Toxicity of electronic cigarettes: A general review of the origins, health hazards, and toxicity mechanisms

Cao, Yuxia; Wu, Dezhen; Ma, Ying; Wang, Shile; Li, Fuxian; Li, Menghan; Zhang, Ting

doi:10.1016/j.scitotenv.2021.145475

Cited by 32 publications

(28 citation statements)

References 115 publications

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“…ENDS, also referred to as electronic cigarettes (e-cigarettes), are devices that utilize an atomizer to aerosolize a liquid typically composed of PG, VG, nicotine, and flavoring chemicals at various concentrations (Cao et al 2021). In 2018, the United States had more than 8000 flavors and 250 e-cigarette brands available on the market (Kaur et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Nose-only Exposure to Cherry and Tobacco Flavored E-cigarettes Induced Lung Inflammation in Mice in a Sex-dependent Manner

Lamb

Meehan-Atrash

Muthumalage

et al. 2022

Preprint

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Flavoring chemicals utilized in electronic nicotine delivery systems (ENDS) have been shown to result in an increase in cellular inflammation, meanwhile, the effects of fruit and tobacco flavors on lung inflammation by nose-only exposures to mice are relatively unknown. We hypothesized that C57BL/6J mice exposed to flavored e-cigarettes would result in an increase in lung inflammation. C57BL/6J mice were exposed to air, propylene glycol/vegetable glycerin (PG/VG), and e-liquids Apple, Cherry, Strawberry, Wintergreen, and Smooth & Mild Tobacco, for one hour per day for a three day exposure. Quantification of flavoring chemicals was measured by proton nuclear magnetic resonance spectroscopy (1H NMR), differential cell counts by flow cytometry, pro-inflammatory cytokines/chemokines by ELISA, and matrix metalloproteinase levels by western blot. Exposure to PG/VG, Apple, and Smooth & Mild Tobacco resulted in an increase in neutrophil cell count in lung bronchoalveolar lavage fluid (BALF). Strawberry exposure increased KC levels in BALF while in lung homogenate KC levels were increased in PG/VG, Cherry, and Smooth & Mild Tobacco exposure. Exposure to PG/VG and Cherry increased IL-6 levels and in all exposed mice there was a male-specific decrease in MCP-1 levels in lung homogenate. Mice exposed to PG and VG, Apple, Cherry, and Wintergreen resulted in an increase in MMP2 levels. Our results indicate that female mice exposed to cherry flavored e-liquids and male mice exposed to tobacco flavored e-liquids resulted in an increase in inflammation, while exposure to mint flavored e-liquids resulted in a decrease in inflammatory cytokine and an increase in tissue repair proteins. This study revealed that flavored-based e-cigarette exposure elicited sex-specific alterations in lung inflammation, with cherry flavors/benzaldehyde eliciting female-specific increases in inflammation. This highlights the toxicity of flavored chemicals and the further need for regulation of flavoring chemicals.

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Section: Introductionmentioning

confidence: 99%

Nose-only Exposure to Cherry and Tobacco Flavored E-cigarettes Induced Lung Inflammation in Mice in a Sex-dependent Manner

Lamb

Meehan-Atrash

Muthumalage

et al. 2022

Preprint

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“…In addition, it may contain variable amounts of nicotine, never exceeding the concentration of 20 mg cm −3 in EU countries [5]. Although they are considered healthier than traditional cigarettes, owing to their lack of toxic products formed by combustion [6][7][8][9], the health risks related to the use of e-cigarettes have also been widely studied [10][11][12][13]. The apparatuses mainly involved are the respiratory [14,15], the cardiovascular [16,17], the nervous [18], and the reproductive systems [19].…”

Section: Introductionmentioning

confidence: 99%

ICP-MS Determination of 23 Elements of Potential Health Concern in Liquids of e-Cigarettes. Method Development, Validation, and Application to 37 Real Samples

et al. 2021

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The lack of interest in the determination of toxic elements in liquids for electronic cigarettes (e-liquids) has so far been reflected in the scarce number of accurate and validated analytical methods devoted to this aim. Since the strong matrix effects observed for e-liquids constitute an exciting analytical challenge, the main goal of this study was to develop and validate an ICP-MS method aimed to quantify 23 elements in 37 e-liquids of different flavors. Great attention has been paid to the critical phases of sample pre-treatment, as well as to the optimization of the ICP-MS conditions for each element and of the quantification. All samples exhibited a very low amount of the elements under investigation. Indeed, the sum of their average concentration was of ca. 0.6 mg kg−1. Toxic elements were always below a few tens of a μg per kg−1 and, very often, their amount was below the relevant quantification limits. Tobacco and tonic flavors showed the highest and the lowest concentration of elements, respectively. The most abundant elements came frequently from propylene glycol and vegetal glycerin, as confirmed by PCA. A proper choice of these substances could further decrease the elemental concentration in e-liquids, which are probably barely involved as potential sources of toxic elements inhaled by vapers.

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“…Electronic cigarettes can wreak havoc on the lungs by causing oxidative stress, inflammation, and DNA damage. 41 The outbreak of electronic cigarettes can result in acute lung injury Electronic Cigarette or Vaping Product Use-associated Lung Injury (EVALI) in the United States of America resulted in a large number of hospitalizations and deaths. The presence of high levels of metals in e-cigarette aerosol is detrimental to lung health.…”

Section: Health Effects Of Electronic Cigarette and Heated Tobacco Pr...mentioning

confidence: 99%

Turkish Thoracic Society’s Statement Report on Electronic Cigarettes and Heated Tobacco Products

Çetinkaya¹,

Bostan²,

Salepçi³

et al. 2022

Turk Thorac J

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Tobacco addiction, which causes the death of more than 8.5 million people in the world every year, is a preventable global public health problem. There are 1.1 billion adult smokers worldwide and 60% of them desire or intend to quit but unfortunately, the tobacco industry continues to profit at the expense of people’s lives by marketing electronic cigarettes and heated tobacco products as a smoking cessation method and they continue to poison young people with new threat tobacco products, promising a “smoke-free future” Turkish Thoracic Society is actively involved in the implementation of the National Tobacco Control Program to protect public health and has warned and raised awareness of new threats to the youth, such as electronic cigarettes and heated tobacco products. The purpose of this report is to provide information about electronic cigarettes and heated tobacco products and to present TTJ’s position on the subject.

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Toxicity of electronic cigarettes: A general review of the origins, health hazards, and toxicity mechanisms

Cited by 32 publications

References 115 publications

Nose-only Exposure to Cherry and Tobacco Flavored E-cigarettes Induced Lung Inflammation in Mice in a Sex-dependent Manner

Nose-only Exposure to Cherry and Tobacco Flavored E-cigarettes Induced Lung Inflammation in Mice in a Sex-dependent Manner

ICP-MS Determination of 23 Elements of Potential Health Concern in Liquids of e-Cigarettes. Method Development, Validation, and Application to 37 Real Samples

Turkish Thoracic Society’s Statement Report on Electronic Cigarettes and Heated Tobacco Products

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