DALLAS, April 21, 2020 -- The American Heart Association is investing nearly $17 million in scientific research to be led by scientists from Boston University, the Ohio State University and Yale University to study the health impacts of e-cigarettes and other nicotine delivery systems on youth and young adults. The ENACT: End Nicotine Addiction in Children and Teens Research Initiative is funding ground-breaking research to fill a critical need for clear scientific knowledge in this area. This is the latest in a multipronged, ongoing commitment announced last fall by the American Heart Association -- the world's leading voluntary organization dedicated to a world of longer, healthier lives -- to fight the growing epidemic of youth vaping.

"E-cigarettes are being marketed as a healthy option to traditional cigarettes, but no one knows if vaping is safe in the long run because e-cigarettes haven't been around long enough to be studied deeply. Some diseases can take years and even decades to develop, so there is more work needed to fully understand all the dangers," said American Heart Association volunteer president Robert A. Harrington, M.D., FAHA, Arthur L. Bloomfield Professor of Medicine and chair of the department of medicine at Stanford University. "There's certainly plenty of indication they're harmful for growing minds and bodies because we know e-cigarettes contain nicotine and we know the harmful effects of nicotine, but it's important we grow that overall body of scientific evidence."

Harrington said there's a sense of urgency because, at a time when regular cigarette smoking has reached an all-time low, young people are turning to e-cigarettes at epidemic proportions with nearly one in four high school students reportedly vaping. That's why these research projects will be high-impact and fast tracked, only two years in length and funded at levels among the highest individual grants awarded in the Association's history. The initiative is designed to produce turnkey programs to support youth as well as provide clear evidence to inform policy decisions.

Research teams from Boston University, the Ohio State University and Yale University will be working over the next two years to identify the biological impacts of vaping on multiple organ systems (heart, brain, lungs, vascular, etc.), behavioral factors and specific social influencers of health to reverse these trends.

The projects, funded for two years, include:

VAPERACE -- Led by Naomi Hamburg, M.D., the Joseph A. Vita, MD Professor at the Boston University School of Medicine, this team will establish the Rapidly Advancing Discovery to Arrest the Outbreak of Youth Vaping Center and will include four intersecting projects at Boston University, Johns Hopkins University, Stanford University and the University of Louisville. These projects include: basic research using human induced pluripotent stem cell samples to test the toxicity of the components of e-cigarettes; mobile health technology to measure the physiological cardiovascular impacts of e-cigarettes on youth in real-world settings and a virtual reality and text messaging delivered e-cigarette cessation program for youth developed by combining social media methods with focus groups.

VERIFY: A Comprehensive Approach to Understanding and Ending Youth E-cigarette Addiction -- Led by Peter Mohler, Ph.D., the vice dean for research and director of the Davis Heart & Lung Research Institute at the Ohio State College of Medicine and Wexner Medical Center, this team comprised of investigators in the Colleges of Medicine, Nursing, Public Health and Engineering and the Comprehensive Cancer Center will work to provide answers about the short- and long-term health effects of e-cigarettes, including their impact on the brain, lungs, and heart; the most effective regulations to reduce the appeal and addictiveness of e-cigarettes for youth; and the best methods to help youth addicted to e-cigarettes quit. Team VERIFY: Vaping's End through Research and Innovation For Youth will recruit youth for a year-long study to look at the relationship between nicotine form, concentration and flavorings on youth e-cig use, addiction, neurocognitive outcomes and pulmonary health compared to healthy peers. They will also study the influence of nicotine form, concentration and flavor on youth puffing behavior, nicotine delivery, abuse liability, toxicant exposure and acute cardiovascular and pulmonary effects; and they will develop and test a multi-point, scalable vaping cessation program to include quit-line-delivered phone counseling, text-based cessation, nicotine replacement therapy and online cessation support.

Understanding and Treating E-cigarette Use Among Youth -- Led by Suchitra Krishnan-Sarin, Ph.D., a professor of psychiatry at Yale University School of Medicine, this team will develop and test several youth-based programs and conduct clinical and behavioral research to learn more about the effect of youth e-cigarette use. They plan to develop a high school-based intervention to educate youth about e-cigarettes, prevent initiation of vaping, promote quitting among those who already use e-cigarettes and change attitudes and perceptions toward e-cigarettes school-wide. They will also develop a cessation program that will use smartphone-based contingency management for nicotine abstinence in combination with individualized, cognitive behavioral therapy. Further, they plan to develop and pilot a computerized cognitive behavioral therapy intervention for youth e-cigarette users. Finally, the team will develop a measure of e-cigarette withdrawal in youth and assess the relationship between withdrawal, dependence, treatment outcomes and e-cigarette characteristics such as flavors and devices.

"The rapid pace of e-cigarette products entering the market and targeting our youth requires an ambitious, aggressive approach beyond the incremental pace achieved through traditional research mechanisms. Policymakers, regulators, medical professionals and schools are looking to enact strategies, policies and solutions but there's inadequate evidence to inform these efforts," Harrington said. "The American Heart Association is proud to be on the forefront of bringing together some of the best minds in their fields to conduct the research, development and testing to bring bold and innovative results to address the growing epidemic of youth vaping in our commitment of longer, healthier lives for all."

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The American Heart Association has funded more than $4.6 billion in cardiovascular research since 1949.

Additional Resources

Vaping industry faces a triple threat - science, advocacy and community action

The science about vaping dangers - and what we don't know yet

AHA Tobacco Center for Regulatory Science

Teen perceptions about e-cigarette health risks vary by socioeconomics and personal demographics

Youth and Tobacco: A New Crisis

Follow AHA/ASA news on Twitter @HeartNews

The American Heart Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https:/ / www. heart. org/ en/ about-us/ aha-financial-information .

About the American Heart Association

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