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Advantages and Disadvantages of Electronic Cigarettes
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Advantages and Disadvantages of Electronic Cigarettes

A special issue of Toxics (ISSN 2305-6304). This special issue belongs to the section "Novel Methods in Toxicology Research".

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 72875

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Prof. Dr. Andrzej Sobczak

E-Mail Website
Guest Editor
Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
Interests: tobacco harm reduction; global health; e-cigarettes; nicotine; toxicology of tobacco smoke; vaping; biomarkers
Dr. Leon Kośmider

E-Mail Website
Guest Editor
Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
Interests: e-cigarettes; nicotine; toxicants; smoking cessation; analytical chemistry of biomarkers
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear colleagues,

Electronic cigarettes (ECs) have been present on the consumer market for over a decade, and the number of scientific publications in the PubMed database has now exceeded seven thousand. Despite the number of publications, there is still no consensus in the scientific community about their safety. However, it should be emphasized that a comparison of the equivalent quantities of tobacco smoke and the aerosol produced from e-cigarettes shows a significantly lower quantity of toxic compounds in the aerosol compared with tobacco smoke. This can be seen as a way of reducing the health damage to cigarette smokers who cannot or are unwilling to quit using conventional methods. In addition, randomized studies are emerging suggesting that ECs could be useful in smoking cessation. On the other hand, ECs are now widely used among adolescents, and may pose a serious risk of future nicotine dependence and health problems in this population, as they counteract the population’s gains from smokers who quit using them. Therefore, as most authors stress, further research is needed that will convincingly resolve the current controversies. Clinicians urgently need evidence-based knowledge to better inform their patients about the use of these emerging tobacco products as a harm-reduction strategy, and regulators to regulate these products in ways that best serve public health, especially taking the youth population into account.

For this Special Issue, we welcome a broad range of studies examining the health effects of ECs. In particular, we welcome original research articles or systematic reviews that focus on the following:

(1) Chemical composition of refill solutions and ECs’ aerosol.

(2) Studies on new tobacco/nicotine products, such as e-cigarettes, snus, and heat but not burn tobacco products in relation to the health impact of these products.

(3) Observational population studies on EC use.

(4) Intervention studies designed to prevent youths from starting to use smoked or smokeless tobacco, as well as studies designed to prevent nicotine addiction that may result from novel nicotine-containing products.

(5) Smoking cessation studies among adult smokers, including studies of novel approaches to smoking cessation. Of special interest are studies that demonstrate the potential efficacy of using vaporized nicotine products, including e-cigarettes, as a type of nicotine replacement for addicted smokers who want to quit.

Prof. Dr. Andrzej Sobczak
Dr. Leon Kośmider
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Toxics is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • e-cigarettes
  • global health
  • vaping
  • tobacco smoke
  • toxicants
  • cessation

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Published Papers (15 papers)

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Editorial

Jump to: Research, Review

3 pages, 199 KiB  
Editorial
Advantages and Disadvantages of Electronic Cigarettes
by Andrzej Sobczak and Leon Kośmider
Toxics 2023, 11(1), 66; https://doi.org/10.3390/toxics11010066 - 11 Jan 2023
Cited by 1 | Viewed by 2918
Abstract
Despite nearly nine thousand publications on e-cigarettes (EC) in the PubMed database, there is still no consensus in the scientific community and among decision makers regarding the risks and benefits of using these products [...] Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)

Research

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11 pages, 284 KiB  
Article
Use of e-Cigarettes and Attendance at Stop Smoking Services: A Population Survey in England
by Greg Hartwell, Matt Egan, Jamie Brown, Triantafyllos Pliakas and Mark Petticrew
Toxics 2022, 10(10), 593; https://doi.org/10.3390/toxics10100593 - 7 Oct 2022
Cited by 1 | Viewed by 1828
Abstract
Little is known about whether e-cigarette use influences tobacco smokers’ decisions around other smoking cessation options, including the most effective one available: stop smoking service (SSS) attendance. Our repeat cross-sectional survey therefore assessed associations between use of e-cigarettes with past and planned future [...] Read more.
Little is known about whether e-cigarette use influences tobacco smokers’ decisions around other smoking cessation options, including the most effective one available: stop smoking service (SSS) attendance. Our repeat cross-sectional survey therefore assessed associations between use of e-cigarettes with past and planned future uptake of SSSs. Nicotine replacement therapy (NRT) use was also assessed as a comparator. Participants were drawn from the Smoking Toolkit Study, a nationally representative, validated, face-to-face survey. Data were aggregated on 2139 English adults reporting current smoking of cigarettes or other tobacco products. Multivariable logistic regression was used to adjust for potential confounders. Results showed dual users of combustible tobacco and e-cigarettes were more likely than other smokers to report having accessed SSSs in the past (AOR 1.43, 95% CI 1.08 to 1.90) and intending to take up these services in future (AOR 1.51, 95% CI 1.14 to 2.00). Dual users of combustible tobacco and NRT showed similar associations. Secondary objectives provided evidence on key psychosocial factors that influenced smokers’ decision-making in this area. In summary, despite speculation that e-cigarette use might deter smokers from accessing SSSs, our study found dual users of tobacco and e-cigarettes were more likely to report uptake of such services, compared to smokers not using e-cigarettes. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
18 pages, 3623 KiB  
Article
e-Cigarette Vapour Condensate Reduces Viability and Impairs Function of Human Osteoblasts, in Part, via a Nicotine Dependent Mechanism
by Thomas Nicholson, Lauren Davis, Edward T. Davis, Matthew Newton Ede, Aaron Scott and Simon W. Jones
Toxics 2022, 10(9), 506; https://doi.org/10.3390/toxics10090506 - 28 Aug 2022
Cited by 5 | Viewed by 5187
Abstract
Cigarette consumption negatively impacts bone quality and is a risk-factor for the development of multiple bone associated disorders, due to the highly vascularised structure of bone being exposed to systemic factors. However, the impact on bone to electronic cigarette (e-cigarette) use, which contains [...] Read more.
Cigarette consumption negatively impacts bone quality and is a risk-factor for the development of multiple bone associated disorders, due to the highly vascularised structure of bone being exposed to systemic factors. However, the impact on bone to electronic cigarette (e-cigarette) use, which contains high doses of nicotine and other compounds including flavouring chemicals, metal particulates and carbonyls, is poorly understood. Here, we present the first evidence demonstrating the impact of e-cigarette vapour condensate (replicating changes in e-cigarette liquid chemical structure that occur upon device usage), on human primary osteoblast viability and function. 24 h exposure of osteoblasts to e-cigarette vapour condensate, generated from either second or third generation devices, significantly reduced osteoblast viability in a dose dependent manner, with condensate generated from the more powerful third generation device having greater toxicity. This effect was mediated in-part by nicotine, since exposure to nicotine-free condensate of an equal concentration had a less toxic effect. The detrimental effect of e-cigarette vapour condensate on osteoblast viability was rescued by co-treatment with the antioxidant N-Acetyl-L-cysteine (NAC), indicating toxicity may also be driven by reactive species generated upon device usage. Finally, non-toxic doses of either second or third generation condensate significantly blunted osteoblast osteoprotegerin secretion after 24 h, which was sustained for up to 7 days. In summary we demonstrate that e-cigarette vapour condensate, generated from commonly used second and third generation devices, can significantly reduce osteoblast viability and impair osteoblast function, at physiologically relevant doses. These data highlight the need for further investigation to inform users of the potential risks of e-cigarette use on bone health, including, accelerating bone associated disease progression, impacting skeletal development in younger users and to advise patients following orthopaedic surgery, dental surgery, or injury to maximise bone healing. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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14 pages, 613 KiB  
Article
Methodological Approaches for Risk Assessment of Tobacco and Related Products
by Yvonne C. M. Staal, Peter M. J. Bos and Reinskje Talhout
Toxics 2022, 10(9), 491; https://doi.org/10.3390/toxics10090491 - 24 Aug 2022
Cited by 3 | Viewed by 2539
Abstract
Health risk assessment of tobacco and related products (TRPs) is highly challenging due to the variety in products, even within the product class, the complex mixture of components in the emission and the variety of user behaviour. In this paper, we summarize methods [...] Read more.
Health risk assessment of tobacco and related products (TRPs) is highly challenging due to the variety in products, even within the product class, the complex mixture of components in the emission and the variety of user behaviour. In this paper, we summarize methods that can be used to assess the health risks associated with the use of TRPs. The choice of methods to be used and the data needed are dependent on the aim. Risk assessment can be used to identify the emission components of highest health concern. Alternatively, risk assessment methods can be used to determine the absolute risk of a TRP, which is the health risk of a product, not related to other products, or to determine the relative risk of a TRP, which is the health risk of a TRP compared to, for example, a cigarette. Generally, health risk assessment can be based on the effects of the complete mixture (whole smoke) or based on the (added) effects of individual components. Data requirements are dependent on the method used, but most methods require substantial data on identity and quantity of components in emissions and on the hazards of these components. Especially for hazards, only limited data are available. Currently, due to a lack of suitable data, quantitative risk assessment methods cannot be used to inform regulation. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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11 pages, 2312 KiB  
Article
Nose-Only Exposure to Cherry- and Tobacco-Flavored E-Cigarettes Induced Lung Inflammation in Mice in a Sex-Dependent Manner
by Thomas Lamb, Thivanka Muthumalage, Jiries Meehan-Atrash and Irfan Rahman
Toxics 2022, 10(8), 471; https://doi.org/10.3390/toxics10080471 - 13 Aug 2022
Cited by 14 | Viewed by 4682 | Correction
Abstract
Flavoring chemicals in electronic nicotine delivery systems have been shown to cause cellular inflammation; meanwhile, the effects of fruit and tobacco flavors on lung inflammation by nose-only exposures to mice are relatively unknown. We hypothesized that exposure to flavored e-cigarettes would cause lung [...] Read more.
Flavoring chemicals in electronic nicotine delivery systems have been shown to cause cellular inflammation; meanwhile, the effects of fruit and tobacco flavors on lung inflammation by nose-only exposures to mice are relatively unknown. We hypothesized that exposure to flavored e-cigarettes would cause lung inflammation in C57BL/6 J mice. The mice were exposed to air, propylene glycol/vegetable glycerin, and flavored e-liquids: Apple, Cherry, Strawberry, Wintergreen, and Smooth & Mild Tobacco, one hour per day for three days. Quantification of flavoring chemicals by proton nuclear magnetic resonance spectroscopy (1H NMR), differential cell counts by flow cytometry, pro-inflammatory cytokines/chemokines by ELISA, and matrix metalloproteinase levels by western blot were performed. Exposure to PG/VG increased neutrophil cell count in lung bronchoalveolar lavage fluid (BALF). KC and IL6 levels were increased by PG/VG exposure and female mice exposed to Cherry flavored e-cigarettes, in lung homogenate. Mice exposed to PG/VG, Apple, Cherry, and Wintergreen increased MMP2 levels. Our results revealed flavor- and sex-based e-cigarette effects in female mice exposed to cherry-flavored e-liquids and male mice exposed to tobacco-flavored e-liquids, namely, increased lung inflammation. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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11 pages, 1966 KiB  
Article
Differences in Acellular Reactive Oxygen Species (ROS) Generation by E-Cigarettes Containing Synthetic Nicotine and Tobacco-Derived Nicotine
by Shaiesh Yogeswaran and Irfan Rahman
Toxics 2022, 10(3), 134; https://doi.org/10.3390/toxics10030134 - 11 Mar 2022
Cited by 12 | Viewed by 3866
Abstract
Electronic nicotine delivery systems (ENDS) containing synthetic nicotine have yet to be classified as tobacco products; consequently, there is ambiguity over whether Food and Drug Administration (FDA) regulatory authority can be extended to include tobacco-free nicotine (TFN) e-cigarettes. In recent years, a more [...] Read more.
Electronic nicotine delivery systems (ENDS) containing synthetic nicotine have yet to be classified as tobacco products; consequently, there is ambiguity over whether Food and Drug Administration (FDA) regulatory authority can be extended to include tobacco-free nicotine (TFN) e-cigarettes. In recent years, a more significant number of e-cigarette companies have been manufacturing TFN-containing e-cigarettes and e-liquids to circumvent FDA regulations. While studies have shown that aerosols generated from tobacco-derived nicotine-containing e-cigarettes contain significant reactive oxygen species (ROS) levels, no comparison studies have been conducted using TFN e-cigarettes. This study uses a single puff aerosol generator to aerosolize TFN and tobacco-derived nicotine-containing vape products and subsequently involves semi-quantifying the ROS generated by these vape products in H2O2 equivalents. We found that the differences between ROS levels generated from TFN and tobacco-derived nicotine-containing vape products vary by flavor. TFN tobacco flavored and fruit flavored products are more toxic in terms of ROS generation than menthol/ice and drink/beverage flavored products using TFN. Our study provides further insight into understanding how flavoring agents used in vape products impact ROS generation from e-cigarettes differently in TFN e-cigarettes than e-cigarettes using tobacco-derived nicotine. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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16 pages, 1538 KiB  
Article
The Impact of the Storage Conditions and Type of Clearomizers on the Increase of Heavy Metal Levels in Electronic Cigarette Liquids Retailed in Romania
by Alexandra Jităreanu, Irina Gabriela Cara, Alexandru Sava, Ioana Mârțu, Ioana-Cezara Caba and Luminița Agoroaei
Toxics 2022, 10(3), 126; https://doi.org/10.3390/toxics10030126 - 5 Mar 2022
Cited by 8 | Viewed by 3052
Abstract
The growing popularity of electronic cigarettes has raised several public health concerns, including the risks associated with heavy metals exposure via e-liquids and vapors. The purpose of this study was to determine, using atomic absorption spectrometry, the concentrations of Pb, Ni, Zn, and [...] Read more.
The growing popularity of electronic cigarettes has raised several public health concerns, including the risks associated with heavy metals exposure via e-liquids and vapors. The purpose of this study was to determine, using atomic absorption spectrometry, the concentrations of Pb, Ni, Zn, and Co in some commercially available e-liquid samples from Romania immediately after purchase and after storage in clearomizers. Lead and zinc were found in all investigated samples before storage. The initial concentrations of Pb ranged from 0.13 to 0.26 mg L−1, while Zn concentrations were between 0.04 and 0.07 mg L−1. Traces of nickel appeared in all investigated e-liquids before storage but in very small amounts (0.01–0.02 mg L−1). Co was below the detection limits. We investigated the influence of the storage period (1, 3, and 5 days), storage temperature (22 °C and 40 °C), and type of clearomizer. In most cases, the temperature rise and storage period increase were associated with higher concentrations of heavy metals. This confirms that storage conditions can affect metal transfer and suggests that the temperature of storage is another parameter that can influence this phenomenon. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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15 pages, 962 KiB  
Article
E-Liquids from Seven European Countries–Warnings Analysis and Freebase Nicotine Content
by Patryk Krystian Bębenek, Vinit Gholap, Matthew Halquist, Andrzej Sobczak and Leon Kośmider
Toxics 2022, 10(2), 51; https://doi.org/10.3390/toxics10020051 - 23 Jan 2022
Cited by 5 | Viewed by 3820
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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13 pages, 293 KiB  
Article
The Use of E-Cigarettes among High School Students in Poland Is Associated with Health Locus of Control but Not with Health Literacy: A Cross-Sectional Study
by Mariusz Duplaga and Marcin Grysztar
Toxics 2022, 10(1), 41; https://doi.org/10.3390/toxics10010041 - 17 Jan 2022
Cited by 5 | Viewed by 3647
Abstract
Since their introduction, the use of electronic cigarettes has increased considerably in the population and among adolescents. Determinants of smoking conventional cigarettes were thoroughly studied in various social groups. However, we know less about the predictors of the use of e-cigarettes in younger [...] Read more.
Since their introduction, the use of electronic cigarettes has increased considerably in the population and among adolescents. Determinants of smoking conventional cigarettes were thoroughly studied in various social groups. However, we know less about the predictors of the use of e-cigarettes in younger generations. The main aim of this study was the assessment of the factors associated with the use of electronic cigarettes among high school students. Specifically, the roles of health literacy (HL) and health locus of control (HLC) were addressed. The analysis was based on the data from a ‘pen-and-pencil’ survey performed in a large sample of 2223 high school students from southern Poland. The tools used in the survey encompassed 133 items, including a 47-item European Health Literacy Survey questionnaire, an 18-item Multidimensional Health Locus of Control Scale, and a set of questions asking about the health behaviors, and sociodemographic and economic characteristics of respondents. In the study sample, 47.5% of the respondents had used e-cigarettes in the past, and 18.6% had used them in the last month. HL was not significantly associated with dependent variables reflecting the use of e-cigarettes. Two types of external HLC were associated with using e-cigarettes in the past, and ‘Chance’ HLC (CHLC) was also associated with their use in the last month. Males, students of schools providing vocational training, and students declaring more Internet use during the week showed a higher likelihood of ever using e-cigarettes or using them in the last month. Students smoking conventional cigarettes were also more prone to use e-cigarettes. To sum up, it was an unexpected result that HL is not associated with the use of e-cigarettes. A greater likelihood of using e-cigarettes was positively associated with higher CHLC scores, as in the case of smoking traditional cigarettes. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
12 pages, 1961 KiB  
Article
Influence of Electronic Cigarettes on Antioxidant Capacity and Nucleotide Metabolites in Saliva
by Dominika Cichońska, Oliwia Król, Ewa M. Słomińska, Barbara Kochańska, Dariusz Świetlik, Jolanta Ochocińska and Aida Kusiak
Toxics 2021, 9(10), 263; https://doi.org/10.3390/toxics9100263 - 14 Oct 2021
Cited by 9 | Viewed by 4283
Abstract
The balance between reactive oxygen species production and the activity of antioxidant systems present in saliva is an important element in maintaining oral environment homeostasis. E-cigarettes adversely affect the oral cavity and their cytotoxic effect is related to oxidative stress. The aim of [...] Read more.
The balance between reactive oxygen species production and the activity of antioxidant systems present in saliva is an important element in maintaining oral environment homeostasis. E-cigarettes adversely affect the oral cavity and their cytotoxic effect is related to oxidative stress. The aim of this study was to assess the influence of using electronic cigarettes on antioxidant capacity of saliva. The study involved 110 subjects (35 e-cigarettes users, 33 traditional cigarettes smokers and 42 non-smokers). Laboratory analysis involved quantitation of uric acid, hypoxanthine, xanthine, TAOS (total antioxidant status) and TEAC (Trolox equivalent antioxidant capacity) in saliva. Lower values for TAOS and TEAC were observed among e-cigarettes users and traditional cigarettes smokers in comparison to non-smokers. Uric acid concentration tended to be higher among e-cigarettes users while no differences in hypoxanthine and xanthine saliva concentrations were observed. Electronic cigarettes usage affects antioxidant capacity of saliva to the same extent as traditional cigarettes, when comparing smokers to non-smokers. Further longitudinal studies on a larger study group are needed to assess the effect of changes in antioxidant status on oral health. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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26 pages, 4559 KiB  
Article
Comparative Reactive Oxygen Species (ROS) Content among Various Flavored Disposable Vape Bars, including Cool (Iced) Flavored Bars
by Shaiesh Yogeswaran, Thivanka Muthumalage and Irfan Rahman
Toxics 2021, 9(10), 235; https://doi.org/10.3390/toxics9100235 - 25 Sep 2021
Cited by 14 | Viewed by 4367
Abstract
Studies have shown that aerosols generated from flavored e-cigarettes contain Reactive Oxygen Species (ROS), promoting oxidative stress-induced damage within pulmonary cells. Our lab investigated the ROS content of e-cigarette vapor generated from disposable flavored e-cigarettes (vape bars) with and without nicotine. Specifically, we [...] Read more.
Studies have shown that aerosols generated from flavored e-cigarettes contain Reactive Oxygen Species (ROS), promoting oxidative stress-induced damage within pulmonary cells. Our lab investigated the ROS content of e-cigarette vapor generated from disposable flavored e-cigarettes (vape bars) with and without nicotine. Specifically, we analyzed vape bars belonging to multiple flavor categories (Tobacco, Minty Fruit, Fruity, Minty/Cool (Iced), Desserts, and Drinks/Beverages) manufactured by various vendors and of different nicotine concentrations (0–6.8%). Aerosols from these vape bars were generated via a single puff aerosol generator; these aerosols were then individually bubbled through a fluorogenic solution to semi-quantify ROS generated by these bars in H2O2 equivalents. We compared the ROS levels generated by each vape bar as an indirect determinant of their potential to induce oxidative stress. Our results showed that ROS concentration (μM) within aerosols produced from these vape bars varied significantly among different flavored vape bars and identically flavored vape bars with varying nicotine concentrations. Furthermore, our results suggest that flavoring chemicals and nicotine play a differential role in generating ROS production in vape bar aerosols. Our study provides insight into the differential health effects of flavored vape bars, in particular cool (iced) flavors, and the need for their regulation. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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14 pages, 641 KiB  
Article
Cross-Sectional Associations of Smoking and E-cigarette Use with Self-Reported Diagnosed Hypertension: Findings from Wave 3 of the Population Assessment of Tobacco and Health Study
by Connor R. Miller, Hangchuan Shi, Dongmei Li and Maciej L. Goniewicz
Toxics 2021, 9(3), 52; https://doi.org/10.3390/toxics9030052 - 9 Mar 2021
Cited by 21 | Viewed by 4394
Abstract
Following their introduction a decade ago, electronic cigarettes (e-cigarettes) have grown in popularity. Given their novelty, knowledge of the health consequences of e-cigarette use remains limited. Epidemiologic studies have not comprehensively explored associations between e-cigarette use and hypertension, a highly prevalent health condition [...] Read more.
Following their introduction a decade ago, electronic cigarettes (e-cigarettes) have grown in popularity. Given their novelty, knowledge of the health consequences of e-cigarette use remains limited. Epidemiologic studies have not comprehensively explored associations between e-cigarette use and hypertension, a highly prevalent health condition and major contributor to cardiovascular disease burden. In this study, cross-sectional associations of cigarette smoking and e-cigarette use (vaping) with self-reported diagnosed hypertension were evaluated among 19,147 18–55 year old respondents in Wave 3 (2015–2016) of the Population Assessment of Tobacco and Health Study. Multivariable analyses first modeled smoking and vaping as separate 2-category variables, then as a 6-category composite variable accounting for former smoking. After adjusting for potential confounders, current vaping (aOR = 1.31; 95%CI: 1.05–1.63) and current smoking (aOR = 1.27; 95%CI: 1.10–1.47) were both associated with higher odds of hypertension. In analyses modeling smoking and vaping compositely, respondents who were concurrently smoking and vaping had the highest odds of hypertension (aOR = 1.77; 95%CI: 1.32–2.39 [referent: never smokers]). These results differ somewhat from prior epidemiologic studies of vaping and respiratory outcomes, which consistently report smaller point estimates for current vaping than for current smoking. Our findings reinforce the uncertainty surrounding long-term health consequences of vaping, as well as highlight important distinctions between respiratory and cardiovascular outcomes when considering the harm reduction potential of e-cigarettes. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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Review

Jump to: Editorial, Research

49 pages, 934 KiB  
Review
Critical Review of the Recent Literature on Organic Byproducts in E-Cigarette Aerosol Emissions
by Sebastien Soulet and Roberto A. Sussman
Toxics 2022, 10(12), 714; https://doi.org/10.3390/toxics10120714 - 22 Nov 2022
Cited by 12 | Viewed by 6359
Abstract
We review the literature on laboratory studies quantifying the production of potentially toxic organic byproducts (carbonyls, carbon monoxide, free radicals and some nontargeted compounds) in e-cigarette (EC) aerosol emissions, focusing on the consistency between their experimental design and a realistic usage of the [...] Read more.
We review the literature on laboratory studies quantifying the production of potentially toxic organic byproducts (carbonyls, carbon monoxide, free radicals and some nontargeted compounds) in e-cigarette (EC) aerosol emissions, focusing on the consistency between their experimental design and a realistic usage of the devices, as determined by the power ranges of an optimal regime fulfilling a thermodynamically efficient process of aerosol generation that avoids overheating and “dry puffs”. The majority of the reviewed studies failed in various degrees to comply with this consistency criterion or supplied insufficient information to verify it. Consequently, most of the experimental outcomes and risk assessments are either partially or totally unreliable and/or of various degrees of questionable relevance to end users. Studies testing the devices under reasonable approximation to realistic conditions detected levels of all organic byproducts that are either negligible or orders of magnitude lower than in tobacco smoke. Our review reinforces the pressing need to update and improve current laboratory standards by an appropriate selection of testing parameters and the logistical incorporation of end users in the experimental design. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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36 pages, 514 KiB  
Review
A Critical Review of Recent Literature on Metal Contents in E-Cigarette Aerosol
by Sebastien Soulet and Roberto A. Sussman
Toxics 2022, 10(9), 510; https://doi.org/10.3390/toxics10090510 - 29 Aug 2022
Cited by 20 | Viewed by 9776
Abstract
The inhalation of metallic compounds in e-cigarette (EC) aerosol emissions presents legitimate concerns of potential harms for users. We provide a critical review of laboratory studies published after 2017 on metal contents in EC aerosol, focusing on the consistency between their experimental design, [...] Read more.
The inhalation of metallic compounds in e-cigarette (EC) aerosol emissions presents legitimate concerns of potential harms for users. We provide a critical review of laboratory studies published after 2017 on metal contents in EC aerosol, focusing on the consistency between their experimental design, real life device usage and appropriate evaluation of exposure risks. All experiments reporting levels above toxicological markers for some metals (e.g., nickel, lead, copper, manganese) exhibited the following experimental flaws: (i) high powered sub-ohm tank devices tested by means of puffing protocols whose airflows and puff volumes are conceived and appropriate for low powered devices; this testing necessarily involves overheating conditions that favor the production of toxicants and generate aerosols that are likely repellent to human users; (ii) miscalculation of exposure levels from experimental outcomes; (iii) pods and tank devices acquired months and years before the experiments, so that corrosion effects cannot be ruled out; (iv) failure to disclose important information on the characteristics of pods and tank devices, on the experimental methodology and on the resulting outcomes, thus hindering the interpretation of results and the possibility of replication. In general, low powered devices tested without these shortcomings produced metal exposure levels well below strict reference toxicological markers. We believe this review provides useful guidelines for a more objective risk assessment of EC aerosol emissions and signals the necessity to upgrade current laboratory testing standards. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
10 pages, 288 KiB  
Review
The Effects of E-Cigarette Aerosol on Oral Cavity Cells and Tissues: A Narrative Review
by Paweł Szumilas, Aleksandra Wilk, Kamila Szumilas and Beata Karakiewicz
Toxics 2022, 10(2), 74; https://doi.org/10.3390/toxics10020074 - 6 Feb 2022
Cited by 13 | Viewed by 6765
Abstract
A wealth of research has comprehensively documented the harmful effects of traditional cigarette smoking and nicotine on human health. The lower rate of exposure to harmful chemicals and toxic substances offered by alternative electronic smoking devices (e-cigarettes, vaping, etc.) has made these methods [...] Read more.
A wealth of research has comprehensively documented the harmful effects of traditional cigarette smoking and nicotine on human health. The lower rate of exposure to harmful chemicals and toxic substances offered by alternative electronic smoking devices (e-cigarettes, vaping, etc.) has made these methods of smoking popular, especially among adolescents and young adults, and they are regarded frequently as safer than regular cigarettes. During vaporization of these so-called e-liquids, toxins, carcinogens and various other chemical substances may be released and inhaled by the user. Data on the potential human health effect attendant on exposure to e-vapor are based mainly on animal and in vitro studies. The oral tissues are the first locus of direct interaction with the components of the inhaled vapor. However, the short-term as well as long-term effects of the exposure are not known. The aim of the review is to briefly present data on the effects of the chemical components and toxins of e-cigarette vapor on oral cavity cells and tissues of oral health. Full article
(This article belongs to the Special Issue Advantages and Disadvantages of Electronic Cigarettes)
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