Explaining the effects of electronic cigarettes on craving for tobacco in recent quitters

Etter, Jean‐François

doi:10.1016/j.drugalcdep.2014.12.030

Cited by 46 publications

(30 citation statements)

References 38 publications

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“…We observed a mean plasma nicotine boost of 33.77 ng/mL in 10 min with some individuals achieving considerably higher concentrations. This level exceeds those reported by other researchers using similar (Farsalinos et al, 2014;2015) or higher nicotine e-liquid strength (Ramôa et al, 2015) and is equivalent to that observed in tobacco smokers (Russell, 1980, Russell et al, 1975 within 5 min of finishing a cigarette. The high plasma nicotine levels are likely due to a combination of: the device used, our ad libitum vaping design, 12 h nicotine abstinence requirement and the nature of our participants.…”

Section: Discussioncontrasting

confidence: 53%

“…The high plasma nicotine levels are likely due to a combination of: the device used, our ad libitum vaping design, 12 h nicotine abstinence requirement and the nature of our participants. The Aspire Nautilus tank used here is a more advanced system with more effective nicotine delivery to the aerosol (Farsalinos et al, 2016) compared to previous studies (Farsalinos et al, 2014;2015;Ramôa et al, 2015). We also selected participants already familiar with using higher nicotine strength liquid and who had baseline salivary cotinine levels exceeding 100 ng/mL.…”

Section: Discussionmentioning

confidence: 99%

“…Their increasing popularity and efficacy for quitting over conventional Nicotine Replacement Therapy (NRT) (Brown, Beard, Kotz, Michie & West, 2014) is commonly attributed to the ability to mimic the behavioural actions of cigarette smoking and to provide an analogous method of nicotine delivery (Polosa, et al, 2014). Although early studies in naive users reported poor nicotine delivery with little to no increase in blood nicotine levels (Bullen, McRobbie, Thornley, Glover, Lin & Laugesen), 2010;Eissenberg, 2010), later studies in experienced users and with newer models (Farsalinos, Spyrou, Tsimopoulou, Stefopoulos, Romagna & Voudris, 2014) have found pronounced increases paralleled by significant cigarette craving reduction (Etter, 2015). In fact, direct comparisons have demonstrated a 50% higher blood nicotine level in experienced versus naive e-cigarette users (Farsalinos et al, 2015) and with a newer versus an older generation device (Farsalinos et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects

Dawkins

Kimber

Doig³

et al. 2016

Psychopharmacology

146

121

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Funding: This study was fully funded by the University of East London PhD Excellence Studentship to CK. Declaration of interests:We declare that we have received no support from any companies for this work and there are no non-financial conflicts of interest that would be considered relevant to this work. LED has previously conducted research for several independent electronic cigarette companies. These companies had no input into the design, conduct or write up of the projects. She has also acted as a consultant for the pharmaceutical industry and as an expert witness in a patent infringement case. CK and OC declare no competing interests. MD and CF have previously supported other research groups by the quantification of cotinine, 3-hydroxy cotinine and nicotine. These groups had no input into the design, conduct or write up of this project.Keywords: Nicotine, Titration, E-cigarette, Puffing topography, Compensation 2 Abstract Rationale Self-titration is well documented in the tobacco literature. The extent to which ecigarette users (vapers) self-titrate is unknown.Objective This study explored the effects of high and low nicotine strength liquid on puffing topography, nicotine delivery and subjective effects in experienced vapers.Methods Eleven experienced male vapers completed 60 minutes of ad libitum vaping under low (6 mg/mL) and high (24 mg/mL) nicotine liquid conditions in two separate sessions.Measurements included: puffing topography (puff number, puff duration, volume of liquid consumed); and changes in: plasma nicotine levels, craving, withdrawal symptoms, selfreported hit, satisfaction and adverse effects.Results Liquid consumption and puff number were higher, and puff duration longer, in the low nicotine strength condition (all ps < 0.01). The mean difference in nicotine boost from baseline in the low condition was 8.59 (7.52) ng/mL, 16.99 (11.72) ng/mL and 22.03 (16.19) ng/mL at 10, 30 and 60 minutes respectively. Corresponding values for the high condition were 33.77 (34.88) ng/mL, 35.48 (28.31) ng/mL and 43.57 (34.78) ng/mL (ps < 0.05). There were no statistically significant differences between conditions in self-reported craving, withdrawal symptoms, satisfaction, hit or adverse effects.Conclusions Vapers engaged in compensatory puffing with lower nicotine strength liquid, doubling their consumption. Whilst compensatory puffing was sufficient to reduce craving and withdrawal discomfort, self-titration was incomplete with significantly higher plasma nicotine levels in the high condition.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects

Dawkins

Kimber

Doig³

et al. 2016

Psychopharmacology

146

121

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“…One report suggested that these effects may be independent of nicotine and can be due to oral and tactile sensations similar to smoking (9), and also likely result from participants using their own devices. The ability of e-cigarettes to reduce urge to smoke and withdrawal symptoms and to increase reward and satisfaction, as shown in prior reports (9, 11, 39, 40), might explain high e-cigarette prevalence of use among former tobacco cigarette users (41–43). …”

Section: Discussionmentioning

confidence: 71%

Nicotine delivery, retention and pharmacokinetics from various electronic cigarettes

et al. 2015

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Aims To measure the systemic retention of nicotine, propylene glycol (PG), and vegetable glycerin (VG) in electronic cigarette (e-cigarette) users, and assess the abuse liability of e-cigarettes by characterizing nicotine pharmacokinetics. Design E-cigarette users recruited over the Internet participated in a 1-day research ward study. Subjects took 15 puffs from their usual brand of e-cigarette. Exhaled breath was trapped in gas-washing bottles and blood was sampled before and several time after use. Setting San Francisco, California, USA. Participants Thirteen healthy, experienced adult e-cigarette users (6 females and 7 males). Measurements Plasma nicotine was analyzed by GC-MS/MS, and nicotine, VG, and PG in e-liquids and gas traps were analyzed by LC-MS/MS. Heart rate changes and subjective effects were assessed. Findings E-cigarettes delivered an average of 1.3 (0.9–1.8) mg (mean and 95% CI) of nicotine and 94% of the inhaled dose, 1.2 (0.8–1.7), was systemically retained. Average maximum plasma nicotine concentration (Cmax) was 8.4 (5.4–11.5) ng/mL and time of maximal concentration (Tmax) was 2 to 5 minutes; one participant had Tmax of 30 minutes. 89% and 92% of VG and PG, respectively, was systemically retained. Heart rate increased by an average of 8.0 bpm after 5 minutes. Withdrawal and urge to smoke decreased and the e-cigarettes were described as satisfying. Conclusions E-cigarettes can deliver levels of nicotine that are comparable to or higher than typical tobacco cigarettes, with similar systemic retention. Although the average maximum plasma nicotine concentration in experienced e-cigarettes users appears to be generally lower than what has been reported from tobacco cigarette use, the shape of the pharmacokinetic curve is similar, suggesting addictive potential.

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“…The devices are divided into first-, second-, or third-generation models. Research suggests that users of second- or third-generation models are more successful in smoking reduction and cessation and more satisfied with their e-cigarettes than users of first-generation models, possibly due to the better device-related availability of nicotine [2,3,4]. In January 2014, an Internet search identified 466 brands and 7,764 unique flavors [5].…”

Section: Introductionmentioning

confidence: 99%

Electronic Cigarettes in Germany: Patterns of Use and Perceived Health Improvement

Lehmann

Kühn²,

Reimer³

2017

Eur Addict Res

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Aims: The aim of the study was to characterize e-cigarette users in terms of their consumption patterns, motives, and the perceived health benefits they experience from using e-cigarettes. Design: The study was a cross-sectional online survey in 2015. A total of 3,320 German e-cigarette users were enrolled. A total of 91.5% were former tobacco smokers, 7.5% used both e-cigarettes and tobacco products, 1.0% were never-smokers. Results: No differences were found between ex-smokers and dual users with regard to sociodemographic and smoking history (mean age 40.8 years, 81% men, 45% with a high school degree or above). Both groups had smoked 26.4 tobacco cigarettes a day for 22 years, had unsuccessfully tried to quit smoking using various other nicotine replacement products, and had used e-cigarettes for an average of 2 years. Ex-smokers consumed lower nicotine strength and more liquid per month, experienced more positive health changes, and had made vaping their hobby. Never-smokers were about 5 years younger, used liquid without nicotine and without tobacco flavor, and had no physical dependency. Conclusions: E-cigarettes were primarily used as an alternative to smoking and a substitute for nicotine. More dual users than ex-smokers used e-cigarettes in places where smoking is forbidden. Positive health changes were more pronounced in ex-smokers than dual users.

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Explaining the effects of electronic cigarettes on craving for tobacco in recent quitters

Cited by 46 publications

References 38 publications

Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects

Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects

Nicotine delivery, retention and pharmacokinetics from various electronic cigarettes

Electronic Cigarettes in Germany: Patterns of Use and Perceived Health Improvement

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