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Yingst JM, Foulds J, Veldheer S, Hrabovsky S, Trushin N, Eissenberg TT, Williams J, Richie JP, Nichols TT, Wilson SJ, Hobkirk AL. Nicotine absorption during electronic cigarette use among regular users. PLoS One 2019; 14:e0220300. [PMID: 31344110 PMCID: PMC6657878 DOI: 10.1371/journal.pone.0220300] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/01/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The capability of electronic cigarette devices (e-cigs) to deliver nicotine is key to their potential to replace combustible cigarettes. We compared nicotine delivery and subjective effects associated with the use of two classes of e-cigarettes and cigarettes. METHODS 14 e-cigarette users were instructed to vape their own e-cigarette device every 20 seconds for 10 minutes while blood was drawn at 1, 2, 4, 6, 8, 10,12, and 15 minutes after initiating vaping. Users rated withdrawal symptoms and side effects before and after vaping. E-cigarette devices were classified as first-generation (same size as cigarette, no activation button) or advanced (larger than cigarette with an activation button). Separately, 10 cigarette smokers completed a similar protocol. Fisher's Exact Test and two-sided t-tests were used as appropriate to determine differences in outcomes between first-generation e-cigarette users, advanced e-cigarette users, and smokers. RESULTS Compared to first-generation devices, advanced devices were associated with greater serum nicotine Cmax (ng/ml) (11.5 v. 2.8, p = 0.0231) and greater nicotine boost (ng/ml) (10.8 v. 1.8, p = 0.0177). Overall, e-cigarettes users experienced a significant reduction in withdrawal and craving, although there were no significant differences between users of first-generation and advanced devices. Comparing e-cigarettes overall to cigarettes, cigarettes were associated with greater Cmax (25.9 v. 9.0, p = 0.0043) and greater nicotine boost (21.0 v. 8.2, p = 0.0128). CONCLUSIONS Advanced e-cigarettes delivered significantly more nicotine than first-generation devices but less than combustible cigarettes. Overall, e-cigarette use was associated with a reduction in withdrawal and craving with no reported side effects. The wide variation in nicotine absorption from different e-cigarette devices should be considered in studies of e-cigarettes for smoking cessation.
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Affiliation(s)
- Jessica M. Yingst
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Jonathan Foulds
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Susan Veldheer
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Shari Hrabovsky
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Neil Trushin
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Thomas T. Eissenberg
- Department of Psychology, Center for the Study on Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Jill Williams
- Division of Addiction Psychiatry, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - John P. Richie
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Travis T. Nichols
- Department of Psychology, Pennsylvania State University, University Park, PA, United States of America
| | - Stephen J. Wilson
- Department of Psychology, Pennsylvania State University, University Park, PA, United States of America
| | - Andrea L. Hobkirk
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
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Hess CA, Olmedo P, Navas-Acien A, Goessler W, Cohen JE, Rule AM. E-cigarettes as a source of toxic and potentially carcinogenic metals. Environ Res 2017; 152:221-225. [PMID: 27810679 PMCID: PMC5135636 DOI: 10.1016/j.envres.2016.09.026] [Citation(s) in RCA: 170] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 09/27/2016] [Accepted: 09/29/2016] [Indexed: 05/19/2023]
Abstract
BACKGROUND AND AIMS The popularity of electronic cigarette devices is growing worldwide. The health impact of e-cigarette use, however, remains unclear. E-cigarettes are marketed as a safer alternative to cigarettes. The aim of this research was the characterization and quantification of toxic metal concentrations in five, nationally popular brands of cig-a-like e-cigarettes. METHODS We analyzed the cartomizer liquid in 10 cartomizer refills for each of five brands by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). RESULTS All of the tested metals (cadmium, chromium, lead, manganese and nickel) were found in the e-liquids analyzed. Across all analyzed brands, mean (SD) concentrations ranged from 4.89 (0.893) to 1970 (1540) μg/L for lead, 53.9 (6.95) to 2110 (5220) μg/L for chromium and 58.7 (22.4) to 22,600 (24,400) μg/L for nickel. Manganese concentrations ranged from 28.7 (9.79) to 6910.2 (12,200) μg/L. We found marked variability in nickel and chromium concentration within and between brands, which may come from heating elements. CONCLUSION Additional research is needed to evaluate whether e-cigarettes represent a relevant exposure pathway for toxic metals in users.
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Affiliation(s)
- Catherine Ann Hess
- University of California, Berkeley, School of Public Health, Prevention Research Center, 180 Grand Ave., Ste. 1200, Oakland, CA 94612, USA; Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Baltimore, MD 21205, USA.
| | - Pablo Olmedo
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Baltimore, MD 21205, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Baltimore, MD 21205, USA; Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Baltimore, MD 21205, USA
| | - Walter Goessler
- Karl-Franzens-Universität Graz, Graz, Institute of Chemistry, Unversitätsplatz 1, 8010 Graz, Austria
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Baltimore, MD 21205, USA
| | - Ana Maria Rule
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Baltimore, MD 21205, USA
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Putzhammer R, Doppler C, Jakschitz T, Heinz K, Förste J, Danzl K, Messner B, Bernhard D. Vapours of US and EU Market Leader Electronic Cigarette Brands and Liquids Are Cytotoxic for Human Vascular Endothelial Cells. PLoS One 2016; 11:e0157337. [PMID: 27351725 PMCID: PMC4924852 DOI: 10.1371/journal.pone.0157337] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 05/28/2016] [Indexed: 12/03/2022] Open
Abstract
The present study was conducted to provide toxicological data on e-cigarette vapours of different e-cigarette brands and liquids from systems viewed as leaders in the e-cigarette market and to compare e-cigarette vapour toxicity to the toxicity of conventional strong high-nicotine cigarette smoke. Using an adapted version of a previously constructed cigarette smoke constituent sampling device, we collected the hydrophilic fraction of e-cigarette vapour and exposed human umbilical vein endothelial cells (HUVECs) to the mixture of compounds present in the vapour of 4 different single-use e-cigarettes, 6 different liquid vapours produced by the same refillable e-cigarette, and one e-cigarette with an exchangeable liquid cartridge. After incubation of cells with various concentrations and for various periods of time we analysed cell death induction, proliferation rates, the occurrence of intra-cellular reactive oxygen species, cell morphology, and we also measured e-cigarette heating coil temperatures. Overall, conventional cigarette smoke extract showed the most severe impact on endothelial cells. However, some e-cigarette vapour extracts showed high cytotoxicity, inhibition of cell proliferation, and alterations in cell morphology, which were comparable to conventional high-nicotine cigarettes. The vapours generated from different liquids using the same e-cigarette show substantial differences, pointing to the liquids as an important source for toxicity. E-cigarette vapour-mediated induction of oxidative stress was significant in one out of the 11 analysed vapours. There is a high variability in the acute cytotoxicity of e-cigarette vapours depending on the liquid and on the e-cigarettes used. Some products showed toxic effects close to a conventional high-nicotine cigarette. Liquid nicotine, menthol content, and the formation of acute intracellular reactive oxygen species do not seem to be the central elements in e-cigarette vapour toxicity.
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Affiliation(s)
- Raphaela Putzhammer
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
- MCI Management Center Innsbruck, Biotechnology, Innsbruck, Austria
| | - Christian Doppler
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Katharina Heinz
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Juliane Förste
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
- MCI Management Center Innsbruck, Biotechnology, Innsbruck, Austria
| | - Katarina Danzl
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Messner
- Cardiac Surgery Research Laboratory, Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - David Bernhard
- Cardiac Surgery Research Laboratory, University Clinic for Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
- * E-mail:
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Abstract
OBJECTIVES Electronic nicotine delivery systems (ENDS) have recently emerged as a component of the tobacco retail environment. The aims of this study were to describe the availability, types of ENDS and placement of ENDS relative to traditional tobacco products at franchised licensed tobacco retailers and non-franchised licensed tobacco retailers. DESIGN Observational study. SETTING Franchised and non-franchised tobacco retailers in Cleveland County, Oklahoma, USA. PRIMARY AND SECONDARY OUTCOME MEASURES The number of stores selling ENDS, the variability in brands of ENDS sold, the location of the ENDS within the retailers, the quantity of ENDS sold compared with traditional tobacco products, and the presence of outdoor signage. RESULTS Data from 57 randomly sampled tobacco retailers were used to describe the presence of ENDS at independent non-franchised and franchised tobacco retailers. The overwhelming majority (90%) of licensed tobacco retailers sold ENDS, and differences were observed between franchised and non-franchised stores. 45 of the 51 retailers (88%) selling ENDS had them placed at the point of sale. 2 of the 21 franchised retailers (9.5%) had ENDS placed at ≤3½ feet above floor level compared to none of the 30 non-franchised retailers (0%). CONCLUSIONS This small study is the first to characterise ENDS within the tobacco retail environment in a county in Oklahoma, USA. The results from this study demonstrate the complexity of the tobacco retail landscape and generate questions for future studies regarding the incorporation and placement of ENDS in tobacco retail environments.
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Affiliation(s)
- L S Brame
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - D S Mowls
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - K E Damphousse
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - L A Beebe
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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Jones C, Moore F. The European Association of Dental Public Health conference resolution on the control of e-cigarettes; or "you have to be a bit crazy to carry on smoking conventional cigarettes when there are e-cigarettes available". Community Dent Health 2014; 31:194-195. [PMID: 25665350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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