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If you’ve been using electronic cigarettes and attempt to quit but can’t, are you addicted? That’s one interpretation of a recent study among US youth, showing that since the introduction of e-cigarettes more unsuccessful quit attempts have been seen. Michael Blaha, an anti-smoking advocate and cardiologist at Johns Hopkins, says he’s persuaded.

Blaha: I do think that unsuccessful quit attempts are a metric of increasing addiction to nicotine. But of course we do want people to try to quit using their nicotine products so in that sense, more people trying to quit is a good thing. But we’re obviously failing in supporting our patients and individuals in the community in succeeding to quit, and this is in part because there are very few strategies out there for informing people who use e-cigarettes or vape, on the most successful strategies for quitting.  :29

Blaha says it’s unclear whether quitting strategies for traditional cigarettes will work for e-cigarettes. At Johns Hopkins, I’m Elizabeth Tracey.

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Youth who take up vaping may have difficulty quitting, a recent analysis from the Monitoring the Future study looking at nicotine use among US 8th, 10th and 12th graders finds. Michael Blaha, an anti-smoking advocate and cardiologist at Johns Hopkins, says he’s seen another disturbing trend.

Blaha: During the pandemic we’re seeing a decrease in occasional use of e-cigarettes, particularly amongst youths and young adults. But of those users we’re seeing a greater percentage of which are daily users that seem to be addicted to nicotine. I think we’re shifting in the research about e-cigarettes and vaping toward more like a product that people are using more like they used to use cigarettes. More daily use, more addiction, and less of the occasional use that we used to see with experimentation with electronic cigarettes early in their development.  :29

Blaha notes that while vaping may be somewhat less harmful than combustible cigarettes harms do exist, some of which won’t be fully known until much more data accumulates. At Johns Hopkins, I’m Elizabeth Tracey.

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While fewer young people seem to be taking up vaping, those who have are having a hard time quitting, recent research shows. Michael Blaha, an anti-smoking advocate and cardiologist at Johns Hopkins, says the very nature of the devices lend themselves to nicotine addiction.

Blaha: With the recent products on the market as far as vaping or e-cigarettes go, we’re seeing equivalent if not higher doses of nicotine being delivered, compared to traditional cigarettes, and that nicotine can be delivered sometimes even faster with modern e-cigarettes, and also the user can be in control of how much nicotine they get with many vaping delivery devices. So this is a whole new world of nicotine delivery. I think it does have a potential for greater nicotine addiction.  :26

The data come from the Monitoring the Future study, surveying 8th, 10th and 12th grade students from a national sample, and point to the need for more stringent policies regarding use of these devices by young people. At Johns Hopkins, I’m Elizabeth Tracey.

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Vaping and use of e-cigarettes has largely been a trend of youth since their introduction several years ago. Now new research shows that when young people attempt to stop using these products they are largely failing to do so. Michael Blaha, an anti-smoking advocate and cardiologist at Johns Hopkins, comments.

Blaha: It’s very interesting that the amount of unsuccessful quit attempts from nicotine have actually increased recently. That’s largely driven by people unsuccessfully trying to quit vaping, and we know very little about quitting vaping. There’s very few clinical guidelines, there’s no FDA approved medications per se, and there’s very little guidance for teachers or parents on how to talk to particularly young people about how to quit nicotine.  :29

Blaha says nicotine addiction is almost uniformly challenging to overcome, and there are no studies to inform the characteristics of the addiction in younger people versus those who’ve used nicotine for prolonged periods. At Johns Hopkins, I’m Elizabeth Tracey.

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When the diabetes medicine metformin is taken by men in the three months prior to conception of sons, it may increase the risk for genital and urinary tract malformations three and a half times, a Danish study finds. Rita Kalyani, a diabetes expert at Johns Hopkins, says while attention has been focused on the health of prospective mothers for some time, it may be time to look at fathers also.

Kalyani: I think this study certainly gives us pause to think about investigating the impact of medication use in the father, whether it’s metformin, other diabetes drugs or drugs in general, on spermatogenesis. The finding that the birth defects in this study were only seen in boys does suggest that there probably is some mechanism related to sex hormones. This was an observational study, it does have limitations, and I do think we need better prospective studies to look at this question.  :30

At Johns Hopkins, I’m Elizabeth Tracey.

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Men who used the diabetes medicine metformin during the three months prior to conception of their son saw malformations of the genital and urinary tracts three and a half times more often in these children, a very large study from Denmark finds. Johns Hopkins diabetes expert Rita Kalyani explains.

Kalyani: What they found was that in this observational study they went back and looked at the use of metformin in fathers and related it to whether their children had birth defects and what they found is that actually there was an increased risk of birth defects in boys born to fathers that used metformin in a formative period, three months before they were conceived.  :26

Kalyani says metformin is recommended as first line treatment for type 2 diabetes and is therefore used quite commonly, so finding out more about this association will be very important. She notes that there are quite a few choices in diabetes medicines that might be used alternatively. At Johns Hopkins, I’m Elizabeth Tracey.

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In the year following a Covid-19 infection, some 40% of adults in one study developed new onset type 2 diabetes. Rita Kalyani, a diabetes expert at Johns Hopkins, says certain populations were much more at risk for this outcome.

Kalyani: Older adults, over the age of 65, Black versus white, those with prediabetes, and those who were obese, were more likely to develop diabetes. These were all people who might have been on the edge. Had risk factors for developing diabetes but hadn’t developed it yet, and then with Covid-19 developed the full blown onset of the disease. Forty percent increased risk is a lot, what this study doesn’t yet answer is will these people have long lasting diabetes, or will it resolve over time.  :31

Kalyani says it may be possible to reverse the condition over time as inflammation decreases, as well as employing diet and exercise strategies to improve blood sugar levels. At Johns Hopkins, I’m Elizabeth Tracey.