Historical Perspective of Proactive and Reactive Regulations of E-cigarettes to Combat Nicotine Addiction

Abstract

Cigarettes and electronic cigarettes (e-cigarettes) are major sources of exposure to nicotine, an addictive chemical. Although these products are being regulated by the Food and Drug Administration (FDA) under the Tobacco Control Act, specifications about the nicotine content in these products have not been established yet. In e-cigarettes, nicotine concentration ranges from 0 to > 50mg/mL, and the recent e-cigarette devices provide control to change nicotine flux for higher nicotine delivery. Due to the lack of robust regulations in manufacturing, distribution and marketing, e-cigarettes have already infiltrated the market with youth appealing flavors and devices. As a result, the country is facing a youth epidemic of e-cigarette use. The unregulated nicotine levels in both cigarettes and e-cigarettes can lead to repeated and overexposure of nicotine to youth which can lead to the addiction and detrimental effects on their cognitive functions. Over the past decade, the corrective measures being taken by the FDA for cigarette and e-cigarette regulations also should focus on nicotine exposure levels. Before it is too late to prevent youth from lifetime addiction to nicotine, it is important to address the issues of nicotine concentration, nicotine flux and the e-cigarette device regulations while offering adults with smoking disorder less harmful alternatives to cigarettes.

Exclusive and dual use of electronic cigarettes among European youth in 32 countries with different regulatory landscapes

“…Prior research has also suggested e-cigarette use at least partially related to higher SES 7 27. On the country level, the prevalence of e-cigarette use has been lower among youth in the middle-income and low-income than high-income countries3; however, to contain the situation, ‘proactive’ rather than ‘reactive’ regulations are needed 28 29…”

E-Liquids from Seven European Countries–Warnings Analysis and Freebase Nicotine Content

“…Meanwhile, nicotine depending on the pH can be presented as a freebase (non-protonated), mono-protonated, or diprotonated form (Figure 1). The freebase and protonated nicotine yield of the e-cigarettes is found to have different effects on the plasma nicotine concentration-time profile in vapers [36][37][38][39]. As the possible reasons for such differences are being studied, it becomes necessary to determine the freebase or protonated nicotine yield of liquids and classify them based on this yield.…”

“…As the possible reasons for such differences are being studied, it becomes necessary to determine the freebase or protonated nicotine yield of liquids and classify them based on this yield. Such classification would eventually help in better regulation of the liquid/e-cigarette market [37,40].…”

“…Such classification would eventually help in better regulation of the liquid/e-cigarette market. [37,40]…”

Machine Learning-Based Nicotine Addiction Prediction Models for Youth E-Cigarette and Waterpipe (Hookah) Users

“…Constituents of e-cigarette liquids such as pulegone, acrolein, formaldehyde, tobacco-specific nitrosamines, and oxidants can also raise the risk of cancer [ 21 ]. E-cigarettes have been on the U.S. market for a little over a decade [ 26 ]. This limits the amount of longitudinal data available to show the long-term effects of this product.…”