Nicotine concentration of e-cigarettes used by adolescents

Abstract

Objective E-cigarettes are popular among youth, but little is known about the nicotine concentrations of e-liquids used by adolescents. Materials and Method In Spring, 2014, we conducted cross-sectional surveys in four Connecticut high schools and two middle schools. Among past-30-day e-cigarette users (n = 513, 45% female, mean age 15.9 [SD=1.4]), we examined what nicotine concentration adolescents typically used in their e-cigarettes (range 0-30mg/mL and “I don’t know”). We first examined whether age, sex, smoking status, e-cigarette use frequency, and/or e-cigarette acquisition source were associated with using nicotine-free e-liquid, nicotine e-liquid, or not knowing the e-liquid nicotine concentration. Among nicotine users (n = 185), we then examined whether the aforementioned variables were associated with using higher nicotine concentrations. Results Adolescents reported using nicotine-free e-liquid (28.5%), nicotine e-liquid (37.4%), or not knowing their e-liquid nicotine concentration (34.1%). Nicotine users comprised more smokers and heavier e-cigarette users compared to nicotine-free e-liquid users and those who did not know their nicotine concentration. Nicotine users also comprised more males and were more likely to purchase e-cigarettes online or from tobacco shops compared to those who did not know their nicotine concentration. Among nicotine users, cigarette smoking, male sex, and purchasing e-cigarettes from tobacco shops predicted using higher nicotine concentrations. Conclusions Adolescents reported using e-liquids with variable nicotine concentrations. Smokers, males, and those who purchased their own e-cigarettes reported using the highest nicotine levels. Of concern, many adolescents were unaware of the nicotine concentration in their e-liquid, raising concerns about inadvertent nicotine exposure among youth.

Gender Differences in U.S. Adolescent E-Cigarette Use

“…It is particularly important to determine the level of nicotine used in the e-liquids, considering the known gender differences in nicotine metabolism and reactivity. One study [64] has examined nicotine concentrations used by adolescents in e-cigarettes. This study observed that 28.5% of adolescent e-cigarette users used nicotine-free e-liquid, 37.5% used nicotine e-liquid, and 34.1% did not know the levels of nicotine in their e-liquids.…”

Studying the interactive effects of menthol and nicotine among youth: An examination using e-cigarettes

“…Combined with their assigned nicotine concentration), participants received, all three menthol concentrations [no menthol (NM)=0%, low menthol (LM)=0.5%, high menthol (HM)=3.5%], each during a separate session, in counterbalanced order. Nicotine concentrations were chosen to represent those commonly used by youth (Morean et al, 2016). The research assistants and the participants were blind to the treatment condition.…”

Associations of Electronic Cigarette Nicotine Concentration With Subsequent Cigarette Smoking and Vaping Levels in Adolescents

“…14 However, it is unknown whether gradations in nicotine concentrations are longitudinally associated with subsequent progression to higher levels of smoking and vaping. Since e-cigarette solutions containing nicotine were recently deemed tobacco products and fall under FDA regulatory jurisdiction, 15 assessing associations of e-cigarette nicotine concentration with use of tobacco products can inform regulatory policy addressing nicotine concentration in e-cigarette products.…”