Electronic cigarette nicotine delivery can exceed that of combustible cigarettes: a preliminary report

Abstract

Introduction Electronic cigarettes (ECIGs) aerosolize a liquid that usually contains propylene glycol and/or vegetable glycerin, flavorants, and the dependence-producing drug nicotine in various concentrations. This laboratory study examined the relationship between liquid nicotine concentration on plasma nicotine concentration and puffing behavior in experienced ECIG users. Methods Sixteen ECIG-experienced participants used a 3.3-Volt ECIG battery attached to a 1.5-Ohm dual-coil “cartomizer” loaded with 1 ml of a flavored propylene glycol/vegetable glycerin liquid to complete four sessions, at least 2 days apart, that differed by nicotine concentration (0, 8, 18, or 36 mg/ml). In each session, participants completed two 10-puff ECIG use bouts (30-sec puff interval) separated by 60 minutes. Venous blood was sampled to determine plasma nicotine concentration. Puff duration, volume, and average flow rate were measured. Results Immediately after bout 1, mean plasma nicotine concentration was 5.5 ng/ml (SD=7.7) for 0 mg/ml liquid, with significantly (p<0.05) higher mean concentrations observed for the 8 (mean=17.8 ng/ml, SD=14.6), 18 (mean=25.9 ng/ml, SD=17.5), and 36 mg/ml (mean=30.2 ng/ml; SD=20.0) concentrations; a similar pattern was observed for bout 2. For bout 1, at 36 mg/ml, the mean post- minus pre-bout difference was 24.1 ng/ml (SD=18.3). Puff topography data were consistent with previous results and revealed few reliable differences across conditions. Discussion This study demonstrates a relationship between ECIG liquid nicotine concentration and user plasma nicotine concentration in experienced ECIG users. Nicotine delivery from some ECIGs may exceed that of a combustible cigarette. The rationale for this higher level of nicotine delivery is uncertain.

Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects

“…We observed a mean plasma nicotine boost of 33.77 ng/mL in 10 min with some individuals achieving considerably higher concentrations. This level exceeds those reported by other researchers using similar (Farsalinos et al, 2014;2015) or higher nicotine e-liquid strength (Ramôa et al, 2015) and is equivalent to that observed in tobacco smokers (Russell, 1980, Russell et al, 1975 within 5 min of finishing a cigarette. The high plasma nicotine levels are likely due to a combination of: the device used, our ad libitum vaping design, 12 h nicotine abstinence requirement and the nature of our participants.…”

“…The high plasma nicotine levels are likely due to a combination of: the device used, our ad libitum vaping design, 12 h nicotine abstinence requirement and the nature of our participants. The Aspire Nautilus tank used here is a more advanced system with more effective nicotine delivery to the aerosol (Farsalinos et al, 2016) compared to previous studies (Farsalinos et al, 2014;2015;Ramôa et al, 2015). We also selected participants already familiar with using higher nicotine strength liquid and who had baseline salivary cotinine levels exceeding 100 ng/mL.…”

“…self-titrate) (Dawkins & Corcoran, 2014). More recently, Ramôa and colleagues (Ramôa et al, 2015), using a ten-puff protocol reported that e-cigarette users increased their puff duration with 0 mg/mL compared with 36 mg/mL nicotine concentration (but not 8 or 18 vs. 36 mg/mL) which may reflect an attempt to self-titrate due to the absence of nicotine (Ramôa et al, 2015). Although this provides some evidence of titration, the use of a standardised ten min ten-puff protocol restricts users' ability to compensate fully.…”

Electronic Cigarette

“…Alınan nikotin, sadece içerdiği nikotin kartuşuna değil, cihazın özelliklerine ve kullanıcıya bağlı olarak değişir. e-sigaralar, sigaralara göre kullanıcıların daha fazla nikotin alımına yol açmaktadır (2) . E-sigaraların kartuşunun içindeki alkoloit sıvıda nikotin yanında propilen glikol, etanol, su, tütün çiçeği ve nane, çi-kolata, meyve gibi çeşitli tat ve kokular içeren farklı esans ve kimyasallar bulunmaktadır.…”

A critique of the US Surgeon General’s conclusions regarding e-cigarette use among youth and young adults in the United States of America

“…Nicotine uptake through e-cigarette use depends on the nicotine concentration (mg/ml) of the e-liquid being consumed, the design of the device, the user's puffing behavior, and the user's experience with the product [31][32][33][34]. This section of the report speculates that highperformance e-cigarettes may promote higher absorption of nicotine than tobacco cigarettes.…”