Real-Time Characterization of E-Cigarettes Use: The 1 Million Puffs Study

Dautzenberg, Bertrand; Bricard, Damien

doi:10.4172/2155-6105.1000229

Cited by 79 publications

(107 citation statements)

References 9 publications

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“…The real challenges of EMA with respect to studies of ENDS pertain to quantification of use (e.g., operational definitions of puffs vs. puffing episodes), particularly when these metrics do not easily translate from conventional smoking (cigarettes per day). The current study provides some guidance worth consideration, as do others (50,51), and newer devices with built-in technology to capture these metrics significantly expand the research potential.…”

Section: Discussionmentioning

confidence: 96%

A Naturalistic, Randomized Pilot Trial of E-Cigarettes: Uptake, Exposure, and Behavioral Effects

Carpenter

Heckman

Wahlquist

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Most studies of electronic nicotine delivery systems (ENDS) compare self-selected users vs. non-users. The few randomized studies to date generally support a positive impact on reducing smoking behavior, but these studies are focused on guided ENDS use. This study presents a randomized naturalistic trial of ENDS with prospective outcomes of uptake and behavioral changes in smoking. Methods Adult smokers with minimal ENDS history were randomized in a 2:1 ratio to receive product for 3 weeks (n=46), or not (n=22). Changes in nicotine delivery (16mg vs. 24mg), midway through the study allowed a compelling opportunity to examine two ENDS products compared to control group. Primary outcomes, assessed via daily diaries during sampling period and in-person lab visits over 4 months, included uptake and usage of ENDS, cessation-related outcomes, and exposure to smoke constituents. Results All ENDS participants tried product at least once, with 48% of 24mg and 30% of 16mg using their assigned product for the entire sampling period. Within 24mg ENDs group, 57% made an independent purchase of ENDS, vs. 28% of 16mg, and 14% of control participants (p=.01). Smokers in both ENDS groups significantly reduced their smoking, whereas control participants did not (p=.03). Cessation behaviors (quit attempts, biologically verified abstinence) numerically but not statistically favored ENDS participants. Conclusions Results suggest that cigarette smokers are willing to use ENDS with trends towards reduced cigarette smoking and positive changes in cessation-related behaviors. Impact Randomized naturalistic trials such as presented herein are needed to understand the population impact of e-cigarettes.

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Section: Discussionmentioning

confidence: 96%

A Naturalistic, Randomized Pilot Trial of E-Cigarettes: Uptake, Exposure, and Behavioral Effects

Carpenter

Heckman

Wahlquist

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…For each product tested, we calculated a daily inhaled dose of benzaldehyde, assuming that an experienced e-cigarette user puffs on an e-cigarette 163 times a day. 8 We compared the inhaled dose using 30 puffs from a flavoured e-cigarette with an inhaled dose from a single tobacco cigarette (0.5-4.5 μg/cigarette). 9 We also compared the inhaled dose from flavoured e-cigarettes with a hypothetical dose inhaled by healthy workers who would be exposed during an 8 h work shift to the permissible exposure limit (PEL) of benzaldehyde as defined by the US Workplace Environmental Exposure Level Guides 10 (90.5 mg=inhalation rate 1.3 4 m 3 /h×8 h×8.7 mg/m 3 PEL).…”

Section: Methodsmentioning

confidence: 99%

Cherry-flavoured electronic cigarettes expose users to the inhalation irritant, benzaldehyde

Kośmider

Sobczak

Prokopowicz

et al. 2016

Thorax

169

148

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Many non-cigarette tobacco products, including e-cigarettes, contain various flavorings, such as fruit flavours. Although many flavorings used in e-cigarettes are generally recognized as safe when used in food products, concerns have been raised about the potential inhalation toxicity of these chemicals. Benzaldehyde, which is a key ingredient in natural fruit flavors, has been shown to cause irritation of respiratory airways in animal and occupational exposure studies. Given the potential inhalation toxicity of this compound, we measured benzaldehyde in aerosol generated in a laboratory setting from flavored e-cigarettes purchased online and detected benzaldehyde in 108 out of 145 products. The highest levels of benzaldehyde were detected in cherry flavored products. The benzaldehyde doses inhaled with 30 puffs from flavored e-cigarettes were often higher than doses inhaled from a conventional cigarette. Levels in cherry flavored products were over 1000 times lower than doses inhaled in the workplace. While e-cigarettes seem to be a promising harm reduction tool for smokers, findings indicate that using these products could result in repeated inhalation of benzaldehyde, with long-term users risking regular exposure to the substance. Given the uncertainty surrounding adverse health effects stemming from long-term inhalation of flavoring ingredients such as benzaldehyde, clinicians need to be aware of this emerging risk and ask their patients about use of flavored e-cigarettes.

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“…If puff topography has a strong effect on e-cigarette emissions, translating results of laboratory studies performed using fixed puff parameters to user exposure becomes problematic because puff topography among e-cigarette users varies widely. Puff durations employed by users of the same e-cigarette device were reported to vary from 0.6 s to over 10 s [18]. In a study of 23 daily e-cigarette users, e-cigarette power output was reported to vary between 5 and 60 W, puff volume varied between 10-251 mL, and puff duration between 1.3 and 5.8 s [19].…”

mentioning

confidence: 99%

Carbonyls and Carbon Monoxide Emissions from Electronic Cigarettes Affected by Device Type and Use Patterns

Son

Bhattarai

Samburova

et al. 2020

IJERPH

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Dangerous levels of harmful chemicals in electronic cigarette (e-cigarette) aerosols were reported by several studies, but variability in e-cigarette design and use patterns, and a rapid development of new devices, such as JUUL, hamper efforts to develop standardized testing protocols and understand health risks associated with e-cigarette use. In this study, we investigated the relative importance of e-cigarette design, power output, liquid composition, puff topography on e-cigarette emissions of carbonyl compounds, carbon monoxide (CO), and nicotine. Four popular e-cigarette devices representing the most common e-cigarette types (e.g., cig-a-like, top-coil, ‘mod’, and ‘pod’) were tested. Under the tested vaping conditions, a top-coil device generated the highest amounts of formaldehyde and CO. A ‘pod’ type device (i.e., JUUL) emitted the highest amounts of nicotine, while generating the lowest levels of carbonyl and CO as compared to other tested e-cigarettes. Emissions increased nearly linearly with puff duration, while puff flow had a relatively small effect. Flavored e-liquids generated more carbonyls and CO than unflavored liquids. Carbonyl concentrations and CO in e-cigarette aerosols were found to be well correlated. While e-cigarettes emitted generally less CO and carbonyls than conventional cigarettes, daily carbonyl exposures from e-cigarette use could still exceed acute exposure limits, with the top-coil device potentially posing more harm than conventional cigarettes.

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Real-Time Characterization of E-Cigarettes Use: The 1 Million Puffs Study

Cited by 79 publications

References 9 publications

A Naturalistic, Randomized Pilot Trial of E-Cigarettes: Uptake, Exposure, and Behavioral Effects

A Naturalistic, Randomized Pilot Trial of E-Cigarettes: Uptake, Exposure, and Behavioral Effects

Cherry-flavoured electronic cigarettes expose users to the inhalation irritant, benzaldehyde

Carbonyls and Carbon Monoxide Emissions from Electronic Cigarettes Affected by Device Type and Use Patterns

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