Special Issue "Advantages and Disadvantages of Electronic Cigarettes"

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

Deadline for manuscript submissions: 31 August 2022 | Viewed by 8171

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.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

Published Papers (8 papers)

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Research

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Article
Differences in Acellular Reactive Oxygen Species (ROS) Generation by E-Cigarettes Containing Synthetic Nicotine and Tobacco-Derived Nicotine
Toxics 2022, 10(3), 134; https://doi.org/10.3390/toxics10030134 - 11 Mar 2022
Viewed by 871
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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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
Toxics 2022, 10(3), 126; https://doi.org/10.3390/toxics10030126 - 05 Mar 2022
Viewed by 610
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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Article
E-Liquids from Seven European Countries–Warnings Analysis and Freebase Nicotine Content
Toxics 2022, 10(2), 51; https://doi.org/10.3390/toxics10020051 - 23 Jan 2022
Viewed by 835
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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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
Toxics 2022, 10(1), 41; https://doi.org/10.3390/toxics10010041 - 17 Jan 2022
Viewed by 680
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)
Article
Influence of Electronic Cigarettes on Antioxidant Capacity and Nucleotide Metabolites in Saliva
Toxics 2021, 9(10), 263; https://doi.org/10.3390/toxics9100263 - 14 Oct 2021
Cited by 2 | Viewed by 667
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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Article
Comparative Reactive Oxygen Species (ROS) Content among Various Flavored Disposable Vape Bars, including Cool (Iced) Flavored Bars
Toxics 2021, 9(10), 235; https://doi.org/10.3390/toxics9100235 - 25 Sep 2021
Cited by 3 | Viewed by 1077
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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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
Toxics 2021, 9(3), 52; https://doi.org/10.3390/toxics9030052 - 09 Mar 2021
Cited by 3 | Viewed by 1154
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

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Review
The Effects of E-Cigarette Aerosol on Oral Cavity Cells and Tissues: A Narrative Review
Toxics 2022, 10(2), 74; https://doi.org/10.3390/toxics10020074 - 06 Feb 2022
Viewed by 887
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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