Patterns of nicotine concentrations in electronic cigarettes sold in the United States, 2013-2018

Romberg, Alexa R.; Lo, Erin J. Miller; Cuccia, Alison; Willett, Jeffrey; Xiao, Huiling; Hair, Elizabeth C.; Vallone, Donna; Marynak, Kristy; King, Brian A.

doi:10.1016/j.drugalcdep.2019.05.029

Cited by 137 publications

(116 citation statements)

References 17 publications

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“…Most participants (79-88%) who used nicotinecontaining e-liquid reported ND symptoms, similar to the 89% of long-term vapers reported by Etter et al (2019) [42]. The new generation of e-liquid often contain nicotine salts which permits easier inhalation of higher levels of nicotine without the harsh taste [43], and nicotine concentrations in e-liquid have increased in the last decade [44]. While the European Union imposed a nicotine cap of 20 mg/ml, Canada has a limit of 66 mg/mL [45] and there is currently no limit in the US [46,47].…”

Section: Discussionsupporting

confidence: 68%

Type of e-liquid vaped, poly-nicotine use and nicotine dependence symptoms in young adult e-cigarette users: a descriptive study

2020

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Background: Data are lacking on type of e-liquid vaped among e-cigarette users. Further, few studies assess all sources of nicotine used by e-cigarette users to assess whether poly-nicotine use relates to nicotine dependence (ND). The objectives were to describe young adult e-cigarette users by: (i) type of e-liquid vaped; (ii) poly-nicotine use; (iii) ND symptoms; and (iv) attempts to quit conventional cigarettes. Methods: Data were available in cycle 23 of a longitudinal investigation on the natural course of cigarette smoking and ND. A total of 775 young adults (44% male; mean (SD) age 30.5(1.0)) completed mailed self-report questionnaires in 2017-20. Results: Of 775 participants, 149 (19.2%) reported past-year e-cigarette use. Overall, 55.0% of e-cigarette users had used cannabis-containing e-liquid (31.5% vaped cannabis e-liquid exclusively); 50.4% used nicotine-containing e-liquid (23.5% vaped nicotine e-liquid exclusively); and 39.9% used e-liquid without nicotine (8.7% vaped e-liquid without nicotine exclusively). Most e-cigarette users (82.6%) used other nicotine-containing products including conventional cigarettes (72.5%); 60.8% reported ND symptoms, rising to 79.4% among those who vaped nicotine-containing e-liquid. Finally, 29.0% tried to quit conventional cigarettes using e-cigarettes in the past-year, but only 16.7% found them helpful. Conclusions: E-cigarettes now appear to appeal to a broader market than smokers who want to quit. More than half of young adult e-cigarette users vaped cannabis-containing e-liquid in the past year while only one-quarter had used e-cigarettes to assist with cessation. Most e-cigarette users used multiple nicotine-containing substances (including combustible cigarettes) which were associated with reports of ND symptoms.

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Section: Discussionsupporting

confidence: 68%

Type of e-liquid vaped, poly-nicotine use and nicotine dependence symptoms in young adult e-cigarette users: a descriptive study

2020

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“…These flavors are amongst the more popular varieties and a dose curve was pursued and a concentration of 2% for both types of eCig liquid exerted changes without affecting cell behavior (data not shown). The concentration of nicotine was selected to be 6 mg following pilot projects that utilized concentrations between 2 and 12 mg and in order to identify a midrange concentration in accordance with current trends of usage (Romberg et al, 2019). For invasion studies, cells were detached, and 20,000 cells/mL were incubated in 2% FBS medium alone, or medium supplemented with 2% eCig liquid in the presence or absence of nicotine.…”

Section: Cell Culture and Treatmentsmentioning

confidence: 99%

Cell invasion, RAGE expression, and inflammation in oral squamous cell carcinoma (OSCC) cells exposed to e‐cigarette flavoring

Tsai

Budge

Lepre

et al. 2020

Clinical & Exp Dental Res

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Objective Electronic cigarettes have given rise to a new, largely unregulated market within the smoking industry. While generally supposed to be less harmful than traditional tobacco smoke, awareness of the biological effects of electronic cigarette liquid is still scarce. Our objective was to determine the impact of electronic cigarette flavoring and nicotine on gingival squamous cell carcinoma invasion, RAGE expression, and the elaboration of pro‐inflammatory molecules. Methods and Materials Gingival and tongue squamous cell carcinoma cells were exposed to Red Hot or Green Apple flavored electronic cigarette flavoring with or without nicotine. Immunofluorescence determined RAGE expression. Real‐time cellular invasion was assessed using a RTCA DP instrument. Culture medium was assayed for cytokine secretion. Results Compared to controls we observed: increased cell invasion in gingival cells with Red Hot electronic cigarette flavoring and decreased cell invasion with Green Apple; decreased cell invasion in tongue cells treated with Red Hot electronic cigarette flavoring and no differences in invasion with Green Apple; flavor and nicotine dependent increases in RAGE expression; and differential expression of IL‐1α, IL‐8, and MMP‐13. Conclusion We conclude that electronic cigarette flavoring and nicotine orchestrate differential regulation of oral squamous cell carcinoma (OSCC) cell invasion and inflammatory effects. This study provides an important initial step in dissecting RAGE‐mediated mechanisms of cancerous invasion and molecular avenues employed by OSCC.

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“…One of the challenges in assessing the outbreak is the lack of clarity regarding the types of vaping products used by affected patients. The US Centers for Disease Control and Prevention has noted that, “no single substance or e-cigarette product has been consistently associated with illness.”1 This lack of clarity underscores the extraordinary range of vaping devices on the market, from mainstream e-cigarette products manufactured by large multinational companies, such as JUUL, to products manufactured by small companies, many of which are modified by users to alter performance 78…”

mentioning

confidence: 99%

Outbreak of pulmonary diseases linked to vaping

Hammond

2019

BMJ

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Patterns of nicotine concentrations in electronic cigarettes sold in the United States, 2013-2018

Cited by 137 publications

References 17 publications

Type of e-liquid vaped, poly-nicotine use and nicotine dependence symptoms in young adult e-cigarette users: a descriptive study

Type of e-liquid vaped, poly-nicotine use and nicotine dependence symptoms in young adult e-cigarette users: a descriptive study

Cell invasion, RAGE expression, and inflammation in oral squamous cell carcinoma (OSCC) cells exposed to e‐cigarette flavoring

Outbreak of pulmonary diseases linked to vaping

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