Acute electronic cigarette use: nicotine delivery and subjective effects in regular users

Abstract

Rationale Electronic cigarettes are becoming increasingly popular among smokers worldwide. Commonly reported reasons for use include: to quit smoking, avoid relapse, reduce urge to smoke, or as a perceived lower risk alternative to smoking. Few studies however, have explored whether e-cigarettes deliver measurable levels of nicotine to the blood.Objective This study in experienced users explores the effect of using an 18 mg/ml nicotine first generation e-cigarette on blood nicotine, tobacco withdrawal symptoms and urge to smoke.Methods Fourteen regular e-cigarette users (3 female), abstinent from smoking and ecigarette use for 12 h, each completed a 3 h testing session. Blood was sampled and questionnaires completed (tobacco-related withdrawal symptoms, urge to smoke, positive and negative subjective effects) at four stages: baseline, 10 puffs, 60 min of ad lib use and a 60 min rest period.Results Complete sets of blood were obtained from 7 participants. Plasma nicotine concentration rose significantly from a mean of 0.74 ng/ml at baseline to 6.77 ng/ml 10 min after 10 puffs, reaching a mean maximum of 13.91 ng/ml by the end of the ad lib puffing period. Tobacco related withdrawal symptoms and urge to smoke were significantly reduced, direct positive effects were strongly endorsed and there was very low reporting of adverse effects.Conclusions These findings demonstrate reliable blood nicotine delivery after acute use of this brand/model of e-cigarette in a sample of regular users. Future studies might usefully quantify nicotine delivery in relation to inhalation technique and the relationship with successful smoking cessation/harm reduction.

Development of a Questionnaire for Assessing Dependence on Electronic Cigarettes Among a Large Sample of Ex-Smoking E-cigarette Users

“…This is perhaps not surprising given that almost all the studies of nicotine absorption from e-cigs suggest that they deliver markedly lower peak nicotine levels compared with cigarettes, and that they deliver nicotine more slowly than cigarettes, both of which are characteristics likely leading to less addiction. [21][22][23][24][25] We also found that users of more advanced e-cigs (in terms of size, battery power, ability to control timing of heat being applied to the coil, cost of e-cig, and so on), score higher on measures of dependence. This is also consistent with existing data, showing that advanced generation models deliver higher blood nicotine levels than current "cigalike" models.…”

First‐ versus second‐generation electronic cigarettes: predictors of choice and effects on urge to smoke and withdrawal symptoms

“…Whether comparable reduction in urge to smoke/WS continue over a longer time period remains unclear. At this time point (10 mins after 10 puffs), although measurable nicotine levels from the e-cigarette will have reached the blood [13], blood nicotine levels are still likely to be rising and it may be that significant differences between groups might emerge after 20/30 minutes [21].…”

“…Third generation devices bear little resemblance to cigarettes, use larger-capacity batteries, replacement heating coils and wicks for atomizers, and adjustable and programmable power delivery. Whilst early studies reported very little nicotine delivery from e-cigarettes [11,12], more recently, studies in experienced users have found measureable nicotine delivery (comparable to nicotine replacement therapy; NRT) [13,14] especially with newer generation devices [15]. E-cigarette use (often referred to as vaping) resembles the act of smoking: the user holds the device and draws on it like a cigarette; the aerosol produced resembles smoke and is drawn into the lungs and exhaled like smoke; tobacco (or menthol) flavouring mimics the taste of tobacco smoke and first generation devices resemble cigarettes exactly.…”

Effects of User Puff Topography, Device Voltage, and Liquid Nicotine Concentration on Electronic Cigarette Nicotine Yield: Measurements and Model Predictions

“…Though the mixture exiting the ECIG mouthpiece is commonly referred to as a "vapor," it is more correctly termed an "aerosol mist"-a system of liquid droplets suspended in a gas or gas mixture. 4 The apparent popularity of these products likely is attributable to a variety of factors, including marketing, 5 their availability in appealing flavors, 6,7 perceptions that they are less lethal than tobacco cigarettes, 8 and their ability to deliver nicotine, 9,10 a psychomotor stimulant that supports dependence. 11 Although some commentators speculate that ECIGs promise reduced tobacco-caused disease and death in cigarette smokers, 12,13 others speculate that daily, long-term use of these novel products imperils users with adverse health consequences, including nicotine dependence in individuals who were not nicotine-experienced prior to their ECIG use.…”

“…11,25 With ECIGs, differences in topography may help explain the fact that sometimes these products deliver nicotine and sometimes they do not. 9,10,16 Indeed, two studies have used observational methods to examine ECIG user puff topography, and both suggest that experienced ECIG users take longer puffs (e.g., approximately 4 s, on average) than tobacco cigarette smokers, approximately 2 s, on average. 26,27 In extreme cases, puff durations as long as 8 s have been observed.…”