicotine products have increased in use and threaten to addict a new generation of youth. This review summarizes current literature on nicotine and tobacco products used by youth, epidemiology, health effects, prevention and treatment of nicotine dependence, and current policies and regulations.

Recent Findings: Electronic cigarettes and oral nicotine products are popular among youth, attracting adolescents through exposure to deceptive marketing and fruit, candy and dessert flavors.

Protecting Children and Adolescents From Tobacco and Nicotine.

Significant strides have been made in reducing rates of cigarette smoking among adolescents in the United States. However, rates of e-cigarette and similar device use among youth are high, and rates of other tobacco product use, such as cigars and hookahs, have not declined. In addition, almost 40% of children 3 to 11 years of age are regularly exposed to secondhand tobacco smoke, and rates of secondhand exposure to e-cigarette aerosol have increased over the last decade.

Protecting Children and Adolescents From Tobacco and Nicotine.

Tobacco use remains the leading preventable cause of disease and death for adults in the United States. Significant strides have been made in reducing rates of cigarette smoking among adolescents in the United States. However, rates of e-cigarette and similar device use among youth are high, and rates of other tobacco product use, such as cigars and hookahs, have not declined.

Protecting Children and Adolescents From Tobacco and Nicotine.

This technical report provides the evidence base for the accompanying tobacco clinical report and policy statement. It builds on, strengthens, and expands AAP recommendations from the previous version in 2015. Tobacco use remains the leading preventable cause of disease and death for adults in the United States.

The youth e-cigarette epidemic: updates and review of devices, epidemiology and regulation.

Adolescent e-cigarette use constitutes a major public health challenge that has reversed the steady progress made in the past three decades to reduce youth tobacco use in the United States (U.S.).

Tobacco Screening and Use in Hospitalized Adolescents at a Children's Hospital.

Objectives: With this study, we aim to evaluate inpatient adolescent screening for tobacco, as well as the relationship between tobacco and other substance use, tobacco types used, and cessation interventions.

Methods: A retrospective chart review of inpatient hospital admissions of adolescents aged ≥13 years to a tertiary care, freestanding, urban children's hospital in 2018 was performed. Tobacco use-related variables were entered into a multiple logistic regression model in which the adjusted odds ratios were determined.

Toxicity assessment of a novel oil dispersant based on silica nanoparticles using Fathead minnow.

Oil spill accidents are a major concern for aquatic organisms. In recent history, the Deepwater Horizon blowout spilled 500 million liters of crude oil into the Gulf of Mexico. Corexit 9500A was used to disperse the oil since it was the method approved at that time, despite safety concerns about its use.

School-based e-cigarette education in Alabama: Impact on knowledge of e-cigarettes, perceptions and intent to try.

Background And Objectives: Educational programs are needed to combat the sharp rise in adolescent e-cigarette use. We assessed adolescent knowledge about e-cigarettes, perceptions of harmfulness and addictiveness and intent to try e-cigarettes before and after an e-cigarette educational session.

Methods: We conducted a one-group pre- and post-test study among middle and high school students in Alabama in 2019.

Tobacco smoke exposure in pediatric cystic fibrosis: A qualitative study of clinician and caregiver perspectives on smoking cessation.

Objective: Tobacco smoke exposure has negative impacts on the lung health of children with cystic fibrosis (CF), yet evidence-based strategies for smoking cessation have not been tested with or tailored to CF caregivers. This qualitative study identified barriers and facilitators of smoking cessation in this population and outlined potential interventional approaches.

Methods: We conducted semi-structured interviews with CF familial caregivers who were current or former smokers, and with members of the CF care team.

Residential instability, neighborhood deprivation, and pediatric asthma outcomes.

Introduction: Limited work has directly compared the role of different neighborhood factors or examined their interactive effects on pediatric asthma outcomes. Our objective was to quantify the main and interactive effects of neighborhood deprivation and residential instability (RI) on pediatric asthma outcomes.

Methods: We conducted a retrospective cross-sectional study of patients with a primary diagnosis of asthma hospitalized at a tertiary care pediatric hospital.

A Public Health Crisis: Electronic Cigarettes, Vape, and JUUL.

Electronic cigarettes (e-cigarettes) and vape devices have rapidly become the most common tobacco products used by youth, driven in large part by marketing and advertising by e-cigarette companies. There is substantial evidence that adolescent e-cigarette use leads to use of combustible tobacco products. E-cigarette companies commonly advertise that e-cigarettes contain nicotine, flavoring chemicals, and humectants (propylene glycol and/or vegetable glycerin), but toxicants, ultrafine particles, and carcinogens have also been found in e-cigarette solutions and emissions, many of which are known to cause adverse health effects.

E-Cigarettes and Similar Devices.

Electronic cigarettes (e-cigarettes) are the most commonly used tobacco product among youth. The 2016 US Surgeon General's Report on e-cigarette use among youth and young adults concluded that e-cigarettes are unsafe for children and adolescents. Furthermore, strong and consistent evidence finds that children and adolescents who use e-cigarettes are significantly more likely to go on to use traditional cigarettes-a product that kills half its long-term users.

Quality Improvement Project to Improve Screening for Tobacco Use in Adolescent Inpatients at a Children's Hospital.

Tobacco use begins in adolescence for the majority of smokers. The purpose of this study was to increase screening and reporting of tobacco use in hospitalized adolescents at a tertiary care children's hospital. We completed a nursing focus group to understand challenges and completed four iterative Plan-Do-Study-Act cycles, which included: (1) in-person nursing education regarding tobacco use screening, (2) addition of an e-cigarette-specific screening question, (3) the creation and dissemination of an educational video for nursing, and (4) adding the video as a mandatory component of nursing orientation.

Predictors of Hospital Reuse Among Publicly Insured Children Hospitalized for Status Asthmaticus.

Background: Asthma is a common cause of pediatric hospitalization. Nonadherence to asthma medications is associated with worse outcomes; however, there is a paucity of data regarding posthospitalization prescription filling and hospital reuse. Our objective was to identify patients at risk for hospital reuse after being hospitalized for asthma.

Improving Inpatient Asthma Management: The Implementation and Evaluation of a Pediatric Asthma Clinical Pathway.

Introduction: Asthma exacerbations are a leading cause of pediatric hospitalizations. Despite national guidelines, variability exists in the use and dosing of bronchodilators, oxygen management, and respiratory assessments of patients. We aimed to implement an inpatient Asthma Clinical Pathway (Pathway) to standardize care and reduce length of stay (LOS).

Implementing Parental Tobacco Dependence Treatment Within Bronchiolitis QI Collaboratives.

Background And Objectives: We sought to implement systematic tobacco dependence interventions for parents and/or caregivers as secondary aims within 2 multisite quality improvement (QI) collaboratives for bronchiolitis. We hypothesized that iterative improvements in tobacco dependence intervention strategies would result in improvement in outcomes between collaboratives.

Methods: This study involved 2 separate yearlong, multisite QI collaboratives that were focused on care provided to inpatients with a primary diagnosis of bronchiolitis.

Multisite Emergency Department Inpatient Collaborative to Reduce Unnecessary Bronchiolitis Care.

Background And Objectives: There is high variation in the care of acute viral bronchiolitis. We sought to promote collaboration between emergency department (ED) and inpatient (IP) units with the goal of reducing unnecessary testing and treatment.

Methods: Multisite collaborative with improvement teams co-led by ED and IP physicians and a 1-year period of active participation.

Sustainability in the AAP Bronchiolitis Quality Improvement Project.

Background And Objectives: Adherence to American Academy of Pediatrics (AAP) bronchiolitis clinical practice guideline recommendations improved significantly through the AAP's multiinstitutional collaborative, the Bronchiolitis Quality Improvement Project (BQIP). We assessed sustainability of improvements at participating institutions for 1 year following completion of the collaborative.

Methods: Twenty-one multidisciplinary hospital-based teams provided monthly data for key inpatient bronchiolitis measures during baseline and intervention bronchiolitis seasons.

Respiratory Scores as a Tool to Reduce Bronchodilator Use in Children Hospitalized With Acute Viral Bronchiolitis.

Background And Objectives: Adoption of clinical respiratory scoring as a quality improvement (QI) tool in bronchiolitis has been temporally associated with decreased bronchodilator usage. We sought to determine whether documented use of a clinical respiratory score at the patient level was associated with a decrease in either the physician prescription of any dose of bronchodilator or the number of doses, if prescribed, in a multisite QI collaborative.

Methods: We performed a secondary analysis of data from a QI collaborative involving 22 hospitals.

Solvent effects on modulus of poly(propylene oxide)-based organogels as measured by cavitation rheology.

A series of novel organogels were synthesized from poly(propylene oxide) (PPO) functionalized with main chain urea moieties which provided rapid gelation and high moduli in a variety of solvents. Three different molecular weight PPOs were used in this study: 430, 2000, and 4000 g mol(-1), each with α,ω-amino-end groups. Four urea groups were introduced into the main chain by reaction with hexamethylene diisocyanate followed by subsequent reaction with a monofunctional alkyl or aromatic amine.