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Jafarzadeh NS, Han DH, Peraza N, Anderson MK, Harlow AF, Monterosso JR, Pang RD, Mason TB, Hong K, Cahn R, Leventhal AM. Effect of packaging with versus without candy-oriented marketing themes on the appeal and sensory attributes of flavoured e-cigarettes. Tob Control 2024:tc-2024-058904. [PMID: 39384403 DOI: 10.1136/tc-2024-058904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 10/01/2024] [Indexed: 10/11/2024]
Abstract
SIGNIFICANCE E-cigarettes with candy-themed marketing are implicated in decisions to first try e-cigarettes but have unknown effects on the experience of vaping. We compared adults' perceived appeal and sensory attributes after self-administering flavoured e-cigarettes in experimentally manipulated packaging with candy-themed versus standard marketing. We also assessed effect modification by salt vs free-base nicotine formulation. METHODS Adults who currently used e-cigarettes and/or cigarettes (N=72; age M(SD)=31.4 (12.8) years) completed single-puff self-administrations from eight individually-packaged pods containing fruit or dessert-flavoured e-liquid via staff-guided video sessions. For each e-liquid flavour, we custom-manufactured packaging with standard (eg, 'mango'; mango fruit image) and candy (eg, 'mango gummy bear'; gummy bear image) marketing versions, which we varied within-subject (four pods candy; four pods standard). After participants opened the package and vaped the pod inside, they rated its sensory attributes and appeal (0-100 scale). Participants were randomised between subjects to salt or free-base ~2.3% nicotine in all pods. RESULTS Marketing theme had no significant main effects on outcomes. Marketing theme × nicotine formulation interactions were significant; candy-themed (vs standard) packaging elevated composite appeal (Bdifference [estimated mean difference between marketing themes]=7.7), liking (Bdifference=8.4), and sweetness (Bdifference=5.7) ratings in free-base but not salt nicotine formulations. Marketing theme did not affect smoothness, harshness and bitterness ratings regardless of nicotine formulation. CONCLUSION Candy-themed marketing may heighten the appeal and sweet sensory experience of vaping flavoured free-base nicotine e-cigarettes. While marketing restrictions are predominantly intended to prevent e-cigarette initiation, candy-themed marketing restrictions could also prevent persistent use by lowering the appeal of flavoured free-base nicotine e-cigarettes.
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Affiliation(s)
- Nikki S Jafarzadeh
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Dae Hee Han
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Natalia Peraza
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Marissa K Anderson
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Alyssa F Harlow
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - John R Monterosso
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Raina D Pang
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Kurt Hong
- Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Department of Psychiatry, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Rael Cahn
- Department of Psychiatry, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
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El Hourani M, Lakkis I, Ammar M, AlGemayel C, Talih S, Golshahi L, Hosseini S, Ashley D, Saleh R, Eissenberg T, Breland A, Shihadeh A. Effects of freebase/protonated nicotine concentration, liquid composition and electrical power on throat hit in direct-to-lung vaping: theory and clinical measurements. Tob Control 2024:tc-2024-058603. [PMID: 39375033 DOI: 10.1136/tc-2024-058603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 09/03/2024] [Indexed: 10/09/2024]
Abstract
BACKGROUND For decades, the tobacco industry has engineered the sensory characteristics of combustible tobacco products including the degree of harshness experienced at the back of the throat. Commonly referred to as 'throat hit', this harshness derives from absorption of gas phase nicotine and other constituents by the sensory nerves. People who use tobacco products associate throat hit with the positive psychological effects of nicotine, making it a secondary reinforcer for smoking. On the other hand, high throat hit can make products aversive to naïve nicotine users and serves as a barrier to consumption of tobacco products. METHODS We developed a first-principles theoretical model to predict nicotine absorption in the throat as a function of electronic nicotine delivery systems (ENDS) device power, liquid composition and puffing topography. The predicted nicotine absorption was compared with subjective throat harshness reported by human participants. We also simulated several ENDS use scenarios to identify the most important processes and factors that govern nicotine absorption in the throat. RESULTS Across various ENDS configurations, we found that computed nicotine gas absorption in the throat was associated with subjective harshness scores (r=0.62; p<0.00001). We also found that liquid nicotine concentration, nicotine form, aerosol temperature and inhalation rate strongly influence nicotine absorption in the throat per unit of nicotine emitted by an ENDS. CONCLUSIONS Nicotine throat hit can be predicted and manipulated through ENDS device and liquid design variables. Regulating ENDS throat hit is feasible and may help reduce product appeal to nicotine-naïve individuals while maintaining acceptability for smokers.
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Affiliation(s)
- Mario El Hourani
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Issam Lakkis
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
| | - Maram Ammar
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
| | - Christina AlGemayel
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Soha Talih
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Laleh Golshahi
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sana Hosseini
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - David Ashley
- Department of Population Health Sciences, Georgia State University, Atlanta, Georgia, USA
| | - Rawad Saleh
- Environmental, Civil, Agricultural, and Mechanical Engineering, University of Georgia, Athens, Georgia, USA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Alison Breland
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Alan Shihadeh
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
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Talhout R, Leventhal AM. Coolants, organic acids, flavourings and other additives that facilitate inhalation of tobacco and nicotine products: implications for regulation. Tob Control 2024:tc-2024-058738. [PMID: 39256038 DOI: 10.1136/tc-2024-058738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 08/19/2024] [Indexed: 09/12/2024]
Abstract
To inform regulatory policy, this article summarises findings on inhalation facilitation from the ninth report of the WHO Study Group on Tobacco Product Regulation. Some additives counteract the harshness and bitterness of tobacco and nicotine product aerosols, making them easier to inhale. Additives that promote inhalability may perpetuate and increase the use of inhaled tobacco and nicotine products, especially by young people. Thus, as a class, additives that facilitate inhalation are an important regulatory target to prevent tobacco and nicotine product uptake. We defined inhalation facilitation as modifications to products during manufacturing that enhance the sensory experience and (potentially) behaviours associated with inhalation (eg, deeper puffs, faster inhalation, larger puff volume, shorter intervals in between puffs and use episodes). Evidence review showed that: (a) menthol and synthetic coolants decrease irritation caused by aerosol constituents by activating sensory perception receptors (eg, cooling receptors) and may promote dependence in inexperienced users; (b) acid additives and sugars, which lower the pH of aerosols and shift nicotine from free-base to protonated salt forms, reduce harshness and increase blood nicotine yield; (c) e-cigarette flavourings perceived as sweet or fruity reduce subjective bitterness, increase attractiveness and may escalate use, although their effects on perceived harshness are inconclusive; (d) sugars in tobacco impart sweet sensations, but limited industry-independent data preclude strong conclusions for sugars' roles in inhalation facilitation. Given these findings, WHO policy recommendations suggest that regulators might consider banning ingredients that facilitate inhalation in all commercial inhaled tobacco and nicotine products.
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Affiliation(s)
- Reinskje Talhout
- Centre for Health Protection, Dutch National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Adam M Leventhal
- Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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Brouwer AF, Jeon J, Jimenez-Mendoza E, Land SR, Holford TR, Friedman AS, Tam J, Mistry R, Levy DT, Meza R. Changing patterns of cigarette and ENDS transitions in the USA: a multistate transition analysis of youth and adults in the PATH Study in 2015-2017 vs 2017-2019. Tob Control 2024; 33:570-579. [PMID: 36977570 PMCID: PMC10533746 DOI: 10.1136/tc-2022-057905] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/13/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION It is unknown how recent changes in the tobacco product marketplace have impacted transitions in cigarette and electronic nicotine delivery system (ENDS) use. METHODS A multistate transition model was applied to 24 242 adults and 12 067 youth in waves 2-4 (2015-2017) and 28 061 adults and 12 538 youth in waves 4 and 5 (2017-2019) of the Population Assessment of Tobacco and Health Study. Transition rates for initiation, cessation and product transitions were estimated in multivariable models, accounting for gender, age group, race/ethnicity and daily versus non-daily product use. RESULTS Changes in ENDS initiation/relapse rates depended on age, including among adults. Among youth who had never established tobacco use, the 1-year probability of ENDS initiation increased after 2017 from 1.6% (95% CI 1.4% to 1.8%) to 3.8% (95% CI 3.4% to 4.2%). Persistence of ENDS-only use (ie, 1-year probability of continuing to use ENDS only) increased for youth from 40.7% (95% CI 34.4% to 46.9%) to 65.7% (95% CI 60.5% to 71.1%) and for adults from 57.8% (95% CI 54.4% to 61.3%) to 78.2% (95% CI 76.0% to 80.4%). Persistence of dual use similarly increased for youth from 48.3% (95% CI 37.4% to 59.2%) to 60.9% (95% CI 43.0% to 78.8%) and for adults from 40.1% (95% CI 37.0% to 43.2%) to 63.8% (95% CI 59.6% to 67.6%). Youth and young adults who used both products became more likely to transition to ENDS-only use, but middle-aged and older adults did not. CONCLUSIONS ENDS-only and dual use became more persistent. Middle-aged and older adults who used both products became less likely to transition to cigarette-only use but not more likely to discontinue cigarettes. Youth and young adults became more likely to transition to ENDS-only use.
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Affiliation(s)
| | - Jihyoun Jeon
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Stephanie R Land
- Tobacco Control Research Branch, National Cancer Institute Division of Cancer Control and Population Sciences, Rockville, Maryland, USA
| | - Theodore R Holford
- Biostatistics, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Abigail S Friedman
- Health Management and Policy, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Jamie Tam
- Health Management and Policy, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Ritesh Mistry
- Health Behavior Health Education, University of Michigan, Ann Arbor, Michigan, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Rafael Meza
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
- Integrative Oncology, BC Cancer Research Centre, Vancouver, British Columbia, Canada
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5
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Jongenelis MI, Brierley MEE, Li R. Patterns of nicotine pouch use among young Australians. Drug Alcohol Depend 2024; 264:112428. [PMID: 39294073 DOI: 10.1016/j.drugalcdep.2024.112428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/22/2024] [Accepted: 08/25/2024] [Indexed: 09/20/2024]
Abstract
BACKGROUND Despite increasing interest in the use of nicotine pouches in Australia - where retail sale of the products is illegal - research exploring patterns of pouch use and reasons for use is lacking. Accordingly, this study explored young Australians' experiences with nicotine pouches. METHODS An online survey was administered to 1598 Australians aged 16-39 years (53 % women). We assessed (i) awareness and use (lifetime and past 30-day) of nicotine pouches, (ii) patterns of use (e.g., flavours and nicotine strength used), (iii) product source, and (iv) reasons for use. Regression analyses were conducted to assess socio-demographic predictors of awareness and use. RESULTS Just over three-quarters (77 %) of the sample reported being aware of nicotine pouches. Lifetime use was reported by 26 % of respondents and past 30-day use by 19 %. Among those who reported past 30-day use, fruit (35 %) and menthol/mint (34 %) flavours were most commonly used. In terms of pouch source, one-third (33 %) reported obtaining the product from a tobacconist. The most common reasons for use were "they come in flavours I like" (34 %) and "to help me quit smoking" (32 %). Awareness, lifetime use, and past 30-day use of nicotine pouches were more likely among men, those who reported current use of tobacco products, and those who reported current use of e-cigarettes. CONCLUSIONS Awareness and use of nicotine pouches among young Australians may be substantial enough to warrant the inclusion of items measuring pouch use in national surveys. Efforts should be made to better enforce existing laws regarding the sale of nicotine pouches.
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Affiliation(s)
- Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Grattan Street, Parkville, 3010, Australia.
| | - Mary-Ellen E Brierley
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Grattan Street, Parkville, 3010, Australia.
| | - Runze Li
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Grattan Street, Parkville, 3010, Australia.
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Harris T. Physical and Chemical Characterization of Aerosols Produced from Experimentally Designed Nicotine Salt-Based E-Liquids. Chem Res Toxicol 2024; 37:1315-1328. [PMID: 39078024 PMCID: PMC11337207 DOI: 10.1021/acs.chemrestox.4c00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 07/31/2024]
Abstract
Nicotine salt-based e-liquids deliver nicotine more rapidly and efficiently to electronic nicotine delivery system (ENDS) users than freebase nicotine formulations. Nicotine salt-based products represent a substantial majority of the United States ENDS market. Despite the popularity of nicotine salt formulations, the chemical and physical characteristics of aerosols produced by nicotine salt e-liquids are still not well understood. To address this, this study reports the harmful and potentially harmful constituents (HPHCs) and particle sizes of aerosols produced by laboratory-made freebase nicotine and nicotine salt e-liquids. The nicotine salt e-liquids were formulated with benzoic acid, citric acid, lactic acid, malic acid, or oxalic acid. The nicotine salt aerosols had different HPHC profiles than the freebase nicotine aerosols, indicating that the carboxylic acids were not innocent bystanders. The polycarboxylic acid e-liquids containing citric acid, malic acid, or oxalic acid produced higher acrolein yields than the monocarboxylic acid e-liquids containing benzoic acid or lactic acid. Across most PG:VG ratios, nicotine benzoate or nicotine lactate aerosols contained the highest nicotine quantities (in %) and the highest nicotine yields (per milligram of aerosol). Additionally, the nicotine benzoate and nicotine lactate e-liquids produced the highest carboxylic acid yields under all tested conditions. The lower acid yields of the citric, malic, and oxalic acid formulations are potentially due to a combination of factors such as lower transfer efficiencies, lower thermostabilities, and greater susceptibility to side reactions because of their additional carboxyl groups serving as new sites for reactivity. For all nicotine formulations, the particle size characteristics were primarily controlled by the e-liquid solvent ratios, and there were no clear trends between nicotine salt and freebase nicotine aerosols that indicated nicotine protonation affected particle size. The carboxylic acids impacted aerosol output, nicotine delivery, and HPHC yields in distinct ways such that interchanging them in ENDS can potentially cause downstream effects.
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Affiliation(s)
- Trevor Harris
- Office of Science, Center
for Tobacco Products, U.S. Food and Drug
Administration, Silver
Spring, Maryland 20993, United States
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7
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Ma S, Brinkman MC, Berman M, Wagener T, Shang C. E-cigarette market share by nicotine claims. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.14.24311761. [PMID: 39185515 PMCID: PMC11343272 DOI: 10.1101/2024.08.14.24311761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Background Nicotine forms (salt vs. freebase) and isomers (synthetic vs. tobacco-derived) are key characteristics of e-cigarettes that manufacturers manipulate, and "tobacco-free" claims may have served to attract new consumers and increase their intention to use. Method This study presents a snapshot of nicotine marketing claims for e-cigarettes using Nielsen ScanTrack data from brick-and-mortar stores. Market share was calculated as the ratio of unit sales of each nicotine claim category to the total unit sales of e-cigarettes during the four weeks ending 1-20-2024. Results We summarized the market share for the following six nicotine form/isomer category: 1) nicotine (77%), 2) nicotine salt (10%), 3) synthetic nicotine (2%), 4) zero tobacco or tobacco-free (2%), 5) zero nicotine or nicotine-free (0.03%), and 6) no claim or CBD/hemp/cannabis (9%). Conclusion The market share of products that explicitly carried nicotine salt claims (10%) or synthetic nicotine or tobacco-free claims (2% each) was notable. This study informs regulatory authorities on the recent trend of nicotine claims marketed by the e-cigarette industry, which may be contributing to the use of these products or addiction to nicotine among young people and non-users.
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Affiliation(s)
- Shaoying Ma
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center
| | - Marielle C. Brinkman
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center
- Division of Epidemiology, College of Public Health, The Ohio State University
| | - Micah Berman
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University
- Michael E. Moritz College of Law, The Ohio State University
| | - Theodore Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine
| | - Ce Shang
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine
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Kasza KA, Rivard C, Goniewicz ML, Fong GT, Hammond D, Cummings KM, Hyland A. E-Cigarette Characteristics and Cigarette Cessation Among Adults Who Use E-Cigarettes. JAMA Netw Open 2024; 7:e2423960. [PMID: 39088219 PMCID: PMC11294961 DOI: 10.1001/jamanetworkopen.2024.23960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/28/2024] [Indexed: 08/02/2024] Open
Abstract
Importance Population-level health outcomes associated with e-cigarettes depend in part on the association between e-cigarettes and combustible cigarette cessation. The US Food and Drug Administration has authority to regulate e-cigarette characteristics, including flavor and device type. Objective To investigate whether e-cigarette characteristics are associated with cigarette cessation behaviors among adults in the US population who use e-cigarettes. Design, Setting, and Participants This cohort study was conducted using longitudinal data collected in 2014 to 2021 by the Population Assessment of Tobacco and Health Study, a population-based, US nationally representative study. Participants were sampled from the civilian noninstitutionalized population using a 4-staged, stratified sampling design. Data were weighted and analyzed from 1985 adults ages 21 or older who smoked cigarettes daily and had used e-cigarettes in the past 30 days. Data were analyzed in May 2021 to May 2024. Exposures The following e-cigarette characteristics were assessed: use frequency (daily and nondaily), flavor type (tobacco, menthol or mint, sweet, and combination), device type (disposable, cartridge, and tank), and year of data collection as a proxy for the evolving e-cigarette marketplace. Main Outcomes and Measures The following cigarette cessation behaviors were assessed: making a cigarette quit attempt, cigarette cessation among individuals who made a quit attempt, and overall cigarette discontinuation regardless of quit attempts. Associations were evaluated between e-cigarette characteristics (assessed at baseline in 1 approach and assessed at follow-up in another approach) and cigarette cessation outcomes, controlling for demographic, cigarette smoking, and other e-cigarette use characteristics. Results The study sample consisted of 1985 participants representing adults in the population (mean age, 40.0 years [95% CI, 39.2-40.9 years]; 49.4% [95% CI, 46.3%-52.6%] male; 11.4% [95% CI, 9.6%-13.4%] Black, 80.7% [95% CI, 77.8%-83.3%] White, and 8.0% [95% CI, 6.3%-10.0%] other race; 9.2% [95% CI, 7.5%-11.2%] Hispanic). Daily vs nondaily e-cigarette use was associated with greater overall cigarette discontinuation rates (12.8% [95% CI, 9.1%-17.7%] vs 6.1% [95% CI, 4.8%-7.7%]; adjusted odds ratio [aOR], 2.26 [95% CI, 1.34-3.81]), and use of e-cigarettes in 2019 to 2021 vs 2014-2015 to 2015-2016 was also associated with greater overall cigarette discontinuation rates (12.0% [95% CI, 8.8%-16.0%] vs 5.3% [95% CI, 2.9%-9.3%]; aOR, 2.75 [95% CI, 1.13-6.67]). Use of menthol or mint vs tobacco flavor e-cigarettes was associated with greater overall cigarette discontinuation rates (9.2% [95% CI, 6.6%-12.8%] vs 4.7% [95% CI, 3.0%-7.1%]; aOR, 2.63 [95% CI, 1.32-5.27]) only when assessing e-cigarette use at baseline. E-cigarette device type was not associated with cigarette discontinuation rates in adjusted analyses. Conclusions and Relevance In this study, daily e-cigarette use and use of e-cigarettes in 2019 to 2021 were consistently associated with greater cigarette discontinuation rates. These findings suggest that research focused on e-cigarettes marketed in recent years is needed to inform product regulation and public health policy decisions.
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Affiliation(s)
- Karin A. Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Cheryl Rivard
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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9
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Andreas S, Chen DTH, Grigg J, Filippidis FT. [European Respiratory Society statement on novel nicotine and tobacco products, their role in tobacco control and "harm reduction"]. Pneumologie 2024; 78:446-452. [PMID: 38670147 DOI: 10.1055/a-2298-8015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
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10
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Kassem NOF, Strongin RM, Stroup AM, Brinkman MC, El-Hellani A, Erythropel HC, Etemadi A, Exil V, Goniewicz ML, Kassem NO, Klupinski TP, Liles S, Muthumalage T, Noël A, Peyton DH, Wang Q, Rahman I, Valerio LG. A review of the toxicity of ingredients in e-cigarettes, including those ingredients having the FDA's "Generally Recognized as Safe (GRAS)" regulatory status for use in food. Nicotine Tob Res 2024:ntae123. [PMID: 38783714 DOI: 10.1093/ntr/ntae123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Some firms and marketers of electronic cigarettes (e-cigarettes; a type of electronic nicotine delivery system (ENDS)) and refill liquids (e-liquids) have made claims about the safety of ingredients used in their products based on the term "GRAS or Generally Recognized As Safe" (GRAS). However, GRAS is a provision within the definition of a food additive under section 201(s) (21 U.S.C. 321(s)) of the U.S. Federal Food Drug and Cosmetic Act (FD&C Act). Food additives and GRAS substances are by the FD&C Act definition intended for use in food, thus safety is based on oral consumption; the term GRAS cannot serve as an indicator of the toxicity of e-cigarette ingredients when aerosolized and inhaled (i.e., vaped). There is no legal or scientific support for labeling e-cigarette product ingredients as "GRAS". This review discusses our concerns with the GRAS provision being applied to e-cigarette products and provides examples of chemical compounds that have been used as food ingredients but have been shown to lead to adverse health effects when inhaled. The review provides scientific insight into the toxicological evaluation of e-liquid ingredients and their aerosols to help determine the potential respiratory risks associated with their use in e-cigarettes. IMPLICATIONS The rise in prevalence of e-cigarette use and emerging evidence of adverse effects, particularly on lung health, warrant assessing all aspects of e-cigarette toxicity. One development is manufacturers' stated or implied claims of the safety of using e-cigarette products containing ingredients determined to be "Generally Recognized As Safe" (GRAS) for use in food. Such claims, typically placed on e-cigarette product labels and used in marketing, are unfounded, as pointed out by the United States Food and Drug Administration (FDA)1 and the Flavor and Extract Manufacturers Association (FEMA)2. Assessment of inhalation health risks of all ingredients used in e-liquids, including those claimed to be GRAS, is warranted.
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Affiliation(s)
- Nada O F Kassem
- Health Promotion and Behavioral Science, San Diego State University, San Diego, CA 92182, U.S
- Hookah Tobacco Research Center, San Diego State University Research Foundation, San Diego, CA 92123, U.S
| | - Robert M Strongin
- Department of Chemistry, Portland State University, Portland, OR 97207-0751, U.S
| | - Andrea M Stroup
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD 20850, U.S
| | - Marielle C Brinkman
- College of Public Health, The Ohio State University, Columbus, OH 43210, U.S
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43214, U.S
| | - Ahmad El-Hellani
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, U.S
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43214, U.S
| | - Hanno C Erythropel
- Department of Chemical and Environmental Engineering, Yale University, New Haven, CT 06511, U.S
- Yale Center for the Study of Tobacco Products (YCSTP), Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, U.S
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD 20892, U.S
| | - Vernat Exil
- School of Medicine, St. Louis University, St. Louis, MO 63104, U.S
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14226, U.S
| | - Noura O Kassem
- Hookah Tobacco Research Center, San Diego State University Research Foundation, San Diego, CA 92123, U.S
| | | | - Sandy Liles
- Hookah Tobacco Research Center, San Diego State University Research Foundation, San Diego, CA 92123, U.S
| | | | - Alexandra Noël
- Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, U.S
| | - David H Peyton
- Department of Chemistry, Portland State University, Portland, OR 97207-0751, U.S
| | - Qixin Wang
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, U.S
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, U.S
| | - Luis G Valerio
- Division of Nonclinical Science (DNCS), Office of Science/Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, U.S
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11
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Cui T, Lu R, Liu C, Wu Z, Jiang X, Liu Y, Pan S, Li Y. Characteristics of second-hand exposure to aerosols from e-cigarettes: A literature review since 2010. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 926:171829. [PMID: 38537812 DOI: 10.1016/j.scitotenv.2024.171829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/29/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024]
Abstract
In recent years, the use of electronic vaping products (also named e-cigarettes) has increased due to their appealing flavors and nicotine delivery without the combustion of tobacco. Although the hazardous substances emitted by e-cigarettes are largely found to be much lower than combustible cigarettes, second-hand exposure to e-cigarette aerosols is not completely benign for bystanders. This work reviewed and synthesized findings on the second-hand exposure of aerosols from e-cigarettes and compared the results with those of the combustible cigarettes. In this review, different results were integrated based upon sampling locations such as residences, vehicles, offices, public places, and experimental exposure chambers. In addition, the factors that influence the second-hand exposure levels were identified by objectively reviewing and integrating the impacts of combustible cigarettes and e-cigarettes on the environment. It is a challenge to compare the literature data directly to assess the effect of smoking/vaping on the indoor environment. The room volume, indoor air exchange rate, puffing duration, and puffing numbers should be considered, which are important factors in determining the degree of pollution. Therefore, it is necessary to calculate the "emission rate" to normalize the concentration of pollutants emitted under various experimental conditions and make the results comparable. This review aims to increase the awareness regarding the harmful effects of the second-hand exposure to aerosols coming from the use of cigarettes and e-cigarettes, identify knowledge gaps, and provide a scientific basis for future policy interventions with regard to the regulation of smoking and vaping.
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Affiliation(s)
- Tong Cui
- School of Civil Engineering, Chang'an University, Xi'an 710054, China; School of Water and Environment, Chang'an University, Xi'an 710054, China; Key Laboratory of Subsurface Hydrology and Ecology Effects in Arid Region, Ministry of Education, Xi'an 710054, China
| | - Rui Lu
- RELX Science Center, Shenzhen RELX Tech. Co., Ltd., Shenzhen, China.
| | - Chuan Liu
- RELX Science Center, Shenzhen RELX Tech. Co., Ltd., Shenzhen, China
| | - Zehong Wu
- RELX Science Center, Shenzhen RELX Tech. Co., Ltd., Shenzhen, China
| | - Xingtao Jiang
- RELX Science Center, Shenzhen RELX Tech. Co., Ltd., Shenzhen, China
| | - Yiqiao Liu
- Department of Mechanical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Song Pan
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing 100124, China
| | - Yanpeng Li
- School of Water and Environment, Chang'an University, Xi'an 710054, China; Key Laboratory of Subsurface Hydrology and Ecology Effects in Arid Region, Ministry of Education, Xi'an 710054, China.
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12
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Rykaczewski C, Tackett AP, Klein EG, Singer JM, Lu B, Wold LE, Wagner DD, Roberts ME. Nicotine information disclosed online by e-cigarette brands popular with young people. Tob Prev Cessat 2024; 10:TPC-10-19. [PMID: 38666216 PMCID: PMC11044183 DOI: 10.18332/tpc/186953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/01/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION E-cigarette use is most prevalent among adolescents and young adults - and there are often misperceptions about product risk. The purpose of this study was to determine what nicotine information is provided on e-cigarette brand websites. METHODS Based on national and local surveys, we identified 44 e-cigarette brands commonly used in the US by adolescents and young adults. For each of these brands, their associated websites were analyzed for disclosed nicotine information. Specifically, for each brand's website, we coded whether there was information on nicotine concentration (recorded if a numerical value was provided such as '5% nicotine'), nicotine form (free-base, nicotine salts, or not stated), and nicotine type (tobacco-derived, synthetically derived, or not stated). Coding allowed for both lay (e.g. 'nic salts') as well as scientific (e.g. 'isomers') terms. RESULTS Of the 44 brands examined, all provided basic information on nicotine concentration (e.g. '5% nicotine'). However, 23% of brands did not disclose information on nicotine form (i.e. nicotine salt vs free-base), and 66% of brands did not disclose information on nicotine type (i.e. synthetic vs tobacco-derived). CONCLUSIONS Overall, these results suggest that the e-cigarette industry is not fully informing its consumers about the nicotine in their products. Given that nicotine form and type have implications for e-cigarette addiction potential, these findings highlight a public health concern. There is a need for more comprehensive national regulations for mandating product constituents and emissions disclosures.
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Affiliation(s)
- Clara Rykaczewski
- College of Public Health, The Ohio State University, Columbus, Ohio, United States
| | - Alayna P. Tackett
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Elizabeth G. Klein
- College of Public Health, The Ohio State University, Columbus, Ohio, United States
| | - Jill M. Singer
- College of Public Health, The Ohio State University, Columbus, Ohio, United States
| | - Bo Lu
- College of Public Health, The Ohio State University, Columbus, Ohio, United States
| | - Loren E. Wold
- The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
| | - Dylan D. Wagner
- Department of Psychology, The Ohio State University, Columbus, Ohio, United States
| | - Megan E. Roberts
- College of Public Health, The Ohio State University, Columbus, Ohio, United States
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13
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Singer JM, Tackett AP, Klein EG, Lu B, Wagner DD, Wold LE, Roberts ME. Demographic and Behavioral Differences Between Adolescents and Young Adults Who Use E-Cigarettes at Low and High Frequency. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:232-239. [PMID: 38258811 DOI: 10.1177/29767342231214115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Among adolescents and young adults (AYAs), "current use" of electronic cigarettes (e-cigarettes) is commonly defined as any use in the past 30 days. However, few studies have examined differences among those within this broad category. This study examined characteristics of AYAs who used e-cigarettes at a low frequency (within the last 3 months but <6 days out of the past 30 days) and those who used e-cigarettes at a high frequency (6+ days out of the past 30 days). METHODS We conducted cross-sectional analyses among 551 Ohio AYAs (15- to 24-year-olds) who reported using an e-cigarette to vape nicotine in the past 3 months. We used descriptive statistics and logistic regression to characterize those using e-cigarettes at a low frequency and a high frequency. RESULTS Among our sample of AYAs who reported past 3-month e-cigarette use, about half (50.8%) reported using an e-cigarette 6 or more days out of the past 30 days (ie, high frequency). In the multivariable analysis, reported nicotine dependence (Odds Ratio [OR]: 7.0, 95% CI: 4.8, 10.3) and current other tobacco product use (OR: 1.8, 95% CI: 1.1, 2.9) were associated with high-frequency e-cigarette use. CONCLUSION Our results suggest that frequency of use is an important characteristic in understanding AYA e-cigarette use. Any use in the past 30 days may not be sensitive enough to understand dependence and tobacco-use behaviors. Further characterizing "current" e-cigarette use by frequency of use may provide meaningful information for public health professionals to better target intervention and cessation efforts to AYAs.
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Affiliation(s)
- Jill M Singer
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Alayna P Tackett
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Elizabeth G Klein
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Bo Lu
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Dylan D Wagner
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Loren E Wold
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Megan E Roberts
- College of Public Health, The Ohio State University, Columbus, OH, USA
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14
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Zuo Y, Solingapuram Sai KK, Jazic A, Bansode AH, Rose JE, Mukhin AG. Comparison of brain nicotine accumulation from traditional combustible cigarettes and electronic cigarettes with different formulations. Neuropsychopharmacology 2024; 49:740-746. [PMID: 38225397 PMCID: PMC10876700 DOI: 10.1038/s41386-024-01800-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024]
Abstract
Rapid brain accumulation is critical for the acute reinforcing effects of nicotine. Although nicotine formulation (free-base vs. protonated or salt) in electronic cigarette (E-cig) liquid affects user satisfaction, its impact on brain nicotine accumulation (BNA) from E-cig use has not been evaluated in comparison with traditional combustible cigarettes (C-cigs) using a within-subjects design. BNA was directly assessed with 29 adult dual users (13 females) of E-cigs and C-cigs, using [11C]nicotine and positron emission tomography (PET). Participants underwent two 15-min upper body (from chest to head) scanning sessions during which they inhaled a single puff of [11C]nicotine-labeled vapor from E-cigs with free-base nicotine or C-cig smoke in a randomized order. Seventeen of them also went through another session during which they inhaled from E-cigs with nicotine salt. A full-body scan was also conducted at each session to measure total absorbed dose of [11C]nicotine. Mean maximum nicotine concentration (Cmax) in brain following inhalation of free-base nicotine E-cig vapor was 19% and 15% lower relative to C-cig smoke and nicotine salt E-cig vapor (ps = 0.014 and 0.043, respectively). The Cmax values did not differ significantly between the C-cig and nicotine salt E-cig. Mean values of time to the maximum concentration (Tmax) were not significantly different between the two types of E-cig, but they were 64% and 40% longer than that for C-cig smoking (ps = 0.0005 and 0.004, respectively). Mean Cmax with C-cigs and free-base nicotine E-cigs were greater in females relative to males and correlated with T1/2 of lung nicotine clearance and participants' pack-years. These results suggest that while E-cigs with free-base nicotine formulation can deliver nicotine rapidly to the brain, those with nicotine salt formulation are capable of even more efficient brain nicotine delivery closely resembling combustible cigarettes. Therefore, nicotine formulation or pH in E-liquid should be considered in evaluation of E-cigs in terms of abuse liability and potential in substituting for combustible cigarettes.
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Affiliation(s)
- Yantao Zuo
- Department of Psychiatry and Behavioral Sciences, Duke University Scholl of Medicine, Durham, NC, 27705, USA
| | - Kiran Kumar Solingapuram Sai
- Department of Radiological Sciences, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Aeva Jazic
- Department of Psychiatry and Behavioral Sciences, Duke University Scholl of Medicine, Durham, NC, 27705, USA
| | - Avinash H Bansode
- Department of Radiological Sciences, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Jed E Rose
- Department of Psychiatry and Behavioral Sciences, Duke University Scholl of Medicine, Durham, NC, 27705, USA
| | - Alexey G Mukhin
- Department of Psychiatry and Behavioral Sciences, Duke University Scholl of Medicine, Durham, NC, 27705, USA.
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15
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Duan Z, Henriksen L, Vallone D, Rath JM, Evans WD, Romm KF, Wysota C, Berg CJ. Nicotine pouch marketing strategies in the USA: an analysis of Zyn, On! and Velo. Tob Control 2024; 33:154-163. [PMID: 35817549 DOI: 10.1136/tc-2022-057360] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/27/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Nicotine pouches are gaining popularity, yet their marketing is understudied. METHODS Using Numerator advertising data from January 2019 to September 2021 regarding three popular brands of nicotine pouch in the USA-Zyn (by Swedish Match, introduced in the USA in July 2016), On! (Altria, August 2016) and Velo (RJ Reynolds, July 2019)-we examined (1) general advertising characteristics (eg, media type, year); (2) ad content (ie, headlines and imagery themes); (3) prominent media channels (ie, specific websites, magazines, etc); and (4) ad expenditures. RESULTS There were 286 unique ads (Zyn: 44.4%; On!: 2.8%; Velo: 52.8%), 119 143 occurrences (Zyn: 3.5%; On!: 0.5%; Velo: 96.0%) and $24 774 650 total expenditures (Zyn: 4.7%; On!: 0.6%; Velo: 94.7%). The greatest proportion of ad occurrences and expenditures were accounted for by radio (75.9% and 28.2%, respectively) and television (16.2% and 56.5%), followed by mobile (0.5% and 7.2%) and online display (6.7% and 3.6%). Across ad occurrences and expenditures, prominent headline themes included 'freedom' (26.0% and 17.1%, respectively), 'brand' (9.6% and 18.6%) and 'flavour' (16.4% and 7.6%); images mainly featured the product alone (61.4% and 56.1%), text (16.2% and 24.6%) or men (8.7% and 8.6%); and prominent channel themes were entertainment (34.7% and 37.3%), news/weather (14.3% and 21.7%), business/finance (12.9% and 9.0%) and sports (9.5% and 1.0%). Zyn and On! prioritised online display and print; Velo prioritised radio and television. Zyn's and Velo's headlines focused on 'freedom', with Zyn also emphasising 'brand' and Velo 'innovation'; On!'s headlines emphasised 'flavour'. CONCLUSIONS Regulatory efforts must be informed by surveillance of nicotine pouch marketing and impacts on consumer subgroups (eg, young people).
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Affiliation(s)
- Zongshuan Duan
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
| | - Donna Vallone
- Truth Initiative Schroeder Institute, Washington, District of Columbia, USA
- School of Global Public Health, New York University, New York, New York, USA
| | - Jessica M Rath
- Truth Initiative Schroeder Institute, Washington, District of Columbia, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - W Douglas Evans
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Katelyn F Romm
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Christina Wysota
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
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16
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Chen DTH, Grigg J, Filippidis FT. European Respiratory Society statement on novel nicotine and tobacco products, their role in tobacco control and "harm reduction". Eur Respir J 2024; 63:2301808. [PMID: 38316440 DOI: 10.1183/13993003.01808-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/27/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Daniel Tzu-Hsuan Chen
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK
| | - Jonathan Grigg
- Centre for Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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Borkar NA, Thompson MA, Bartman CM, Khalfaoui L, Sine S, Sathish V, Prakash YS, Pabelick CM. Nicotinic receptors in airway disease. Am J Physiol Lung Cell Mol Physiol 2024; 326:L149-L163. [PMID: 38084408 PMCID: PMC11280694 DOI: 10.1152/ajplung.00268.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 01/26/2024] Open
Abstract
With continued smoking of tobacco products and expanded use of nicotine delivery devices worldwide, understanding the impact of smoking and vaping on respiratory health remains a major global unmet need. Although multiple studies have shown a strong association between smoking and asthma, there is a relative paucity of mechanistic understanding of how elements in cigarette smoke impact the airway. Recognizing that nicotine is a major component in both smoking and vaping products, it is critical to understand the mechanisms by which nicotine impacts airways and promotes lung diseases such as asthma. There is now increasing evidence that α7 nicotinic acetylcholine receptors (α7nAChRs) are critical players in nicotine effects on airways, but the mechanisms by which α7nAChR influences different airway cell types have not been widely explored. In this review, we highlight and integrate the current state of knowledge regarding nicotine and α7nAChR in the context of asthma and identify potential approaches to alleviate the impact of smoking and vaping on the lungs.
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Affiliation(s)
- Niyati A Borkar
- Department of Anesthesiology and Perioperative Medicine, North Dakota State University, Fargo, North Dakota, United States
| | - Michael A Thompson
- Department of Anesthesiology and Perioperative Medicine, North Dakota State University, Fargo, North Dakota, United States
| | - Colleen M Bartman
- Department of Anesthesiology and Perioperative Medicine, North Dakota State University, Fargo, North Dakota, United States
| | - Latifa Khalfaoui
- Department of Anesthesiology and Perioperative Medicine, North Dakota State University, Fargo, North Dakota, United States
| | - Steven Sine
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States
| | - Venkatachalem Sathish
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota, United States
| | - Y S Prakash
- Department of Anesthesiology and Perioperative Medicine, North Dakota State University, Fargo, North Dakota, United States
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States
| | - Christina M Pabelick
- Department of Anesthesiology and Perioperative Medicine, North Dakota State University, Fargo, North Dakota, United States
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, United States
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18
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Schmidt C. Nicotine, Flavor, and More: E-Cigarette Aerosols Deliver Toxic Metals. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:24002. [PMID: 38345786 PMCID: PMC10860703 DOI: 10.1289/ehp14425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/05/2024] [Indexed: 02/15/2024]
Abstract
In laboratory experiments, e-cigarettes generated aerosols containing nickel, lead, arsenic, manganese, and other toxic metals. None of the MODs, P ODs, or d-P ODs tested delivered completely metalfree aerosol.
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19
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Dorotheo EU, Arora M, Banerjee A, Bianco E, Cheah NP, Dalmau R, Eissenberg T, Hasegawa K, Naidoo P, Nazir NT, Newby LK, Obeidat N, Skipalskyi A, Stępińska J, Willett J, Wang Y. Nicotine and Cardiovascular Health: When Poison is Addictive - a WHF Policy Brief. Glob Heart 2024; 19:14. [PMID: 38312998 PMCID: PMC10836189 DOI: 10.5334/gh.1292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/28/2023] [Indexed: 02/06/2024] Open
Abstract
Nicotine is universally recognized as the primary addictive substance fuelling the continued use of tobacco products, which are responsible for over 8 million deaths annually. In recent years, the popularity of newer recreational nicotine products has surged drastically in many countries, raising health and safety concerns. For decades, the tobacco industry has promoted the myth that nicotine is as harmless as caffeine. Nonetheless, evidence shows that nicotine is far from innocuous, even on its own. In fact, numerous studies have demonstrated that nicotine can harm multiple organs, including the respiratory and cardiovascular systems. Tobacco and recreational nicotine products are commercialized in various types and forms, delivering varying levels of nicotine along with other toxic compounds. These products deliver nicotine in profiles that can initiate and perpetuate addiction, especially in young populations. Notably, some electronic nicotine delivery systems (ENDS) and heated tobacco products (HTP) can deliver concentrations of nicotine that are comparable to those of traditional cigarettes. Despite being regularly advertised as such, ENDS and HTP have demonstrated limited effectiveness as tobacco cessation aids in real-world settings. Furthermore, ENDS have also been associated with an increased risk of cardiovascular disease. In contrast, nicotine replacement therapies (NRT) are proven to be safe and effective medications for tobacco cessation. NRTs are designed to release nicotine in a slow and controlled manner, thereby minimizing the potential for abuse. Moreover, the long-term safety of NRTs has been extensively studied and documented. The vast majority of tobacco and nicotine products available in the market currently contain nicotine derived from tobacco leaves. However, advancements in the chemical synthesis of nicotine have introduced an economically viable alternative source. The tobacco industry has been exploiting synthetic nicotine to circumvent existing tobacco control laws and regulations. The emergence of newer tobacco and recreational nicotine products, along with synthetic nicotine, pose a tangible threat to established tobacco control policies. Nicotine regulations need to be responsive to address these evolving challenges. As such, governments should regulate all tobacco and non-medical nicotine products through a global, comprehensive, and consistent approach in order to safeguard tobacco control progress in past decades.
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Affiliation(s)
| | | | - Amitava Banerjee
- University College London, United Kingdom
- Amrita Institute of Medical Sciences, India
| | | | | | | | | | - Koji Hasegawa
- National Hospital Organization Kyoto Medical Center, Japan
| | - Pamela Naidoo
- Heart and Stroke Foundation South Africa, South Africa
- University of the Western Cape, South Africa
| | | | | | | | | | - Janina Stępińska
- Department of Medical Communication, School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
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20
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Lamb T, Kaur G, Rahman I. Tobacco-derived and tobacco-free nicotine cause differential inflammatory cell influx and MMP-9 in mouse lung. Respir Res 2024; 25:51. [PMID: 38254111 PMCID: PMC10804532 DOI: 10.1186/s12931-023-02662-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Electronic nicotine delivery systems (ENDS) or electronic cigarettes (e-cigarettes) aerosolize an e-liquid composed of propylene glycol (PG) and vegetable glycerin (VG) as humectants, flavoring chemicals, and nicotine. Nicotine naturally occurs in two isomers R- and S-nicotine, with tobacco-derived nicotine (TDN) composed of S-nicotine, and tobacco-free/synthetic nicotine (TFN) composed of a racemic mixture of R- and S-nicotine. Currently, there is limited knowledge of the potential differences in the toxicity of TFN versus TDN. We hypothesized that exposure of TFN and TDN salts to C57BL/6J mice would result in a differential response in lung inflammation and protease/ antiprotease imbalance. METHODS Five-week-old male and female C57BL/6J mice were exposed to air, PG/VG, PG/VG with TFN salts (TFN), or PG/VG with TDN salts (TDN) by nose-only exposure. Lung inflammatory cell counts, cytokine/chemokine levels, and matrix metalloproteinase (MMP) protein abundance and activity levels were determined by flow cytometry, ELISA, immunoblotting, and gel zymography, respectively. RESULTS Exposure to the humectants (PG/VG) alone increased cytokine levels- IL-6, KC, and MCP-1 in the BALF and KC levels in lung homogenate of exposed mice. While no change was observed in the cytokine levels in lung homogenate of TDN aerosol exposed mice, exposure to TFN aerosols resulted in an increase in KC levels in the lungs of these mice compared to air controls. Interestingly, exposure to TDN aerosols increased MMP-9 protein abundance in the lungs of female mice, while exposure to TFN aerosol showed no change. The metabolism of nicotine or the clearance of cotinine for TFN exposure may differ from that for TDN. CONCLUSION Exposure to humectants, PG/VG alone, induces an inflammatory response in C57BL/6J mice. TFN and TDN salts show distinct changes in inflammatory responses and lung proteases on acute exposures. These data suggest variable toxicological profiles of the two forms of nicotine in vivo. Future work is thus warranted to delineate the harmful effects of synthetic/natural nicotine with humectants to determine the potential toxicological risks for users.
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Affiliation(s)
- Thomas Lamb
- Department of Environmental Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Box 850, Rochester, NY, 14642, USA
| | - Gagandeep Kaur
- Department of Environmental Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Box 850, Rochester, NY, 14642, USA
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Box 850, Rochester, NY, 14642, USA.
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21
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Aherrera A, Lin JJ, Chen R, Tehrani M, Schultze A, Borole A, Tanda S, Goessler W, Rule AM. Metal Concentrations in E-Cigarette Aerosol Samples: A Comparison by Device Type and Flavor. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:127004. [PMID: 38048100 PMCID: PMC10695266 DOI: 10.1289/ehp11921] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/18/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The rapid evolution of electronic cigarette (e-cigarette) products warrants surveillance of the differences in exposure across device types-modifiable devices (MODs), cartridge ("pod")-containing devices (PODs), disposable PODs (d-PODs)-and flavors of the products available on the market. OBJECTIVE This study aimed to measure and compare metal aerosol concentrations by device type and common flavors. METHODS We collected aerosol from 104 MODs, 67 PODs (four brands: JUUL, Bo, Suorin, PHIX), and 23 d-PODs (three brands: ZPOD, Bidi, Stig) via droplet deposition in a series of conical pipette tips. Metals and metalloids [aluminum (Al), arsenic (As), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), lead (Pb), antimony (Sb), tin (Sn), and zinc (Zn)] were measured using inductively coupled plasma mass spectrometry (ICP-MS), results were log-transformed for statistical analysis, and concentrations are reported in aerosol units (mg / m 3 ). RESULTS Of the 12 elements analyzed, concentrations were statistically significantly higher in MOD devices, except for Co and Ni, which were higher in PODs and d-PODs. Of the POD brands analyzed, PHIX had the highest median concentrations among four metals (Al, Ni, Pb, and Sn) compared to the rest of the POD brands. According to POD flavor, seven metals were three to seven orders of magnitude higher in tobacco-flavored aerosol compared to those in mint and mango flavors. Among the d-POD brands, concentrations of four metals (Al, Cu, Ni, and Pb) were higher in the ZPOD brand than in Bidi Stick and Stig devices. According to d-POD flavor, only Cr concentrations were found to be statistically significantly higher in mint than tobacco-flavored d-PODs. DISCUSSION We observed wide variability in aerosol metal concentrations within and between the different e-cigarette device types, brands, and flavors. Overall, MOD devices generated aerosols with higher metal concentrations than PODs and d-PODs, and tobacco-flavored aerosols contained the highest metal concentrations. Continued research is needed to evaluate additional factors (i.e., nicotine type) that contribute to metal exposure from new and emerging e-cigarette devices in order to inform policy. https://doi.org/10.1289/EHP11921.
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Affiliation(s)
- Angela Aherrera
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Pediatric Pulmonary Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joyce Jy Lin
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rui Chen
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mina Tehrani
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrew Schultze
- Department of Biochemistry, Ithaca College School of Humanities and Sciences, Ithaca, New York, USA
| | - Aryan Borole
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Stefan Tanda
- Institute of Chemistry, University of Graz, Graz, Austria
| | | | - Ana M. Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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22
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Lamb T, Kaur G, Rahman I. Tobacco-Derived and Tobacco-Free Nicotine cause differential inflammatory cell influx and MMP9 in mouse lung. RESEARCH SQUARE 2023:rs.3.rs-3650978. [PMID: 38077054 PMCID: PMC10705704 DOI: 10.21203/rs.3.rs-3650978/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Electronic nicotine delivery systems (ENDS) or electronic cigarettes (e-cigarettes) have propylene glycol (PG) and vegetable glycerin (VG) as humectants, flavoring chemicals, and nicotine. Nicotine naturally occurs in two isomers R- and S-nicotine, with both tobacco-derived nicotine (TDN) composed of S-nicotine and synthetic nicotine (TFN) composed of a racemic mixture of R- and S-nicotine. Currently there is limited knowledge of the potential differences in the toxicity of TFN vs TDN. We hypothesized that exposure of TFN salts to C57BL/6J mice will result in a differential response in inflammation and lung protease and antiprotease imbalance compared to TDN salts exposed mice. We studied the toxicological impact of these isomers by exposing mice to air, PG/VG, PG/VG with TFN salts, or PG/VG with TDN salts by nose-only exposure and measured the cytokine levels in BALF and lung homogenate along with MMP protein abundance in the lungs of exposed mice. Exposure to the humectants, PG/VG, used in e-cigarettes alone was able to increase cytokine levels-IL-6, KC, and MCP-1 in BALF and KC levels in lung homogenate. Further, it showed differential responses on exposure to PG/VG with TDN salts and PG/VG with TFN salts since PG/VG with TDN salts did not alter the cytokine levels in lung homogenate while PG/VG with TFN salts resulted in an increase in KC levels. PG/VG with TDN salts increased the levels of MMP9 protein abundance in female exposed mice, while PG/VG with TFN salts did not alter MMP9 levels in female mice. The metabolism of nicotine or the clearance of cotinine from TFN may differ from the metabolism of nicotine or the clearance of cotinine from TDN. Thus exposure of humectants alone to induce an inflammatory response while PG/VG with TFN salts and PG/VG with TDN salts may differentially alter inflammatory responses and lung proteases in acute exposures. These data suggest the harmful effects of synthetic/natural nicotine and PG/VG and potential toxicological risk for users.
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23
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Ma T, Chen H, Liao YP, Li J, Wang X, Li L, Li J, Zhu Y, Xia T. Differential Toxicity of Electronic Cigarette Aerosols Generated from Different Generations of Devices In Vitro and In Vivo. ENVIRONMENT & HEALTH (WASHINGTON, D.C.) 2023; 1:315-323. [PMID: 38028320 PMCID: PMC10660664 DOI: 10.1021/envhealth.3c00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 12/01/2023]
Abstract
Electronic cigarettes (e-cigs) have become increasingly popular, especially among youth, raising concerns about their potential health risks. JUUL and Tank devices are two common types of e-cigs that deliver aerosols with varying nicotine levels and flavors. However, the differences in the aerosols generated from different devices and their corresponding cytotoxicity and pulmonary injury effects remain poorly understood. This study addresses these knowledge gaps by characterizing the aerosols of JUUL and Tank e-cig devices and testing their toxic effects on THP-1 and BEAS-2B human cell lines as well as the C57BL/6J mouse model. In our study, the lower-voltage device, the 3.7 V JUUL generates 2.72 mg/puff aerosols by using e-liquid containing 3% nicotine salt (i.e., nicotine benzoate), which is less than the 11.06 mg/puff aerosols generated by the 7.5 V Tank using e-liquid containing 2.4% freebase nicotine. Yet, the cytotoxicity results reveal that JUUL aerosols induced higher toxicity and increased production of pro-inflammation cytokines compared to Tank aerosols per puff. Additionally, we observed that JUUL induced more severe pulmonary inflammation and DNA damage compared to Tank after normalizing for cotinine, a nicotine metabolite, in vivo. Our findings suggest that the device design plays a more important role in e-cig aerosol-induced toxicity than the composition of the e-liquid or voltage. These results provide valuable insights into the health risks associated with various electronic-cig devices and offer an approach for evaluating them.
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Affiliation(s)
- Tiancong Ma
- Division
of Nanomedicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1772, United
States
- Department
of Environmental Health Sciences, Jonathan and Karin Fielding School
of Public Health, University of California,
Los Angeles, Los Angeles, California 90095-1772, United States
| | - Haoxuan Chen
- Department
of Environmental Health Sciences, Jonathan and Karin Fielding School
of Public Health, University of California,
Los Angeles, Los Angeles, California 90095-1772, United States
| | - Yu-Pei Liao
- Division
of Nanomedicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1772, United
States
| | - Jiulong Li
- Division
of Nanomedicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1772, United
States
| | - Xiang Wang
- Division
of Nanomedicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1772, United
States
| | - Liqiao Li
- Department
of Environmental Health Sciences, Jonathan and Karin Fielding School
of Public Health, University of California,
Los Angeles, Los Angeles, California 90095-1772, United States
| | - Jing Li
- Department
of Environmental Health Sciences, Jonathan and Karin Fielding School
of Public Health, University of California,
Los Angeles, Los Angeles, California 90095-1772, United States
| | - Yifang Zhu
- Department
of Environmental Health Sciences, Jonathan and Karin Fielding School
of Public Health, University of California,
Los Angeles, Los Angeles, California 90095-1772, United States
| | - Tian Xia
- Division
of Nanomedicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1772, United
States
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24
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Han P, Jing X, Han S, Wang X, Li Q, Zhang Y, Yu P, Liu XA, Wu P, Chen H, Hou H, Hu Q. Pharmacokinetic differences in nicotine and nicotine salts mediate reinforcement-related behavior: an animal model study. Front Neurosci 2023; 17:1288102. [PMID: 38033549 PMCID: PMC10687399 DOI: 10.3389/fnins.2023.1288102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/17/2023] [Indexed: 12/02/2023] Open
Abstract
Since their introduction in the United States and Europe in 2007, electronic cigarettes (E-Cigs) have become increasingly popular among smokers. Nicotine, a key component in both tobacco and e-cigarettes, can exist in two forms: nicotine-freebase (FBN) and nicotine salts (NS). While nicotine salt is becoming more popular in e-cigarettes, the effect of nicotine salts on reinforcement-related behaviors remains poorly understood. This study aimed to compare the reinforcing effects of nicotine and nicotine salts in animal models of drug self-administration and explore potential mechanisms that may contribute to these differences. The results demonstrated that three nicotine salts (nicotine benzoate, nicotine lactate, and nicotine tartrate) resulted in greater reinforcement-related behaviors in rats compared to nicotine-freebase. Moreover, withdrawal-induced anxiety symptoms were lower in the three nicotine salt groups than in the nicotine-freebase group. The study suggested that differences in the pharmacokinetics of nicotine-freebase and nicotine salts in vivo may explain the observed behavioral differences. Overall, this study provides valuable insights into the reinforcing effects of nicotine as well as potential differences between nicotine-freebase and nicotine salts.
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Affiliation(s)
- Pengfei Han
- Institute of Biomedical Engineering, College of Life Sciences, Qingdao University, Qingdao, China
- China National Tobacco Quality Supervision and Test Center, Zhengzhou, China
- Key Laboratory of Tobacco Biological Effects, Zhengzhou, China
- Beijing Life Science Academy, Beijing, China
- Key Laboratory of Tobacco Biological Effects and Biosynthesis, Beijing, China
| | - Xiaoyuan Jing
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Shulei Han
- China National Tobacco Quality Supervision and Test Center, Zhengzhou, China
- Key Laboratory of Tobacco Biological Effects, Zhengzhou, China
- Beijing Life Science Academy, Beijing, China
- Key Laboratory of Tobacco Biological Effects and Biosynthesis, Beijing, China
| | - Xinsheng Wang
- Institute of Biomedical Engineering, College of Life Sciences, Qingdao University, Qingdao, China
| | - Qiannan Li
- China National Tobacco Quality Supervision and Test Center, Zhengzhou, China
- Key Laboratory of Tobacco Biological Effects, Zhengzhou, China
- Beijing Life Science Academy, Beijing, China
- Key Laboratory of Tobacco Biological Effects and Biosynthesis, Beijing, China
| | - Yuan Zhang
- China National Tobacco Quality Supervision and Test Center, Zhengzhou, China
- Key Laboratory of Tobacco Biological Effects, Zhengzhou, China
- Beijing Life Science Academy, Beijing, China
- Key Laboratory of Tobacco Biological Effects and Biosynthesis, Beijing, China
| | - Pengpeng Yu
- China National Tobacco Quality Supervision and Test Center, Zhengzhou, China
- Key Laboratory of Tobacco Biological Effects, Zhengzhou, China
- Beijing Life Science Academy, Beijing, China
- Key Laboratory of Tobacco Biological Effects and Biosynthesis, Beijing, China
| | - Xin-an Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Beijing, China
| | - Huan Chen
- China National Tobacco Quality Supervision and Test Center, Zhengzhou, China
- Key Laboratory of Tobacco Biological Effects, Zhengzhou, China
- Beijing Life Science Academy, Beijing, China
- Key Laboratory of Tobacco Biological Effects and Biosynthesis, Beijing, China
| | - Hongwei Hou
- China National Tobacco Quality Supervision and Test Center, Zhengzhou, China
- Key Laboratory of Tobacco Biological Effects, Zhengzhou, China
- Beijing Life Science Academy, Beijing, China
- Key Laboratory of Tobacco Biological Effects and Biosynthesis, Beijing, China
| | - Qingyuan Hu
- China National Tobacco Quality Supervision and Test Center, Zhengzhou, China
- Key Laboratory of Tobacco Biological Effects, Zhengzhou, China
- Beijing Life Science Academy, Beijing, China
- Key Laboratory of Tobacco Biological Effects and Biosynthesis, Beijing, China
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25
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Balzer G, Landrus A, Ovestrud I, Singer JM, Lu B, Wagner DD, Klein EG, Wold LE, Wilson C, Tackett AP, Roberts ME. What do young people know about the nicotine in their e-cigarettes? Tob Control 2023:tc-2023-058234. [PMID: 37973361 PMCID: PMC11096260 DOI: 10.1136/tc-2023-058234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION In recent years, the nicotine in e-cigarettes has been available in either a 'free-base' (unprotonated) or 'nicotine salt' (protonated) form. Additionally, e-cigarette nicotine can be either 'synthetic' or 'tobacco-derived'. These dimensions of nicotine have implications for nicotine absorption, bioavailability and sensory experiences. However, it is unclear if the young people using e-cigarettes are aware of these nicotine dimensions. METHODS Data came from a cohort of Ohio youth (aged 15-24) who reported using an e-cigarette in the past 4 months (N=271). Participants were enrolled and provided background information in 2021; their 12-month follow-up survey asked about the presence, form and type of nicotine in their usual e-cigarette. Individuals who reported that they could distinguish between tobacco-derived and synthetic nicotine were additionally asked to describe the difference. RESULTS Of the 247 youth who reported that there was nicotine in their usual e-cigarette, 71.7% did not know whether it was free-base or nicotine salt and 75.7% did not know whether it was synthetic or tobacco-derived. Awareness was higher among youth who were using e-cigarettes at a greater frequency and quantity. The majority reported that they could not detect a difference between the experience of using synthetic vs tobacco-derived nicotine. CONCLUSIONS These findings indicate the generally limited awareness about nicotine among youth who used e-cigarettes. Improvements in health communications and requirements for e-cigarette industry disclosures are necessary to ensure that consumers are better informed about the dimensions-and the risks-of the nicotine they are consuming.
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Affiliation(s)
- Grace Balzer
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Anthony Landrus
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Ilona Ovestrud
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Jill M Singer
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Bo Lu
- College of Public Health Division of Biostatistics, The Ohio State University, Columbus, Ohio, USA
| | - Dylan D Wagner
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Elizabeth G Klein
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Loren E Wold
- Division of Cardiac Surgery, Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Clark Wilson
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Alayna P Tackett
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Megan E Roberts
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
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26
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Cui T, Lu R, Liu Q, Jiang X, Li Y, Pan S. PM 1 exposure and spatial transmission of nicotine from the simulated second-hand vapor of pod-based electronic cigarettes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 897:165355. [PMID: 37419341 DOI: 10.1016/j.scitotenv.2023.165355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/09/2023]
Abstract
Electronic cigarettes (E-cigarettes) have gained significant popularity in recent years as a substitute for combustible cigarettes. However, there is growing concern regarding the safety of E-cigarette products for both the users and those exposed passively to second-hand emissions, which contain nicotine and other toxic substances. In particular, the characteristics of second-hand PM1 exposure and the transmission of nicotine from E-cigarettes remain unclear. In this study, the untrapped mainstream aerosols from the E-cigarette and smoke from cigarettes were exhausted by the smoking machines which were operated under standardized puffing regimes to simulate second-hand vapor or smoke exposure. The concentrations and components of PM1 released from cigarettes and E-cigarettes were compared under varying environmental conditions and regulated using a heating, ventilation, and air conditioning (HVAC) system. Additionally, the ambient nicotine concentrations and the size distribution of the generated aerosols were determined at different distances from the release source. Results showed that PM1 accounted for the highest proportion (98 %) of the released particulate matter (PM1, PM2.5, and PM10). The mass median aerodynamic diameter (MMAD) of cigarette smoke (0.5 ± 0.01 μm, geometric standard deviation (GSD) 1.97 ± 0.1) was smaller than that of E-cigarette aerosols (1.06 ± 0.14 μm, GSD 1.79 ± 0.19). The PM1 concentrations and chemical components were effectively reduced when the HVAC system was utilized. Nicotine concentrations in E-cigarette aerosols were comparable to those of combustible cigarette emissions when close to the exposure source (0 m), while they declined more rapidly than cigarette smoke emissions with increasing distance from the source. Furthermore, the maximum nicotine concentrations occurred in 1 μm and 0.5 μm particles in E-cigarette and cigarette emissions, respectively. These results provide a scientific basis for the assessment of E-cigarette and cigarette aerosol passive exposure risks, guiding the development of environmental and human health control measures for these products.
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Affiliation(s)
- Tong Cui
- School of Civil Engineering, Chang'an University, Xi'an 710054, China; School of Water and Environment, Chang'an University, Xi'an 710054, China; Key Laboratory of Subsurface Hydrology and Ecology Effects in Arid Region, Ministry of Education, Xi'an 710054, China
| | - Rui Lu
- RELX Technical Science Center, Shenzhen RELX Tech. Co., Ltd., Shenzhen, China
| | - Qianyun Liu
- RELX Technical Science Center, Shenzhen RELX Tech. Co., Ltd., Shenzhen, China
| | - Xingtao Jiang
- RELX Technical Science Center, Shenzhen RELX Tech. Co., Ltd., Shenzhen, China
| | - Yanpeng Li
- School of Water and Environment, Chang'an University, Xi'an 710054, China; Key Laboratory of Subsurface Hydrology and Ecology Effects in Arid Region, Ministry of Education, Xi'an 710054, China.
| | - Song Pan
- Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing 100124, China
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27
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Reveil L, Pearcy AC, Povlick J, Poklis JL, Halquist MS, Peace MR. A determination of the aerosolization efficiency of drugs of abuse in a eutectic mixture with nicotine in electronic cigarettes. Drug Test Anal 2023; 15:1091-1098. [PMID: 35851853 PMCID: PMC10062404 DOI: 10.1002/dta.3343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 01/26/2023]
Abstract
Eutectic mixtures can be formed by adding drugs other than nicotine (DOTNs) to nicotine-based e-liquids in electronic cigarettes (e-cigarettes). Thus, the interaction between nicotine e-liquids and DOTNs must be evaluated. Presented is the change in e-cigarette aerosolization of nicotine and methadone alone versus a 1:1 nicotine:methadone mixture to evaluate the possible formation of a eutectic mixture that can result in an increase of drug delivery. E-liquids were prepared in-house using 1:1 propylene glycol (PG):vegetable glycerin (VG) as a base plus nicotine, methadone hydrochloride, or 1:1 nicotine:methadone hydrochloride. The e-liquids were aerosolized via an automated vaping machine using parameters adopted from the Cooperation Centre for Scientific Research Relative to Tobacco (CORESTA) E-cigarette Task Force method. Drug recovery was determined by capturing the aerosol from 15 puffs generated by the e-cigarette. Concentrations of nicotine and methadone aerosolized were determined by gas chromatography-mass spectrometry using nicotine (n = 3), methadone (n = 3), and combined nicotine/methadone e-liquids (n = 3), each prepared in-house at 12 mg/ml. The concentration of nicotine and methadone in 15 puffs of the single drug e-liquids were determined to be 1.60 ± 0.20 and 2.67 ± 0.12 mg, respectively. The concentration of nicotine and methadone in 15 puffs of the multidrug e-liquid were determined to be 3.66 ± 0.49 and 3.65 ± 0.10 mg, respectively. The single nicotine and methadone e-liquids had recoveries of 70 ± 0.1% and 84 ± 0.1%, respectively. In the 1:1 mixture, the recovery of both drugs increased. The development of a eutectic mixture can promote aerosolization of the drug and deliver a greater dose to the user.
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Affiliation(s)
- Laerissa Reveil
- Department of Forensic Science, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Adam C. Pearcy
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jazmine Povlick
- Department of Forensic Science, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Justin L. Poklis
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Matthew S. Halquist
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michelle R. Peace
- Department of Forensic Science, Virginia Commonwealth University, Richmond, Virginia, USA
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28
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Chu M, Deng J, Hu H, Wang R, Li D, Chen Z, Liu XA, Lu J. Nicotine transport across calu-3 cell monolayer: effect of nicotine salts and flavored e-liquids. Drug Dev Ind Pharm 2023; 49:628-636. [PMID: 37751149 DOI: 10.1080/03639045.2023.2263791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/21/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE This study aimed to investigate the transport capability of nicotine across Calu-3 cell monolayer in various nicotine forms, including nicotine freebase, nicotine salts, and flavored e-liquids with nicotine benzoate. SIGNIFICANCE Nicotine is rapidly absorbed from the respiratory system into systemic circulation during e-cigarettes use. However, the mechanism of nicotine transport in the lung has not been well understood yet. This study may offer critical biological evidence and have implications for the use and regulation of e-cigarettes. METHODS The viability of Calu-3 cells after administration of nicotine freebase, nicotine salts and representative e-liquid were evaluated using the MTT assay, and the integrity of the Calu-3 cell monolayer was evaluated by transepithelial electrical resistance measurement and morphological analysis. Further, the nicotine transport capacity across the Calu-3 cell monolayer in various formulations of nicotine was investigated by analysis of nicotine transport amount. RESULTS The findings indicated that nicotine transport occurred passively and was time-dependent across the Calu-3cell monolayer. In addition, the nicotine transport was influenced by the type of nicotine salts and their respective pH value. The nicotine benzoate exhibited the highest apparent permeability coefficient (Papp), and higher nicotine-to-benzoic acid ratios led to higher Papp values. The addition of flavors to e-liquid resulted in increased Papp values, with the most significant increment being observed in tobacco-flavored e-liquid. CONCLUSIONS In summary, the transport capability of nicotine across the Calu-3 cell monolayer was influenced by the pH values of nicotine salts and flavor additives in e-liquids.
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Affiliation(s)
- Ming Chu
- Laboratory of Life and Health Sciences, Shenzhen First Union Technology Co., Ltd, Shenzhen, P.R. China
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, P.R. China
| | - Jingjing Deng
- Laboratory of Life and Health Sciences, Shenzhen Health Union Biotechnology Co., Ltd, Shenzhen, P.R. China
| | - Hao Hu
- Laboratory of Life and Health Sciences, Shenzhen First Union Technology Co., Ltd, Shenzhen, P.R. China
| | - Ruoxi Wang
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, P.R. China
| | - Ding Li
- Laboratory of Life and Health Sciences, Shenzhen First Union Technology Co., Ltd, Shenzhen, P.R. China
- Laboratory of Life and Health Sciences, Shenzhen Health Union Biotechnology Co., Ltd, Shenzhen, P.R. China
| | - Zuxin Chen
- Shenzhen Key Laboratory of Drug Addiction, Shenzhen Neher Neural Plasticity Laboratory, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences (CAS); Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, P.R. China
- University of the Chinese Academy of Sciences, Beijing, P.R. China
| | - Xin-An Liu
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, P.R. China
- University of the Chinese Academy of Sciences, Beijing, P.R. China
| | - Jin Lu
- Laboratory of Life and Health Sciences, Shenzhen First Union Technology Co., Ltd, Shenzhen, P.R. China
- Laboratory of Life and Health Sciences, Shenzhen Health Union Biotechnology Co., Ltd, Shenzhen, P.R. China
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29
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Li X, Lu L, He Y, Zhang H, Zhang Y, Sheng H, Chen M, Ru J, Gao Y. Pharmacological effects of nicotine salts on dopamine release in the nucleus accumbens. Front Pharmacol 2023; 14:1279512. [PMID: 37841907 PMCID: PMC10568619 DOI: 10.3389/fphar.2023.1279512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023] Open
Abstract
With the growing number of individuals regularly using e-cigarettes, it has become increasingly important to understand the psychobiological effects of nicotine salts. Nicotine increases the release of dopamine (DA) into the nucleus accumbens (NAc), causing feelings of satisfaction. However, the differences in the DA-increasing effects of different nicotine salts have not been reported. In this study, we used a G protein-coupled receptor-activated DA fluorescent probe (GRABDA1m) and optical fiber photometric recording equipment to monitor the dynamic changes and kinetics of DA release in the NAc of mice exposed to different e-cigarette aerosols, including nicotine, nicotine benzoate, nicotine tartrate, nicotine lactate, nicotine levulinic acid, nicotine malate, and nicotine citrate. The results of this study were as follows: 1) Different types of nicotine salts could increase the release of DA in the NAc. 2) The slopes and half-effective concentrations of the fitted curves were different, suggesting that each nicotine salt had a difference in the efficiency of increasing DA release with concentration changes. 3) The absorption rates of different nicotine salts containing the same original nicotine concentration were significantly different by measuring the blood nicotine content. The effect of nicotine salts on increasing DA was directly proportional to the blood nicotine level. In conclusion, by observing the effects of nicotine salts on DA release in real time in vivo, differences in the pharmacological effects of nicotine salts are revealed to better understand the mechanism underlying the regulatory effects of nicotine salts on the brain.
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Affiliation(s)
- Xiaonan Li
- Shanghai New Tobacco Product Research Institute Co., Ltd, Shanghai, China
| | - Lehua Lu
- Shanghai New Tobacco Product Research Institute Co., Ltd, Shanghai, China
| | - Ying He
- Shanghai New Tobacco Product Research Institute Co., Ltd, Shanghai, China
| | - Hui Zhang
- Shanghai New Tobacco Product Research Institute Co., Ltd, Shanghai, China
| | - Yihui Zhang
- Shanghai New Tobacco Product Research Institute Co., Ltd, Shanghai, China
| | - Huaquan Sheng
- Shanghai New Tobacco Product Research Institute Co., Ltd, Shanghai, China
| | - Ming Chen
- School of Life Science and Technology, ShanghaiTech University, Shanghai, China
- MOE Frontier Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Jiexiong Ru
- Shanghai New Tobacco Product Research Institute Co., Ltd, Shanghai, China
| | - Yihan Gao
- Shanghai New Tobacco Product Research Institute Co., Ltd, Shanghai, China
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Frosina J, McEwan M, Ebajemito J, Thissen J, Taluskie K, Baxter-Wright S, Hardie G. Assessing the impact of protonating acid combinations in e-cigarette liquids: a randomised, crossover study on nicotine pharmacokinetics. Sci Rep 2023; 13:10563. [PMID: 37386281 PMCID: PMC10310785 DOI: 10.1038/s41598-023-37539-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 06/23/2023] [Indexed: 07/01/2023] Open
Abstract
The addition of protonating acids to e-cigarette liquid formulations (e-liquids) enhances nicotine bioavailability in e-cigarette use. However, little is known about the impact of different combinations of protonating acid on nicotine pharmacokinetics. The objectives of this study were to compare pharmacokinetics of nicotine absorption following use of a closed-system e-cigarette, containing e-liquids with two different nicotine levels and with different ratios of three common protonating acids-lactic, benzoic and levulinic. In a randomised, controlled, crossover study, nicotine pharmacokinetics and product liking were assessed for prototype e-liquids used in a Vuse e-cigarette containing either 3.5% or 5% nicotine and varying ratios of lactic, benzoic and/or levulinic acid. During an 8-day confinement period, 32 healthy adult current cigarette smokers/e-cigarette dual users used a single study e-liquid each day during 10-min fixed and ad libitum use periods after overnight nicotine abstinence. For most comparisons, Cmax and AUC0-60 following both fixed and ad libitum puffing were significantly higher for e-liquids containing 5% nicotine compared with 3.5% nicotine. However, Cmax and AUC0-60 were not statistically different for 5% nicotine e-liquids containing varying ratios of lactic, levulinic and benzoic acid when compared to an e-liquid containing lactic acid only. Mean scores for product liking were similar for all e-liquid formulations assessed, regardless of nicotine concentration, acid content, and whether the product was used in a fixed or ad libitum puffing regimen. While e-liquid nicotine concentration significantly affected users' nicotine uptake, the different combinations of benzoic, levulinic and lactic acid in the e-liquids assessed had limited impact on nicotine pharmacokinetics and product liking scores.
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Affiliation(s)
- Justin Frosina
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK.
| | - Michael McEwan
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | - James Ebajemito
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | - Jesse Thissen
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | | | | | - George Hardie
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
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31
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Tosakoon S, Romm KF, Berg CJ. Nicotine pouch awareness, use and perceptions among young adults from six metropolitan statistical areas in the United States. Tob Prev Cessat 2023; 9:19. [PMID: 37293565 PMCID: PMC10246475 DOI: 10.18332/tpc/163243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/07/2023] [Accepted: 05/09/2023] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Nicotine pouches, which emerged in the US in 2016 and are marketed as 'tobacco-free', may appeal to young adults. This study examined young adults' nicotine pouch awareness, use, use intentions, and related factors. METHODS We analyzed Spring 2022 survey data from 942 young adults recruited via social media from six US cities (mean age=27.61 years, 34.3% men, 33.1% racial/ethnic minority) to characterize nicotine pouch awareness, ever use, use intentions, exposure, and perceptions. RESULTS Nicotine pouch awareness and ever use were reported by 34.6% and 9.8%, respectively. Males (AOR=1.79; 95% CI: 1.33-2.38), non-White participants (vs White; AOR=1.64; 95% CI: 1.04-2.61), and those using cigarettes (AOR=2.67; 95% CI: 1.63-4.38), e-cigarettes (AOR=2.28; 95% CI: 1.57-3.31), and smokeless tobacco (SLT) (AOR=14.46; 95% CI: 1.81-115.61) had greater odds of awareness. Among those aware of nicotine pouches, males (AOR=2.27; 95% CI: 1.33-3.85), White participants (vs Asian; AOR=0.40; 95% CI: 0.17-0.94), and SLT users (AOR=4.90; 95% CI: 1.26-18.98) had greater odds of ever use; being male (B=0.39; 95% CI: -0.67 - -0.12) and using SLT (B=1.73; 95% CI: 1.10-2.36) predicted greater use intentions. Overall, 31.4% reported past-month advertising exposure, most often via tobacco retailers (67.3%). Ever users most commonly purchased them at gas stations (46.7%). The most frequently reported use motives were to quit combusted tobacco (16.8%) and reduce tobacco smell (15.4%). Nicotine pouches were perceived as less harmful and less addictive than cigarettes, e-cigarettes, and SLT, and more socially acceptable than cigarettes and SLT. CONCLUSIONS Young adults were exposed to advertising, accessed nicotine pouches via various sources, and perceived these products favorably. Marketing and use surveillance is needed to monitor their impact on those likely to use them (e.g. males, SLT users).
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Affiliation(s)
- Sararat Tosakoon
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Katelyn F. Romm
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, United States
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, United States
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
- George Washington Cancer Center, George Washington University, Washington, United States
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Patten T, Johnson NL, Shaw JK, Dossat AM, Dreier A, Kimball BA, Wesson DW, De Biasi M. Strawberry Additive Increases Nicotine Vapor Sampling and Systemic Exposure But Does Not Enhance Pavlovian-Based Nicotine Reward in Mice. eNeuro 2023; 10:ENEURO.0390-22.2023. [PMID: 37253590 PMCID: PMC10275399 DOI: 10.1523/eneuro.0390-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/01/2023] [Accepted: 05/10/2023] [Indexed: 06/01/2023] Open
Abstract
Nicotine is an addictive drug whose popularity has recently increased, particularly among adolescents, because of the availability of electronic nicotine devices (i.e., "vaping") and nicotine e-liquids containing additives with rich chemosensory properties. Some efforts to understand the role of these additives in nicotine reward suggest that they increase nicotine reward and reinforcement, but the sensory contributions of additives, especially in their vapor forms, are largely untested. Here, to better understand how a fruit-flavored (i.e., strawberry) additive influences nicotine reward and aversion, we used a conditioned place preference (CPP) procedure in which nicotine and a strawberry additive were delivered as a vapor to male and female adolescent mice. We found that nicotine vapor alone can lead to a dose-dependent CPP when using a biased design. The strawberry additive did not produce CPP on its own, and we did not observe an effect of the strawberry additive on nicotine vapor-induced reward. Nevertheless, mice exposed to nicotine plus strawberry additive vapor had higher plasma cotinine concentrations, which did not appear to reflect altered nicotine metabolism. Instead, by directly measuring vapor sampling through respiration monitoring, we uncovered an increase in the amount of sniffing toward strawberry-containing nicotine vapor compared with nicotine vapor alone. Together these data indicate that chemosensory-rich e-liquid additives may enhance the perceived sensory profile of nicotine vapors rather than the reward value per se, which leads to overall increased nicotine exposure.
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Affiliation(s)
- Theresa Patten
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Pharmacology Graduate Group, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Natalie L Johnson
- Department of Pharmacology and Therapeutics, Center for Smell and Taste, Center for Addiction Research and Education, University of Florida College of Medicine, Gainesville, Florida 32610
| | - Jessica K Shaw
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Amanda M Dossat
- Department of Pharmacology and Therapeutics, Center for Smell and Taste, Center for Addiction Research and Education, University of Florida College of Medicine, Gainesville, Florida 32610
| | - Allison Dreier
- School of Arts and Sciences, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Bruce A Kimball
- Monell Chemical Senses Center, Philadelphia, Pennsylvania 19104
| | - Daniel W Wesson
- Department of Pharmacology and Therapeutics, Center for Smell and Taste, Center for Addiction Research and Education, University of Florida College of Medicine, Gainesville, Florida 32610
| | - Mariella De Biasi
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Department of Neuroscience, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Pharmacology Graduate Group, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- School of Arts and Sciences, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
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Hosseini S, Gholap V, Halquist MS, Golshahi L. Effects of Device Settings and E-Liquid Characteristics on Mouth-Throat Losses of Nicotine Delivered with Electronic Nicotine Delivery Systems (ENDS). JOURNAL OF AEROSOL SCIENCE 2023; 171:106178. [PMID: 37092025 PMCID: PMC10121190 DOI: 10.1016/j.jaerosci.2023.106178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Currently it is not fully understood how the device settings and electronic liquid (e-liquid) composition, including their form of nicotine content, impact mouth and throat losses, and potentially lead to the variations in total nicotine delivery to the human lungs. An in situ size assessment method was developed for real-time measurements at the mouthpiece and outlet of a biorelevant mouth-throat to account for the dynamic nature of the aerosol. The aerosol size, temperature, and delivery through the mouth-throat replica and the exhaled aerosol between the puff intervals were measured at different wattages using various e-liquid compositions. The effects of body temperature and humidity on aerosol size and nicotine delivery were also explored to evaluate the importance of considering realistic in vivo conditions in in vitro measurements. Notably, in vitro tests with body temperature and humidity in mouth-throat model vs room conditions, resulted in larger aerosol size at the end of the throat (Dv50=5.83±0.33 μm vs 3.05±0.15 μm), significantly higher thoracic nicotine delivery (>90% vs 50-85%) potentially due to the lower exhaled amount (<10% vs 15-50%). Besides, higher VG/PG ratios resulted in significantly lower exhaled amount and higher mouth-throat nicotine deposition. One of the main outcomes of the study was finding significantly lower exhaled amount and higher thoracic nicotine delivery with nicotine salt form vs free-base. Considering body temperature and humidity also showed significant enhancement in nicotine delivery, so it is essential to account for biorelevant experimental conditions in benchtop testing.
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Affiliation(s)
- Sana Hosseini
- Department of Mechanical and Nuclear Engineering, VCU, Richmond, VA, USA
| | - Vinit Gholap
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | - Matthew S Halquist
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | - Laleh Golshahi
- Department of Mechanical and Nuclear Engineering, VCU, Richmond, VA, USA
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Yang Q, Ma S, He Y, Qiu Z, Chen J, Shang C. What types of e-liquid products were more likely to offer price promotions? Tob Control 2023:tc-2022-057781. [PMID: 37197949 PMCID: PMC10915894 DOI: 10.1136/tc-2022-057781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 05/03/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION The present study empirically examined the association between price discounts and product attributes of e-liquids sold by online retailers. METHODS We analysed 14 000 e-liquid products from five major online e-cigarette retailers between April and May 2021 to determine the association between price discounts and product attributes such as nicotine level and form, flavour and vegetable glycerine/propylene glycol ratio. A fixed-effects model was used in the analysis and discounts were calculated in US cents/mL of e-liquid volume. RESULTS Out of 14 407 e-liquid products, 92.5% were offered at a discounted price. On average, the price discount for the 13 324 products that had discounts was 16.84 cents/mL across the five stores. Among the three forms of nicotine (salt, freebase and nicotine free), salt e-liquids had the highest average price discount. CONCLUSION Our findings suggest that e-liquids with salt nicotine have a higher average price discount when sold online, which may influence consumer purchasing behaviour. Further research is needed to assess the potential impact of these discounts on youth and adult tobacco use. Policymakers may consider implementing measures to limit online price discounts for e-liquids as a means of reducing sales among young people.
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Affiliation(s)
- Qian Yang
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Shaoying Ma
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Yanyun He
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Zefeng Qiu
- Computer Science and Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Jian Chen
- Computer Science and Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Ce Shang
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Rabenstein A, Rahofer A, Vukas J, Rieder B, Störzenhofecker K, Stoll Y, Burgmann N, Pieper E, Laux P, Luch A, Rüther T, Mallock-Ohnesorg N. Usage Pattern and Nicotine Delivery during Ad Libitum Consumption of Pod E-Cigarettes and Heated Tobacco Products. TOXICS 2023; 11:434. [PMID: 37235249 PMCID: PMC10221897 DOI: 10.3390/toxics11050434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023]
Abstract
Many different nicotine delivery products, such as e-cigarettes (e-cigs) or heated tobacco products (HTPs), are available on the market. To better understand these products, it is crucial to learn how consumers use them and how much nicotine they deliver. Therefore, a pod e-cig, an HTP, and a conventional cigarette (CC) were each used by 15 experienced users of the respective product category for 90 min without special use instructions ("ad libitum"). Sessions were video recorded to analyze usage patterns and puff topography. At defined time points, blood was sampled to determine nicotine concentrations, and subjective effects were inquired about using questionnaires. During the study period, the CC and HTP groups averaged the same number of consumption units (both 4.2 units). In the pod e-cig group, the highest number of puffs was taken (pod e-cig 71.9; HTP: 52.2; CC: 42.3 puffs) with the most extended mean puff duration (pod e-cig: 2.8 s; HTP: 1.9 s; CC: 1.8 s). Pod e-cigs were predominantly used with single puffs or in short clusters of 2-5 puffs. The maximum plasma nicotine concentration was highest for CCs, followed by HTPs, and then pod e-cigs with 24.0, 17.7, and 8.0 ng/mL, respectively. Craving was reduced by all products. The results suggest that the high nicotine delivery known for tobacco-containing products (CCs and HTPs) may not be needed for non-tobacco-containing products (pod e-cigs) to satisfy cravings in experienced users.
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Affiliation(s)
- Andrea Rabenstein
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstraße 7, 80336 Munich, Germany; (A.R.); (B.R.)
| | - Anna Rahofer
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstraße 7, 80336 Munich, Germany; (A.R.); (B.R.)
| | - Jochen Vukas
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstraße 7, 80336 Munich, Germany; (A.R.); (B.R.)
| | - Benedikt Rieder
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstraße 7, 80336 Munich, Germany; (A.R.); (B.R.)
| | - Kristin Störzenhofecker
- Department of Social Services, Katholische Hochschule Nordrhein-Westfalen, Standort Köln, Wörthstraße 10, 50668 Cologne, Germany
| | - Yvonne Stoll
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstraße 7, 80336 Munich, Germany; (A.R.); (B.R.)
| | - Nestor Burgmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstraße 7, 80336 Munich, Germany; (A.R.); (B.R.)
| | - Elke Pieper
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Peter Laux
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Andreas Luch
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Tobias Rüther
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich (LMU), Nussbaumstraße 7, 80336 Munich, Germany; (A.R.); (B.R.)
| | - Nadja Mallock-Ohnesorg
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
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Felicione NJ, Kaiser L, Leigh NJ, Page MK, Block AC, Schurr BE, O’Connor RJ, Goniewicz ML. Comparing POD and MOD ENDS Users' Product Characteristics, Use Behaviors, and Nicotine Exposure. Nicotine Tob Res 2023; 25:498-504. [PMID: 36073762 PMCID: PMC9910144 DOI: 10.1093/ntr/ntac211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/24/2022] [Accepted: 09/06/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION POD electronic nicotine delivery systems (ENDS), often containing high concentrations of nicotine salts, have replaced MODs (ie, open/modifiable devices) as the most popular devices. The purpose of this study was to compare device/liquid characteristics, use behavior, and nicotine exposure between POD and MOD users. METHODS Data from the initial visit of a prospective observational study of exclusive ENDS users compared MOD (n = 48) and POD (n = 37) users. Participants completed questionnaires on demographic characteristics, patterns of ENDS use, and ENDS features. A urine sample was collected to test for cotinine and an ENDS liquid sample was collected to test for nicotine and salts. Puff topography was captured during an ad libitum bout at the end of the session. RESULTS MOD and POD users did not differ on demographic characteristics. MOD users reported purchasing more liquid in the past month than POD users (180.4 ± 28.0 vs. 50.9 ± 9.0 ml, p < .001). Differences in characteristics of devices used by MOD and POD users included flavor type (p = .029), nicotine concentration (liquids used by MOD users contained less nicotine than those used by POD users: 8.9 ± 2.0 vs. 41.6 ± 3.2 mg/ml, p < .001), and presence of the nicotine salt (fewer MOD liquids had salts present than POD liquids: 11.9% vs. 77.4%, p < .001). User groups did not differ on urinary cotinine levels or puff topography (ps > .05). CONCLUSIONS Despite different characteristics of MOD and POD ENDS, users of those products are exposed to similar amounts of nicotine, likely due to using more liquid among MOD users. IMPLICATIONS This study directly compares ENDS product characteristics, user behavior, and nicotine exposure between MOD and POD ENDS users. Although POD products contained higher nicotine concentrations compared to MOD products, users of PODs reported consuming less liquid than MOD users. Ultimately, MOD and POD users were exposed to similar levels of nicotine, suggesting users behaviorally compensate for differences in product characteristics.
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Affiliation(s)
- Nicholas J Felicione
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lisa Kaiser
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Noel J Leigh
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Michelle K Page
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Ashleigh C Block
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bradley E Schurr
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Richard J O’Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Noël A, Ghosh A. Carbonyl Profiles of Electronic Nicotine Delivery System (ENDS) Aerosols Reflect Both the Chemical Composition and the Numbers of E-Liquid Ingredients-Focus on the In Vitro Toxicity of Strawberry and Vanilla Flavors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16774. [PMID: 36554655 PMCID: PMC9779252 DOI: 10.3390/ijerph192416774] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Propylene glycol (PG) and glycerin (G) are the most widely used humectants in electronic nicotine delivery system (ENDS) devices. Carbonyls are present in aerosols produced when ENDS devices heat PG and G. Whether aerosolized PG and G are innocuous to the lungs has not been established. Here, we determined the chemical profiles of ENDS aerosols containing three humectant ratios (30/70, 50/50 and 70/30, PG/VG), for three flavors (strawberry, vanilla and Catalan cream) containing either 12 or 18 mg/mL of nicotine. Additionally, we examined the in vitro toxicity of the strawberry- and vanilla-flavored ENDS aerosol in human lung epithelial cells (BEAS-2B) exposed at the air-liquid interface for 1 h. For strawberry- and vanilla-flavored aerosols produced by a 3rd-generation ENDS device with the same PG/G ratio, the e-liquid nicotine content of 12 and 18 mg/mL did not transfer to the aerosol with substantial differences in concentrations. Our data also indicate the presence of carbonyls in all three flavored e-cig aerosols analyzed, with levels exceeding 1 µg/puff for acetone, butyraldehyde, and acetaldehyde, in strawberry-, vanilla, and Catalan cream-flavored e-cig aerosols, respectively. Furthermore, closed-system ENDS of the fourth generation emitted trace levels of carbonyls in the aerosols (<0.3 µg/puff), while open-system tank-style ENDS of the third generation produced elevated levels of harmful chemicals, including acrolein (>1 µg/puff), formaldehyde (>5 µg/puff), and m- & p-tolualdehyde (>4 µg/puff). Moreover, under non-cytotoxic conditions, BEAS-2B cells exposed to strawberry-flavored aerosols exhibited significantly increased reactive oxygen and nitric oxide species (ROS/NOS) levels in cell media compared to air controls, while vanilla-flavored ENDS aerosols up-regulated the expression of pro-inflammatory and oxidative stress markers. Our data suggest (a) that ENDS aerosol chemical composition will vary based upon the presence and concentration of the initial e-liquid ingredients, with a pronounced impact of the flavoring components; and (b) short-term exposures to flavored ENDS aerosols may impair lung cells' redox signaling in a flavor-specific manner.
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Han S, Chen H, Su Y, Cui L, Feng P, Fu Y, Tian Y, Liu T, Hou H, Hu Q. Simultaneous quantification of nicotine salts in e-liquids by LC-MS/MS and GC-MS. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2022; 14:4185-4192. [PMID: 36278415 DOI: 10.1039/d2ay00799a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Nicotine salts, formed by nicotine and organic acids, are commonly added to electronic cigarette liquids for their ability to provide desirable sensory effects. Analytical strategies have been developed to detect the types of organic acids and nicotine levels, but methods for directly measuring nicotine salts are still desirable. Herein, a novel approach is presented for the simultaneous quantification of non-volatile and volatile nicotine salts via liquid chromatography/tandem mass spectroscopy (LC-MS/MS) and gas chromatography/mass spectroscopy (GC-MS). This approach was validated with recovery experiments, which yielded recovery values between 92.0% and 110.8%. This method is the first technique for quantifying multiple nicotine salts that could be present in commercial e-liquids. Without using derivatization steps, different nicotine salts could be detected rapidly and conveniently. This new method was demonstrated with 10 e-cigarette liquid samples, providing satisfactory outcomes. It could be used to study organic acids and protonated nicotine in e-liquids and the release behaviour of nicotine salts in electronic cigarettes.
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Affiliation(s)
- Shulei Han
- China National Tobacco Quality Supervision and Test Center, Zhengzhou 450001, China.
- Key Laboratory of Tobacco Biological Effects, Zhengzhou 450001, China
| | - Huan Chen
- China National Tobacco Quality Supervision and Test Center, Zhengzhou 450001, China.
- Key Laboratory of Tobacco Biological Effects, Zhengzhou 450001, China
| | - Yue Su
- China National Tobacco Quality Supervision and Test Center, Zhengzhou 450001, China.
- Key Laboratory of Tobacco Biological Effects, Zhengzhou 450001, China
| | - Lili Cui
- China National Tobacco Quality Supervision and Test Center, Zhengzhou 450001, China.
- Key Laboratory of Tobacco Biological Effects, Zhengzhou 450001, China
| | - Pengxia Feng
- China National Tobacco Quality Supervision and Test Center, Zhengzhou 450001, China.
- Key Laboratory of Tobacco Biological Effects, Zhengzhou 450001, China
| | - Ya'ning Fu
- China National Tobacco Quality Supervision and Test Center, Zhengzhou 450001, China.
- Key Laboratory of Tobacco Biological Effects, Zhengzhou 450001, China
| | - Yushan Tian
- China National Tobacco Quality Supervision and Test Center, Zhengzhou 450001, China.
- Key Laboratory of Tobacco Biological Effects, Zhengzhou 450001, China
| | - Tong Liu
- China National Tobacco Quality Supervision and Test Center, Zhengzhou 450001, China.
- Key Laboratory of Tobacco Biological Effects, Zhengzhou 450001, China
| | - Hongwei Hou
- China National Tobacco Quality Supervision and Test Center, Zhengzhou 450001, China.
- Key Laboratory of Tobacco Biological Effects, Zhengzhou 450001, China
| | - Qingyuan Hu
- China National Tobacco Quality Supervision and Test Center, Zhengzhou 450001, China.
- Key Laboratory of Tobacco Biological Effects, Zhengzhou 450001, China
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Page MK, Block AC, Santiago AL, Leigh NJ, Kaiser LM, Martin CD, Schurr BE, O'Connor RJ, Goniewicz ML. Changes in product labelling practices and the use of flavouring chemical additives in vaping products after enactment of statewide flavour legislation. Tob Control 2022; 31:s223-s229. [PMID: 36328467 PMCID: PMC9664102 DOI: 10.1136/tc-2022-057469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/16/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION On 18 May 2020, New York State enacted legislation banning the sale of vaping products with distinguishable flavours (other than tobacco). According to this new statute, vaping products are deemed flavoured if they include a statement, whether expressed or implied, that have distinguishable tastes or aromas other than tobacco. This study aimed to determine how manufacturers responded. METHODS We collected 555 vaping products from daily vapers (238 preban and 317 postban). We compared preban and postban labelling of products for expressed and implied flavour descriptions, graphics and colours. Flavouring chemicals and concentrations were identified using chromatography methods and were compared preban and postban. RESULTS Analysis of the labels preban and postban did not reveal a change in products with expressed flavoured descriptors (45.8% vs 44.2%) and a minimal decrease in implied descriptors (22.3% vs 14.5%). An increase in products without any descriptors was observed (28.2% vs 37.2%) notably within products from a popular pod brand. The average concentration of eight popular flavourings identified preban was 1.4±2.7 compared with 2.3±3.5 mg/mL (p<0.001) postban. No significant changes between individual flavouring concentrations in the most popular refill solutions and pods were found. CONCLUSION While a majority of products appeared to remain non-compliant, this study suggests that enactment of legislation on vaping products making expressed or implied flavour claims may result in some manufacturer changes to product labelling including removal of flavour descriptors. However, use of flavouring additives in vaping products appeared not to be impacted by the ban.
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Affiliation(s)
- Michelle K Page
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Ashleigh C Block
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Angel L Santiago
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Noel J Leigh
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Lisa M Kaiser
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Connor D Martin
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Bradley E Schurr
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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40
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Seaman EL, Ali FRM, Schillo BA, Vallone DM, King BA. Different Times Call for Different Measures: Using Retail Sales to Monitor the Tobacco Product Landscape. Am J Prev Med 2022; 63:e99-e102. [PMID: 35599174 DOI: 10.1016/j.amepre.2022.03.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022]
Affiliation(s)
| | | | - Barbara A Schillo
- Schroeder Institute, Truth initiative, Washington, District of Columbia
| | - Donna M Vallone
- Schroeder Institute, Truth initiative, Washington, District of Columbia
| | - Brian A King
- Office on Smoking and Health (OSH), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention, Atlanta, Georgia
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41
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Noel A, Campen M, McKinney W. The Importance of Conventional Toxicological Metrics of Aerosol Characterization. Toxicol Sci 2022; 189:153-154. [PMID: 36168881 PMCID: PMC9801704 DOI: 10.1093/toxsci/kfac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Alexandra Noel
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | | | - Willie McKinney
- McKinney Regulatory Science Advisors, LLC, Henrico, Virginia 23231, USA
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Bourgart E, Leclerc L, Pourchez J, Sleiman M. Toward Better Characterization of a Free-Base Nicotine Fraction in e-Liquids and Aerosols. Chem Res Toxicol 2022; 35:1234-1243. [PMID: 35686948 DOI: 10.1021/acs.chemrestox.2c00041] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Given that nicotine salts are a growing market, methods are needed to characterize nicotine forms in e-cigarette vaping products. By lowering the free-base nicotine fraction (αfb) in favor of protonated forms, the addition of organic acids to the e-liquid mix greatly modulates nicotine pharmacokinetics and improves vapers' craving. This research investigated (1) the performance of pH measurement, liquid-liquid extraction (LLE), and acid/nicotine molar ratio calculation methods for αfb estimation in 6 nicotine benzoate and nicotine salicylate e-liquids and (2) nicotine protonation in the aerosol post vaporization. Aerosols were generated with a JUUL device and another mod-pod on a vaping machine to assess device effects. E-liquid and aerosol samples were then analyzed after further analytical optimization of previous methods and careful consideration of biases. Globally, performances were comparable between methods. αfb accounted for less than 5% of nicotine content regardless of experimental conditions. αfb were consistent between e-liquids and aerosols irrespective of e-cigarette devices. Hence, e-liquids are adequate surrogates for aerosols, facilitating the establishment of regulations. pH measurement is one of the most used methods and enables the establishment of relative scales for e-liquid classification but lacks automation possibility. Until now, the extent of sample dilution remained arbitrary. The dilution factor was fixed at 10, as usually achieved, since no effect of dilution was noted. pH values ranged from 5.3 to 6.3 in accordance with the literature. By contrast, LLE relies on the specificity of organic solvent for free-base nicotine extraction, causing discrepancies in previous studies. Here, the results were similar to αfb values from pH determination. Yet, LLE presented the highest variability and was the most time-consuming protocol. Finally, αfb calculation from molar ratio was the most robust and versatile method. Estimations can be made in silico from reported composition data and/or after liquid chromatography routine analysis.
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Affiliation(s)
- Etienne Bourgart
- Clermont Auvergne, Clermont Auvergne INP, CNRS, Institut de Chimie de Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Lara Leclerc
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, Etablissement Français du Sang, INSERM, U1059 Sainbiose, Centre CIS, F-42023 Saint-Etienne, France
| | - Jérémie Pourchez
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, Etablissement Français du Sang, INSERM, U1059 Sainbiose, Centre CIS, F-42023 Saint-Etienne, France
| | - Mohamad Sleiman
- Clermont Auvergne, Clermont Auvergne INP, CNRS, Institut de Chimie de Clermont-Ferrand, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
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Kaliamurthy S, Camenga DR. Clinical approach to the treatment of e-cigarette use among adolescents. Curr Probl Pediatr Adolesc Health Care 2022; 52:101203. [PMID: 35534404 DOI: 10.1016/j.cppeds.2022.101203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
E-cigarette use remains a serious public health threat for adolescents in the United States. Pediatric providers can intervene early to prevent the adverse, and sometimes life-long, health consequences of e-cigarette use. This article reviews the clinical management of e-cigarette use among adolescents using the "Ask-Counsel-Treat" model. This model was recently introduced by the American Academy of Pediatrics to help pediatric healthcare providers manage e-cigarette screening, counseling, and treatment. Behavioral treatments for e-cigarette cessation can be delivered via multiple formats, including via text, in-person, or online. Additionally, pediatric healthcare providers may consider the off-label use of nicotine replacement therapy in individuals less than 18 years of age to alleviate some of the symptoms of nicotine withdrawal. Further research is needed to inform the design and implementation of effective e-cigarette cessation strategies for adolescents.
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Affiliation(s)
- Sivabalaji Kaliamurthy
- Children's National Hospital, Washington, DC, USA; Department of Psychiatry, Yale University, New Haven, CT, USA.
| | - Deepa R Camenga
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
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Bębenek PK, Gholap V, Halquist M, Sobczak A, Kośmider L. E-Liquids from Seven European Countries-Warnings Analysis and Freebase Nicotine Content. TOXICS 2022; 10:51. [PMID: 35202238 PMCID: PMC8875468 DOI: 10.3390/toxics10020051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/04/2022] [Accepted: 01/17/2022] [Indexed: 01/30/2023]
Abstract
Electronic cigarettes are available in a variety of devices with e-liquids also available in many flavors, and nicotine concentrations, albeit less than 20 mg/mL in Europe. Given the dynamics of these products, it is important to evaluate product content, including labeling, nicotine content versus labeled claim, nicotine form, and other aspects that may help policy decisions and align with the Tobacco Product Directive (TPD). Herein, we performed a study on 86 e-liquids from seven European countries (Croatia, Czech Republic, France, Germany, Italy, Poland, and the United Kingdom) with 34 different liquid brands and 57 different flavors. Nicotine content versus labeled claim, labeling, volume, pH, and nicotine form (i.e., freebase nicotine) were evaluated. From all tested products, eight of them from Germany, Poland, and UK (from 3 to 18 mg/mL), met the ±2% criteria. The ±10% criteria was fulfilled by 50 (58.1%) liquids from all countries. Among 71 liquids which contained nicotine, (one e-liquid labeled as 6 mg/mL had no nicotine level quantified), the amount of freebase nicotine differed from 0 to 97.8%, with a mean value 56.5 ± 35.7. None of the tested liquids had nicotine salt listed in the ingredients. Therefore, a low level of freebase nicotine in some liquids was most likely achieved by added flavorings. All tested liquids presented in this study met the basic requirements of the TPD. There were differences in the scope of information about harmfulness, type of warnings on packaging, attaching leaflets, placing graphic symbols, and discrepancies between the declared and quantified nicotine concentrations.
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Affiliation(s)
- Patryk Krystian Bębenek
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellonska 4, 41-200 Sosnowiec, Poland; (P.K.B.); (A.S.)
| | - Vinit Gholap
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA; (V.G.); (M.H.)
| | - Matthew Halquist
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA; (V.G.); (M.H.)
| | - Andrzej Sobczak
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellonska 4, 41-200 Sosnowiec, Poland; (P.K.B.); (A.S.)
| | - Leon Kośmider
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellonska 4, 41-200 Sosnowiec, Poland; (P.K.B.); (A.S.)
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Leone FT, Evers-Casey S. Tobacco Use Disorder. Med Clin North Am 2022; 106:99-112. [PMID: 34823737 PMCID: PMC8630801 DOI: 10.1016/j.mcna.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Tobacco use disorder is highly prevalent; more than a billion individuals use tobacco worldwide. Popular views on the addictive potential of tobacco often underestimate the complex neural adaptations that underpin continued use. Although sometimes trivialized as a minor substance, effects of nicotine on behavior lead to profound morbidity over a lifetime of exposure. Innovations in processing have led to potent forms of tobacco and delivery devices. Proactive treatment strategies focus on pharmacotherapeutic interventions. Innovations on the horizon hold promise to help clinicians address this problem in a phenotypically tailored manner. Efforts are needed to prevent tobacco use for future generations.
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Affiliation(s)
- Frank T Leone
- Comprehensive Smoking Treatment Program, Penn Lung Center, Suite 251 Wright-Saunders Building, 51 North 39th Street, Philadelphia, PA, USA; Abramson Cancer Center, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
| | - Sarah Evers-Casey
- Comprehensive Smoking Treatment Program, Penn Lung Center, Suite 251 Wright-Saunders Building, 51 North 39th Street, Philadelphia, PA, USA
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46
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Peraza N, Bello MS, Schiff SJ, Cho J, Zhang Y, Callahan C, Tackett A, Leventhal AM. Drug and alcohol dependence acute effects of pod-style e-cigarettes in vaping-naïve smokers. Drug Alcohol Depend 2021; 228:109083. [PMID: 34600262 PMCID: PMC8631487 DOI: 10.1016/j.drugalcdep.2021.109083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/01/2021] [Accepted: 09/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study investigated the acute effects of exposure to pod-style e-cigarettes on subjective, behavioral, and physiological outcomes indicative of the potential to encourage vaping-naïve smokers to switch to e-cigarettes. METHODS In a within-subject experiment, never-vaping adult smokers interested in trying e-cigarettes (n = 24) completed 4 laboratory visits following 16-hr tobacco abstinence. Visits involved controlled puffing from preferred brand cigarettes (OwnCig) or a standardized pod-style e-cigarette with either no nicotine (NoNic), nicotine freebase (NicFreebase; 0.5% nicotine concentration), or nicotine salt (NicSalt E-Cig; 2.8% concentration) solutions. Outcomes included smoking urge, mood, user experience, plasma nicotine, and a behavioral task assessing ability to delay smoking. RESULTS NoNic, NicFreebase, and NicSalt pod-style e-cigarettes were significantly less effective than OwnCig at reducing smoking urge and increasing plasma nicotine, positive affect, satisfying user experience ratings, and ability to delay smoking on the behavioral task. Differences among pod-style e-cigarette conditions were limited to: (a) NicFreebase (vs. NoNic) preferentially suppressed participants' urge to smoke to alleviate negative mood, (b) NicFreebase (vs. NicSalt) slightly preferentially increased plasma nicotine; and (c) NicFreebase and NicSalt (vs. NoNic) produced higher aversive user experience ratings. CONCLUSIONS In tobacco deprived smokers' initial vaping experience, controlled administration of certain pod-style e-cigarettes with 0.5% NicFreebase or 2.8% NicSalt may be deficient comparators to cigarettes in terms of their capacity to acutely improve mood, deliver nicotine, suppress smoking motivation, and offer a satisfying user experience. Future research is needed to test pod-style e-cigarettes with higher nicotine doses and confirm whether NicFreebase vs. NicSalt enhances nicotine absorption.
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Affiliation(s)
- Natalia Peraza
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mariel S Bello
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Sara J Schiff
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Junhan Cho
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Yi Zhang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Carly Callahan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Alayna Tackett
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA 90033, USA.
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Abstract
This study uses retail scanner data to assess nicotine pouch sales in the US between 2016 and 2020.
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Affiliation(s)
- Kristy L. Marynak
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Xu Wang
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Michael A. Tynan
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Brian A. King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Abstract
As ultraprocessed foods (i.e., foods composed of mostly cheap industrial sources of dietary energy and nutrients plus additives) have become more abundant in our food supply, rates of obesity and diet-related disease have increased simultaneously. Food addiction has emerged as a phenotype of significant empirical interest within the past decade, conceptualized most commonly as a substance-based addiction to ultraprocessed foods. We detail (a) how approaches used to understand substance-use disorders may be applicable for operationalizing food addiction, (b) evidence for the reinforcing potential of ingredients in ultraprocessed foods that may drive compulsive consumptions, (c) the utility of conceptualizing food addiction as a substance-use disorder versus a behavioral addiction, and (d) clinical and policy implications that may follow if ultraprocessed foods exhibit an addictive potential. Broadly, the existing literature suggests biological and behavioral parallels between food addiction and substance addictions, with ultraprocessed foods high in both added fat and refined carbohydrates being most implicated in addictive-like eating. Future research priorities are also discussed, including the need for longitudinal studies and the potential negative impact of addictive ultraprocessed foods on children. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109, USA;
| | - Erica M Schulte
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
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Gholap VV, Pearcy AC, Halquist MS. Potential factors affecting free base nicotine yield in electronic cigarette aerosols. Expert Opin Drug Deliv 2021; 18:979-989. [PMID: 33576695 DOI: 10.1080/17425247.2021.1890714] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The free base and protonated nicotine forms in e-cigarette aerosol have shown different absorption profiles in users. Therefore, it is also important to identify the factors which can affect the ratio of these nicotine forms in the aerosol. Such factors may include nicotine concentrations, flavors, PG:VG ratios, types of nicotine chemical compounds and e-cigarette battery power outputs. The current study attempts to identify such factors using a controlled experiment. RESEARCH DESIGNS AND METHODS The aerosol was generated using validated aerosol generating model. Various factors were tested for their effect on nicotine forms. Additionally, a degradation study of one of the nicotine compounds, nicotine salicylate, was also carried out using mass spectrometry. RESULTS The free base nicotine in the aerosol was found to be affected by flavors, battery power output, nicotine compound type and PG:VG ratios. Based on the preliminary mass spectrometry data, degradation of nicotine salicylate was found to be one of the significant factors affecting free base nicotine in aerosol. CONCLUSIONS Potential factors affecting free base nicotine in e-cigarette aerosol have been identified in this study. These findings would help in understanding the nicotine delivery better and assist for better regulations.
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Affiliation(s)
- Vinit V Gholap
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, USA
| | - Adam C Pearcy
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, USA
| | - Matthew S Halquist
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, USA
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50
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Talih S, Salman R, El-Hage R, Karaoghlanian N, El-Hellani A, Saliba N, Shihadeh A. Effect of free-base and protonated nicotine on nicotine yield from electronic cigarettes with varying power and liquid vehicle. Sci Rep 2020; 10:16263. [PMID: 33004992 PMCID: PMC7530983 DOI: 10.1038/s41598-020-73385-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/16/2020] [Indexed: 12/11/2022] Open
Abstract
Nicotine in electronic cigarette (ECIG) liquids can exist in a free-base or protonated (or "salt") form. Protonated nicotine is less aversive upon inhalation than free-base nicotine, and many ECIG manufacturers have begun marketing protonated nicotine products, often with high nicotine concentrations. Regulations intended to control ECIG nicotine delivery limit nicotine concentration but do not consider nicotine form. In this study, we systematically examined the effect of nicotine form on nicotine yield for varying powers and liquid vehicles. A Kanger Subox Mini-C tank ECIG (0.5 Ω) was used to generate aerosols at varying powers (5-45 W) from liquid solutions that contained either free-base or protonated nicotine at 15 mg/g concentration, with a liquid vehicle consisting of either propylene glycol (PG) or vegetable glycerin (VG), resulting in four different solutions (free-base/PG, free-base/VG, protonated/PG, and protonated/VG). Nicotine yield was quantified using gas chromatography-mass spectrometry. Nicotine yields were not influenced by nicotine form under any condition investigated. At each power level, PG-based liquids resulted in approximately double the nicotine yield of VG-based liquids. Nicotine concentrations in the aerosols matched those of the parent liquids for both the PG and VG conditions. Increasing power led to greater nicotine yield across all conditions. The amount of nicotine emitted by an ECIG is independent of whether the nicotine is free-base or protonated, however the liquid vehicle has a strong effect on yield. Regulations intended to limit nicotine emissions must consider not only nicotine concentration, but also liquid vehicle and device power.
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Affiliation(s)
- Soha Talih
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Bliss Street, PO. Box 11-0236, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 821 West Franklin Street, Richmond, VA, 23284, USA
| | - Rola Salman
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Bliss Street, PO. Box 11-0236, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 821 West Franklin Street, Richmond, VA, 23284, USA
| | - Rachel El-Hage
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Bliss Street, PO. Box 11-0236, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 821 West Franklin Street, Richmond, VA, 23284, USA
| | - Nareg Karaoghlanian
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Bliss Street, PO. Box 11-0236, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 821 West Franklin Street, Richmond, VA, 23284, USA
| | - Ahmad El-Hellani
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Bliss Street, PO. Box 11-0236, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 821 West Franklin Street, Richmond, VA, 23284, USA
| | - Najat Saliba
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Bliss Street, PO. Box 11-0236, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 821 West Franklin Street, Richmond, VA, 23284, USA
| | - Alan Shihadeh
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Bliss Street, PO. Box 11-0236, Beirut, Lebanon.
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 821 West Franklin Street, Richmond, VA, 23284, USA.
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