Evaluation of Toxicant and Carcinogen Metabolites in the Urine of E-Cigarette Users Versus Cigarette Smokers

Hecht, Stephen S.; Carmella, Steven G.; Kotandeniya, Delshanee; Pillsbury, Makenzie E.; Chen, Menglan; Ransom, Benjamin W.; Vogel, Rachel Isaksson; Thompson, Elizabeth A.; Murphy, Sharon E.; Hatsukami, Dorothy K.

doi:10.1093/ntr/ntu218

Cited by 208 publications

(198 citation statements)

References 29 publications

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“…[8][9][10][11][12][13] Very little research on observed toxicant levels in e-cigarette users has been conducted. 14,15 To help better inform whether or not e-cigarettes pose real utility as a harm reduction device, data are needed to assess levels of nicotine, carcinogenic substances, and other toxicants in cigarette smokers who switch to e-cigarettes. In this longitudinal within-subjects observational study, we evaluated the effects of e-cigarettes on nicotine delivery and exposure reduction to selected carcinogens and toxicants.…”

Section: Introductionmentioning

confidence: 99%

Exposure to Nicotine and Selected Toxicants in Cigarette Smokers Who Switched to Electronic Cigarettes: A Longitudinal Within-Subjects Observational Study

Goniewicz

Gawron

Smith

et al. 2016

NICTOB

252

193

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Introduction: Electronic cigarettes (e-cigarettes) are purported to deliver nicotine aerosol without any toxic combustion products present in tobacco smoke. In this longitudinal within-subjects observational study, we evaluated the effects of e-cigarettes on nicotine delivery and exposure to selected carcinogens and toxicants. Methods: We measured seven nicotine metabolites and 17 tobacco smoke exposure biomarkers in the urine samples of 20 smokers collected before and after switching to pen-style M201 e-cigarettes for 2 weeks. Biomarkers were metabolites of 13 major carcinogens and toxicants in cigarette smoke: one tobacco-specific nitrosamine (NNK), eight volatile organic compounds (1,3-butadiene, crotonaldehyde, acrolein, benzene, acrylamide, acrylonitrile, ethylene oxide, and propylene oxide), and four polycyclic aromatic hydrocarbons (naphthalene, fluorene, phenanthrene, and pyrene). Changes in urine biomarkers concentration were tested using repeated measures analysis of variance. Results: In total, 45% of participants reported complete abstinence from cigarette smoking at 2 weeks, while 55% reported continued smoking. Levels of total nicotine and some polycyclic aromatic hydrocarbon metabolites did not change after switching from tobacco to e-cigarettes. All other biomarkers significantly decreased after 1 week of using e-cigarettes (p < .05). After 1 week, the greatest percentage reductions in biomarkers levels were observed for metabolites of 1,3-butadiene, benzene, and acrylonitrile. Total NNAL, a metabolite of NNK, declined by 57% and 64% after 1 and 2 weeks, respectively, while 3-hydroxyfluorene levels declined by 46% at week 1, and 34% at week 2. Conclusions: After switching from tobacco to e-cigarettes, nicotine exposure remains unchanged, while exposure to selected carcinogens and toxicants is substantially reduced. Implications: To our knowledge, this is the first study that demonstrates that substituting tobacco cigarettes with an e-cigarette may reduce user exposure to numerous toxicants and carcinogens otherwise present in tobacco cigarettes. Data on reduced exposure to harmful constituents that are present in tobacco cigarettes and e-cigarettes can aid in evaluating e-cigarettes as a potential harm reduction device.

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Section: Introductionmentioning

confidence: 99%

Exposure to Nicotine and Selected Toxicants in Cigarette Smokers Who Switched to Electronic Cigarettes: A Longitudinal Within-Subjects Observational Study

Goniewicz

Gawron

Smith

et al. 2016

NICTOB

252

193

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“…[1][2][3] Lower biomarker levels from toxicants associated with tobacco-related disease were observed in e-cigarette users. 4 From a technical perspective, the perception of the relative safety of e-cigarettes is based on their different mechanism of aerosol/vapor formation, compared with traditional combustible tobacco products. It is assumed that e-cigarettes do not generate many of the harmful and potentially harmful constituents (HPHCs 5 ) inherent to combustible tobacco smoke because unlike the traditional cigarette that burns the tobacco leafs the e-cigarette heats the vegetable glycerine, propylene glycol, and other components of e-liquids at a lower temperature.…”

Section: Introductionmentioning

confidence: 99%

Real-Time Measurement of Electronic Cigarette Aerosol Size Distribution and Metals Content Analysis

Mikheev

Brinkman

Granville

et al. 2016

NICTOB

164

140

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Introduction: Electronic cigarette (e-cigarette) use is increasing worldwide and is highest among both daily and nondaily smokers. E-cigarettes are perceived as a healthier alternative to combustible tobacco products, but their health risk factors have not yet been established, and one of them is lack of data on aerosol size generated by e-cigarettes. Methods: We applied a real-time, high-resolution aerosol differential mobility spectrometer to monitor the evolution of aerosol size and concentration during puff development. Particles generated by e-cigarettes were immediately delivered for analysis with minimal dilution and therefore with minimal sample distortion, which is critically important given the highly dynamic aerosol/ vapor mixture inherent to e-cigarette emissions.Results: E-cigarette aerosols normally exhibit a bimodal particle size distribution: nanoparticles (11-25 nm count median diameter) and submicron particles (96-175 nm count median diameter). Each mode has comparable number concentrations (10 7 -10 8 particles/cm 3 ). "Dry puff" tests conducted with no e-cigarette liquid (e-liquid) present in the e-cigarette tank demonstrated that under these conditions only nanoparticles were generated. Analysis of the bulk aerosol collected on the filter showed that e-cigarette emissions contained a variety of metals.Conclusions: E-cigarette aerosol size distribution is different from that of combustible tobacco smoke. E-cigarettes generate high concentrations of nanoparticles and their chemical content requires further investigation. Despite the small mass of nanoparticles, their toxicological impact could be significant. Toxic chemicals that are attached to the small nanoparticles may have greater adverse health effects than when attached to larger submicron particles. Implications: The e-cigarette aerosol size distribution is different from that of combustible tobacco smoke and typically exhibits a bimodal behavior with comparable number concentrations of nanoparticles and submicron particles. While vaping the e-cigarette, along with submicron particles the user is also inhaling nano-aerosol that consists of nanoparticles with attached chemicals that has not been fully investigated. The presence of high concentrations of nanoparticles requires nanotoxicological consideration in order to assess the potential health impact of e-cigarettes. The toxicological impact of inhaled nanoparticles could be significant, though not necessarily similar to the biomarkers typical of combustible tobacco smoke.

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“…Studies have also shown that acrolein levels in ENDS users, smokers who converted to ENDS use and smokers who entered dual use were much lower than in cigarette users. 24,25 Toxins and carcinogens Analysis of vapour and urine from ENDS user shows lower concentrations of hazardous toxins and carcinogens compared to cigarette users. 24,26 Comparing the presence and level of known harmful substances in ENDS and cigarettes, it has been estimated that ENDS are 95% less harmful.…”

Section: Aldehydesmentioning

confidence: 99%

“…24,25 Toxins and carcinogens Analysis of vapour and urine from ENDS user shows lower concentrations of hazardous toxins and carcinogens compared to cigarette users. 24,26 Comparing the presence and level of known harmful substances in ENDS and cigarettes, it has been estimated that ENDS are 95% less harmful. 27 However, it has been shown that toxin levels vary widely between different ENDS products.…”

Section: Aldehydesmentioning

confidence: 99%

E-cigarettes: promise or threat?

Nachiappan¹,

Selvavinayagam

2017

Int J Community Med Public Health

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Use of the electronic cigarette or electronic nicotine delivery system (ENDS) is increasing globally. Its vapour delivers nicotine without the 6000 odd chemicals released during cigarette smoking and the associated harm. Experts are divided on whether ENDS promise reduction in tobacco use or threaten tobacco control. This review presents up-to-date evidence. Two trials showed an increase in cessation, but not a reduction in cigarette use. Eight cohort studies showed no increase in cessation, and two cohort studies and a recent trial showed an increased reduction in cigarette use. A US population study showed association between ENDS use and smoking cessation. Nicotine addiction and potential harm to non-smokers who use ENDS are key concerns. Nicotine affects lung and brain development. An increase in accidental poisoning, though mild, is reported in children. No significant short term health effects are reported. When heated, ENDS may emit potential toxic and carcinogenic substances such as aldehydes, acrolein, flavouring agents etc. at very low levels - but their long term impact is not known. ENDS bring potential benefits to smokers, but there are concerns about their potential for nicotine addiction, gateway effect and renormalisation of smoking. However, in the UK and the US, a rise in ENDS use is associated with a fall in the prevalence of smoking. Countries differ in their approach to ENDS. India seems to be edging towards a total ban. India should collect local data and conduct research to monitor the impact and make informed, evidence based decisions, where needed.

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Evaluation of Toxicant and Carcinogen Metabolites in the Urine of E-Cigarette Users Versus Cigarette Smokers

Abstract: With respect to the compounds analyzed here, e-cigarettes have a more favorable toxicity profile than tobacco cigarettes.

Cited by 208 publications

References 29 publications

Exposure to Nicotine and Selected Toxicants in Cigarette Smokers Who Switched to Electronic Cigarettes: A Longitudinal Within-Subjects Observational Study

Exposure to Nicotine and Selected Toxicants in Cigarette Smokers Who Switched to Electronic Cigarettes: A Longitudinal Within-Subjects Observational Study

Real-Time Measurement of Electronic Cigarette Aerosol Size Distribution and Metals Content Analysis

E-cigarettes: promise or threat?

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