Few published studies have investigated the presence of lead in the e-liquid of electronic nicotine delivery systems (ENDS). Lead inhalation is associated with increased risk of stroke, heart disease, and other diseases. This study used a novel application of graphite furnace technology to compare the concentration of lead between e-liquids of different packaging and product designs using e-liquids that are or were commercially available in the United States and Canada. Eleven nicotine-free disposable ENDS devices and 12 bottled refill solutions that contained nicotine were purchased from retailers in Canada and the United States between 2015 and 2017. E-liquids extracted from the disposable products and individual containers were analyzed for lead content by graphite furnace using atomic absorption detection. The lead concentration of open-wick ENDS devices ranged from 25.2 ppb to 838.4 ppb, with a standard deviation of 187.4 ppb. None of the bottled e-liquids contained quantifiable levels of lead. This study found that quantifiable levels of lead are present in certain disposable e-cigarette devices, and there is evidence from this study that the design of ENDS devices may contribute to lead exposure. These findings suggest that lead testing should be incorporated into future chemical analyses of ENDS devices.
Background: Smoke-free air policies exist to protect users and nonusers from exposure to tobacco smoke. Although electronic nicotine delivery systems (ENDS) may expose passerby to nicotine and particulate matter, few US states regulate indoor use of ENDS. The purpose of this study was to investigate reported rationales for ENDS use and reported ENDS use in public smoke-free places by dual cigarette/ENDS users. Methods: A population of ENDS/cigarette co-users (n = 2051) was drawn from Wave 2 of the Population Assessment of Tobacco and Health (PATH) dataset (2014–2015). Harm reduction beliefs and cessation behavior of co-users were investigated as predictors of ENDS use in public smoke-free places using logistic regression. Results: Fifty-eight percent of dual users reported past 30-day ENDS use in public smoke-free places. Reported use of ENDS to cut down on cigarette smoking (OR: 2.38, 95% CI: 1.86, 3.05), as an alternative to quitting tobacco (OR: 1.71, 95% CI: 1.37, 2.13), or because of belief that ENDS help people to quit cigarettes (OR: 1.52, 95% CI: 1.20, 1.92) were significantly associated with increased odds of ENDS use in smoke-free places. Conclusions: Beliefs that ENDS were useful as cessation tools or posed modified risk to users and nonusers were associated with elevated odds of use ENDS in locations where conventional tobacco is prohibited. Due to limitations in the survey instrument, in-home ENDS use could not be directly assessed in this analysis. However, these self-reported findings suggest that use of ENDS in public places where cigarette use is prohibited is prevalent enough to be of concern for future regulation and enforcement efforts.
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