Majority of Patients Do Not Believe e-Cigarettes and Vapes Impact Bone Fracture Healing

Today the American Academy of Orthopaedic Surgeons (AAOS) reports the use of e-cigarettes, a flawless vape and mods have increased as smokers liken these alternatives as healthier and not having the same side effects of traditional cigarettes. Because e-cigarettes are readily available over the internet, unlike the sale of cigarettes, it perpetuates the notion that these are a safer alternative.i A new study, “The New Era of Nicotine: Better for Patients?” released as part of the American Academy of Orthopaedic Surgeons’ (AAOS) Virtual Education Experience found that smokers and non-smokers believe the use of e-cigarettes and other smoking alternatives have less of an impairment on bone fracture healing than smoking traditional cigarettes, when in fact the nicotine found in both cigarettes and e-cigarettes can impede the healing process.

“Many smokers, especially adolescents and young adults, don’t realize that e-cigarettes contain similar chemicals to those found in traditional cigarettes, such as anti-freeze, formaldehyde, nicotine and tobacco––all with varying degrees of concentration,” said Colin T. Ackerman, MD, lead author and orthopaedic resident at Temple University Hospital in Philadelphia. “Unfortunately, e-cigarettes have been positioned as a safer alternative and a solution to help people quit smoking. Much of this narrative has caused misconceptions when it comes to how e-cigarettes can impact a person’s bone health, not to mention their overall health and wellness.”

Because smoking while healing from a bone fracture can cause adverse effects in patients such as wound complications, infections and nonunions (when a broken bone fails to heal), ii iii Dr. Ackerman and his team wanted to understand patients’ perceptions of traditional cigarette and e-cigarette use on fracture healing and willingness to quit.

According to co-author Christopher L Haydel, MD, FAAOS, the researchers developed a multiple-choice survey (in English and Spanish) that was randomly distributed to 231 patients, 18 years and older, who sustained an extremity fracture. All surveys were administered in an outpatient orthopaedic surgery clinic at a Level 1 urban trauma center. They received 100% participation, and of all the respondents, 55.3% were male and 46.8% African American with a mean age of 46 years old. Use of either cigarettes or e-cigarettes represented 41.1% of respondents with 79.8% being daily smokers. The study found that:

  • A greater percentage of nonsmokers felt that cigarettes “definitely” impaired fracture healing (29.4% of nonsmokers vs. 20% of smokers).
  • Concerning cigarette alternatives (e-cigarettes/vapes), 22.8% of nonsmokers and 14.7% of smokers answered they “definitely” impaired fracture healing.
  • A larger portion of smokers (36.8%) felt that e-cigarettes didn’t impact bone fracture healing compared to 25.3% of smokers who felt that traditional cigarettes did not affect bone fracture healing.
  • Among smokers, 87.6% responded that they would be interested in smoking cessation if told nicotine impaired fracture healing.

The survey also highlighted the gap in patient education regarding this topic in a low income, urban healthcare setting.

“It’s our hope that this information can be used to guide clinicians in acquiring more thorough social health histories and better inform patients about the dangers of not only traditional cigarette smoking, but smoking alternatives,” said Dr. Haydel. As the latest generation of e-cigarettes comes to market, more research is needed to fully understand how the toxins in these products impact the health of the smoker.

i NIDA. Electronic Cigarettes (E-cigarettes). Accessed June 10, 2018.

ii Scolaro JA, Schenker ML, Yannascoli S, Baldwin K, Mehta S, Ahn J. Cigarette Smoking Increases Complications Following Fracture: A Systematic Review. J Bone Jt Surg-Am Vol. 2014;96(8):674-681. doi:10.2106/JBJS.M.00081

iii Raikin SM, Landsman JC, Alexander VA, Froimson MI, Plaxton NA. Effect of Nicotine on the Rate and Strength of Long Bone Fracture Healing. Clin Orthop Relat Res. 1998;353:231.


Medical Device News Magazine
Our publication is dedicated to bringing our readers the latest medical device news. We are proud to boast that our subscribers include medical specialists, device industry executives, investors, and other allied health professionals, as well as patients who are interested in researching various medical devices. We hope you find value in our easy-to-read publication and its overall purpose and objectives! Medical Device News Magazine is a division of PTM Healthcare Marketing, Inc. Pauline T. Mayer is the managing editor.

More News!

Data from clinical studies of STK-001 demonstrated clinical benefit for patients ages 2 to 18 years old, including reductions in seizures and improvements in cognition and behavior that support the potential for disease modificatio. Analysis of 72 patients treated in STK-001 clinical trials suggests that higher STK-001 drug exposure in brain leads to greater seizure reductions. Two-year data from the longest prospective natural history study of Dravet syndrome showed that, on average, patients experienced no meaningful improvement in convulsive seizure frequency and exhibited widening gaps in cognition and behavior despite treatment with the best available anti-seizure medicines.
"Exact Sciences is looking forward to presenting new evidence at SABCS that adds important perspectives to treating breast cancer patients and showing that some patients may be able to de-escalate treatments and still have positive outcomes," said Dr. Rick Baehner, Chief Medical Officer, Precision Oncology, Exact Sciences. "Every year, we build upon the precedent set by the Oncotype DX Breast Recurrence Score® test and its prognostic and predictive abilities to determine the chemotherapy benefit for specific breast cancer patients. We are pleased to see authorities expanding access to this test as we continue to develop key evidence in collaboration with some of the world's most prestigious, breast cancer-focused organizations."
Clozapine has been established as the most effective antipsychotic medication for treatment-resistant schizophrenia. However, it is significantly underutilized mainly due to the risk of developing agranulocytosis and the need to frequently monitor the absolute neutrophil count (ANC).
Dagi-Ben Noon, CEO of Inspira Technologies, reflects on the partnership's significance: "By Integrating our technology to oxygenate blood directly with Ennocure's infection prevention solutions, we are focusing on potentially improving patient outcomes in ICUs and paving the way for safer, more effective life-support treatments. This collaboration is expected to accelerate the development and broaden the implementation of our advanced technology."
The findings suggest that the novel, non-invasive genomic test can help physicians guide next steps for these patients, enabling them to potentially avoid unnecessary invasive procedures or accelerate time to appropriate treatment.

By using this website you agree to accept Medical Device News Magazine Privacy Policy