Five-Day Changes in Biomarkers of Exposure Among Adult Smokers After Completely Switching From Combustible Cigarettes to a Nicotine-Salt Pod System

Jay, J. Bennett; Pfaunmiller, Erika L.; Huang, Norman; Cohen, Gal; Graff, Donald W.

doi:10.1093/ntr/ntz206

Cited by 29 publications

(72 citation statements)

References 33 publications

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“…Tobacco smokers who switch completely to e-cigarettes significantly reduce their levels of exposure to known cigarette toxicants, as shown recently in a 5-days trial by the manufacturer (Jay et al 2019). A closed system device with a low power setting has the advantage that toxicant generation is comparatively low and no easy manipulation by the consumer is feasible as with open systems.…”

Section: Discussionmentioning

confidence: 93%

Trendy e-cigarettes enter Europe: chemical characterization of JUUL pods and its aerosols

Mallock

Trieu²,

Macziol³

et al. 2020

Arch Toxicol

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The popularity and the high nicotine content of the American pod e-cigarette JUUL have raised many concerns. To comply with European law, the nicotine concentration in the liquids of the European version, which has been recently released on the market, is limited to below 20 mg/mL. This limit can possibly be circumvented by technological adjustments that increase vaporization and consequently, elevate nicotine delivery. In this study, we compare vapor generation and nicotine delivery of the initial European version, a modified European version, and the original American high-nicotine variant using a machine vaping setup. Additionally, benzoic acid and carbonyl compounds are quantified in the aerosol. Further, concentrations of nicotine, benzoic acid, propylene glycol, and glycerol, along with the density and pH value of JUUL e-liquids have been assessed. Whereas the initial European version did not compensate for the low nicotine content in the liquid, we provide evidence for an increased vaporization by the modified European version. As a consequence, nicotine delivery per puff approximates the American original. Notably, this is not associated with an increased generation of carbonyl compounds. Our data suggest a similar addictiveness of the enhanced European version and the original American product.

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Section: Discussionmentioning

confidence: 93%

Trendy e-cigarettes enter Europe: chemical characterization of JUUL pods and its aerosols

Mallock

Trieu²,

Macziol³

et al. 2020

Arch Toxicol

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“…Two were experimental studies, one quasi-experimental and two were cross-sectional. In terms of study quality, two of the five studies were funded by commercial interests in ENDS use/tobacco [33, 34]. Nevertheless, a particular advantage of one of these was that it kept users in a controlled environment (albeit only for five days) [33], which may have reduced the risks of contamination via undeclared dual use of ENDS use and tobacco products, as well as exposure to secondhand smoke/ENDS aerosol from others.…”

Section: Resultsmentioning

confidence: 99%

Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking

Wilson

Summers

Ouakrim

et al. 2020

Preprint

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IntroductionAlthough the harm to health from electronic nicotine delivery systems (ENDS) use relative to smoked tobacco remains highly uncertain, society and governments still need to know the likely range of the relative harm to inform regulatory policies for ENDS and smoking.MethodsWe identified biomarkers with specificity of association with different disease groupings e.g., volatile organic compound (VOCs) for chronic obstructive pulmonary disease; and tobacco-specific N’-nitrosamines (TSNAs) and polycyclic aromatic hydrocarbons (PAHs) for all cancers. We conducted a review of recent studies (post January 2017) that compared these biomarkers between people exclusively using ENDS and those exclusively smoking tobacco. The percentage differences in these biomarkers were assumed to reflect the likely percentage difference in disease harm between ENDS and smoking, and were applied to previously modelled estimates of smoking-related health loss (in health-adjusted life-years; HALYs).ResultsThe respective relative biomarker levels (ENDS vs smoking) weighted by study size and adjusted for acrolein from other sources were: 28% for respiratory diseases (five results, three studies); 42% for cancers (five results, four studies); and 35% for cardiovascular (seven results, four studies). When integrated with the HALY impacts by disease, the overall harm to health from ENDS was estimated to be 33% that of smoking.ConclusionsThis analysis suggests that the use of modern ENDS devices (vaping) could be a third as harmful to health as smoking in a high-income country setting. But this is probably best considered a maximal level given the potential biases in our method (i.e., the biomarkers used being correlated with more unaccounted for toxicants in smoking compared to with using ENDS).

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“…Lower volatility may also facilitate greater lung exposure and absorption of nicotine rather than buccal absorption 21 , offering quicker and more efficient nicotine transport to the brain. Indeed, in the past year, two studies have demonstrated that e-cigarettes with nicotine salt formulations (nicotine lactate and nicotine benzoate) can achieve nicotine absorption equivalent to that of conventional cigarettes, although the nicotine e-liquid concentrations investigated were up to 48 mg/ mL and 59 mg/mL, respectively 11,22 , which are considerably higher than the limits set by some regulatory bodies.…”

mentioning

confidence: 94%

A randomised controlled single-centre open-label pharmacokinetic study to examine various approaches of nicotine delivery using electronic cigarettes

Ebajemito

McEwan

Gale

et al. 2020

Sci Rep

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Smokers who switch completely to e-cigarettes may reduce their relative risk of tobacco-related disease. Effective nicotine delivery from e-cigarettes is important in consumer acceptance. We assessed whether protonated nicotine and e-cigarette devices delivering greater aerosol mass increase nicotine delivery and product liking. A randomised controlled non-blinded eight-arm crossover study was used to assess plasma nicotine pharmacokinetics and product liking for two e-cigarettes (Vype ePen3 and Vype ePen) with various nicotine e-liquid formulations and a conventional cigarette among 24 healthy dual-users of cigarettes and e-cigarettes. Product use and puff count were also assessed. Results show that nicotine bioavailability was greater for Vype ePen3 with greater aerosol mass delivery than for Vype ePen (Cmax, p = 0.0073; AUC0–120 min, p = 0.0102). Protonated nicotine (18 mg/mL, medium protonation) e-liquid yielded higher nicotine bioavailability than unprotonated nicotine (18 mg/mL) e-liquid (Cmax, p = 0.0001; AUC0–120 min, p = 0.0026). There was no significant difference in Tmax between e-liquids. Nicotine bioavailability did not differ between nicotine benzoate formulation (30 mg/mL nicotine, high protonation) and combustible cigarettes (Cmax, p = 0.79; AUC0–120 min, p = 0.13). Vype ePen3 with protonated nicotine delivers nicotine more efficiently with the potential to increase product liking relative to earlier devices using unprotonated e-liquid.

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Five-Day Changes in Biomarkers of Exposure Among Adult Smokers After Completely Switching From Combustible Cigarettes to a Nicotine-Salt Pod System

Cited by 29 publications

References 33 publications

Trendy e-cigarettes enter Europe: chemical characterization of JUUL pods and its aerosols

Trendy e-cigarettes enter Europe: chemical characterization of JUUL pods and its aerosols

Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking

A randomised controlled single-centre open-label pharmacokinetic study to examine various approaches of nicotine delivery using electronic cigarettes

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