Effects of Switching to Electronic Cigarettes with and without Concurrent Smoking on Exposure to Nicotine, Carbon Monoxide, and Acrolein

Nicotine is responsible for the psychoactive and habit-forming effects of tobacco. Approximately 30% of Americans use tobacco products; half of them are nicotine-dependent. Nicotine has mild stimulant effects. Overdose is rare in experienced users. Some may develop nausea, vomiting, weakness, and dizziness. Withdrawal symptoms include craving, irritability, anxiety, restlessness, and increased appetite. Smokers have elevated exhaled carbon monoxide and serum carboxyhemoglobin levels. Cotinine, a metabolite of nicotine, can be detected in blood and urine. Many medical conditions are associated with tobacco use (particularly smoking), including cardiovascular disease, chronic lung disease, and a variety of malignancies. A number of interventions can help increase smoking cessation rates, including physician advice, counseling, nicotine replacement, varenicline, and bupropion. Electronic cigarettes may help smokers quit or reduce their smoking.

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Carbon Monoxide and Small Hydrocarbon Emissions from Sub-ohm Electronic Cigarettes

Chemical Research in Toxicology ◽

10.1021/acs.chemrestox.8b00324 ◽

2019 ◽

Vol 32 (2) ◽

pp. 312-317 ◽

Cited By ~ 14

Author(s):

Ahmad El-Hellani ◽

Samira Al-Moussawi ◽

Rachel El-Hage ◽

Soha Talih ◽

Rola Salman ◽

...

Keyword(s):

Carbon Monoxide ◽

Electronic Cigarettes ◽

Hydrocarbon Emissions

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Vaping and Commitment Flu-B Infection Is a Deadly Combination for Spontaneous Pneumomediastinum

Case Reports in Pulmonology ◽

10.1155/2021/9944491 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Md Didar Ul Alam ◽

Khandakar Hussain ◽

Samsone Garedew ◽

Muhammad imtiaz

Keyword(s):

Carbon Monoxide ◽

Electronic Cigarettes ◽

Influenza Infection ◽

The United States ◽

Past Medical History ◽

Young Population ◽

Injury Patterns ◽

Rare Finding ◽

Spontaneous Pneumomediastinum ◽

Flavoring Agent

Vaping or E-cigarettes were created to deliver nicotine-containing aerosol to users with a flavoring agent without agents such as tars, oxidant gases, and carbon monoxide smoke found in traditional tobacco cigarettes. The use of E-cigarettes is steadily increasing in the United States, especially among the young population. Electronic cigarettes seem capable of causing various injury patterns in the lungs, collectively called E-cigarettes or vaping-associated lung injury (EVALI). Spontaneous pneumomediastinum (SPM) is a rare finding in EVALI. Here, we report a case of spontaneous pneumomediastinum secondary to vaping in a young man with no past medical history except for daily vaping and a recent untreated influenza infection.

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Carbon monoxide concentration in mainstream E-cigarette emissions measured with diode laser spectroscopy

Tobacco Control ◽

10.1136/tobaccocontrol-2019-055078 ◽

2019 ◽

pp. tobaccocontrol-2019-055078 ◽

Cited By ~ 2

Author(s):

Rileigh Casebolt ◽

S Jewel Cook ◽

Ana Islas ◽

Alyssa Brown ◽

Karen Castle ◽

...

Keyword(s):

Carbon Monoxide ◽

Diode Laser ◽

Organic Compounds ◽

Laser Spectroscopy ◽

Electronic Cigarettes ◽

Chemical Species ◽

Direct Function ◽

Carbon Monoxide Concentration ◽

Diode Laser Spectroscopy ◽

Co Concentration

The e-fluid heated in electronic cigarettes (e-cigarettes) is largely composed of organic compounds, specifically propylene glycol, vegetable glycerin and flavouring compounds. When heated, as it is in an e-cigarette, the chemical species in this fluid have the potential to oxidise into carbon monoxide (CO) and other species. Using diode laser spectroscopy, the concentration of CO in e-cigarette mainstream effluent as a function of e-cigarette power and flavour was measured. Carbon monoxide concentration was found to be a direct function of the power of the resistive heating. At the highest powers testable using commercial e-cigarette components, the maximum CO concentration measured was over 180 ppm. The flavouring compounds in the e-fluid also had an effect on the concentration of carbon monoxide present in the effluent.

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Effects of exposure to direct and secondhand hookah and e-cigarette aerosols on ambient air quality and cardiopulmonary health in adults and children: protocol for a panel study

BMJ Open ◽

10.1136/bmjopen-2019-029490 ◽

2019 ◽

Vol 9 (6) ◽

pp. e029490 ◽

Cited By ~ 7

Author(s):

Jenni Shearston ◽

Lily Lee ◽

James Eazor ◽

Saher Meherally ◽

Su Hyun Park ◽

...

Keyword(s):

New York ◽

Carbon Monoxide ◽

Air Quality ◽

Biological Samples ◽

Electronic Cigarettes ◽

Panel Study ◽

Ambient Air ◽

Quality Measures ◽

New York University ◽

Adults And Children

IntroductionUse of alternative nicotine delivery systems, such as electronic cigarettes and hookahs, has increased dramatically in the USA, but limited research has been conducted on the secondhand effects of these products, especially in children. The objective of this study is to assess the cardiopulmonary effects of e-cigarette and hookah use in vaping and smoking adults, and in non-smoking/non-vaping adults and children exposed to secondhand particles and gases.Methods and analysisThis study uses a pre/post design, with four groups: two control groups (non-smoking/non-vaping and cigarette smoking) and two test groups (hookah smoking and e-cigarette vaping). Participants will be recruited by household, so that each home includes one smoking or vaping adult and one non-smoking/non-vaping adult and/or child (5–18 years). Non-smoking/non-vaping homes include an adult and child who do not smoke or vape and do not live with individuals who do. Air quality measures will be completed during a household smoking or vaping session (ambient air for non-smoking/non-vaping group), while cardiopulmonary measures and biological samples will be taken directly before and after the smoking/vaping session, and again 24 hours later, for all participants. Air quality measures include carbon monoxide, black carbon, particulate matter, trace elements, nicotine and carbonyls; cardiopulmonary measures include heart rate variability, blood pressure, pulmonary function and exhaled carbon monoxide; biological samples will assess cotinine, inflammatory cytokines and biomarkers in urine, saliva and nasal mucosa.Ethics and disseminationThis study was approved by the Institutional Review Board at New York University School of Medicine (s16-02226 and s17-01143). Special attention was given to the inclusion of children, who are likely significantly impacted by the use of these products at home, and thus should be included in research. Results of the study will be distributed at conferences, in peer-reviewed journals and to relevant public health authorities for use in developing policy.

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Carbonyls and Carbon Monoxide Emissions from Electronic Cigarettes Affected by Device Type and Use Patterns

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17082767 ◽

2020 ◽

Vol 17 (8) ◽

pp. 2767 ◽

Cited By ~ 5

Author(s):

Yeongkwon Son ◽

Chiranjivi Bhattarai ◽

Vera Samburova ◽

Andrey Khlystov

Keyword(s):

Carbon Monoxide ◽

Standardized Testing ◽

Electronic Cigarettes ◽

Rapid Development ◽

Liquid Composition ◽

Cigarette Use ◽

Exposure Limits ◽

Use Patterns ◽

Type Device ◽

Cigarette Design

Dangerous levels of harmful chemicals in electronic cigarette (e-cigarette) aerosols were reported by several studies, but variability in e-cigarette design and use patterns, and a rapid development of new devices, such as JUUL, hamper efforts to develop standardized testing protocols and understand health risks associated with e-cigarette use. In this study, we investigated the relative importance of e-cigarette design, power output, liquid composition, puff topography on e-cigarette emissions of carbonyl compounds, carbon monoxide (CO), and nicotine. Four popular e-cigarette devices representing the most common e-cigarette types (e.g., cig-a-like, top-coil, ‘mod’, and ‘pod’) were tested. Under the tested vaping conditions, a top-coil device generated the highest amounts of formaldehyde and CO. A ‘pod’ type device (i.e., JUUL) emitted the highest amounts of nicotine, while generating the lowest levels of carbonyl and CO as compared to other tested e-cigarettes. Emissions increased nearly linearly with puff duration, while puff flow had a relatively small effect. Flavored e-liquids generated more carbonyls and CO than unflavored liquids. Carbonyl concentrations and CO in e-cigarette aerosols were found to be well correlated. While e-cigarettes emitted generally less CO and carbonyls than conventional cigarettes, daily carbonyl exposures from e-cigarette use could still exceed acute exposure limits, with the top-coil device potentially posing more harm than conventional cigarettes.

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A pre-post pilot study of electronic cigarettes to reduce smoking in people with severe mental illness

Psychological Medicine ◽

10.1017/s0033291718001782 ◽

2018 ◽

Vol 49 (6) ◽

pp. 1033-1040 ◽

Cited By ~ 11

Author(s):

Lauren M. Hickling ◽

Rocio Perez-Iglesias ◽

Ann McNeill ◽

Lynne Dawkins ◽

John Moxham ◽

...

Keyword(s):

Carbon Monoxide ◽

Pilot Study ◽

Harm Reduction ◽

Psychotic Disorder ◽

Electronic Cigarettes ◽

Mental Illnesses ◽

Cigarette Use ◽

Smoking Cigarette ◽

Harm Reduction Intervention ◽

Serious Mental Illnesses

AbstractBackgroundSmoking is the largest single contributor to poor physical health and increased mortality in people with serious mental illnesses. The aim of the study was to investigate the utility of electronic cigarettes (e-cigarettes) as a harm reduction intervention in this population.MethodFifty tobacco smokers with a psychotic disorder were enrolled onto a 24-week pilot study (ClinicalTrials.gov: NCT02212041) investigating the efficacy of a 6-week free e-cigarette intervention to reduce smoking. Cigarette and e-cigarette use was self-reported at weekly visits, and verified using carbon monoxide tests. Psychopathology, e-cigarette acceptability and adverse effects were assessed using standardised scales.ResultsThere was a significant (⩾50%) reduction in cigarettes consumed per day between baseline and week 6 [F(2.596,116.800) = 25.878, p < 0.001], and e-cigarette use was stable during this period [F(2.932,46.504) = 2.023, p = 0.115]. These changes were verified by significant carbon monoxide reductions between these time points [F(3.335,126.633) = 5.063, p = 0.002].ConclusionsThe provision of e-cigarettes is a potentially useful harm reduction intervention in smokers with a psychotic disorder.

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Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study

Tobacco Control ◽

10.1136/tobaccocontrol-2016-053539 ◽

2017 ◽

Vol 27 (4) ◽

pp. 365-372 ◽

Cited By ~ 61

Author(s):

Mark Conner ◽

Sarah Grogan ◽

Ruth Simms-Ellis ◽

Keira Flett ◽

Bianca Sykes-Muskett ◽

...

Keyword(s):

Socioeconomic Status ◽

Carbon Monoxide ◽

Cigarette Smoking ◽

Prospective Study ◽

Electronic Cigarettes ◽

Cigarette Use ◽

School Meals ◽

Cross Sectional ◽

Age Range

BackgroundIn cross-sectional surveys, increasing numbers of adolescents report using both electronic cigarettes (e-cigarettes) and cigarettes. This study assessed whether adolescent e-cigarette use was associated prospectively with initiation or escalation of cigarette use.MethodsData were from 2836 adolescents (aged 13–14 years at baseline) in 20 schools in England. At baseline, breath carbon monoxide levels, self-reported e-cigarette and cigarette use, sex, age, friends and family smoking, beliefs about cigarette use and percentage receiving free school meals (measure of socioeconomic status) were assessed. At 12-month follow-up, self-reported cigarette use was assessed and validated by breath carbon monoxide levels.ResultsAt baseline, 34.2% of adolescents reported ever using e-cigarettes (16.0% used only e-cigarettes). Baseline ever use of e-cigarettes was strongly associated with subsequent initiation (n=1726; OR 5.38, 95% CI 4.02 to 7.22; controlling for covariates, OR 4.06, 95% CI 2.94 to 5.60) and escalation (n=318; OR 1.91, 95% CI 1.14 to 3.21; controlling for covariates, this effect became non-significant, OR 1.39, 95% CI 0.97 to 1.82) of cigarette use.ConclusionsThis is the first study to report prospective relationships between ever use of e-cigarettes and initiation and escalation of cigarette use among UK adolescents. Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use. Further research with longer follow-up in a broader age range of adolescents is required.

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Exhaled Carbon Monoxide Levels in Forty Resistant to Cessation Male Smokers after Six Months of Full Switch to Electronic Cigarettes (e-Cigs) or to A Tobacco Heating Systems (THS)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16203916 ◽

2019 ◽

Vol 16 (20) ◽

pp. 3916 ◽

Cited By ~ 3

Author(s):

Fabio Beatrice ◽

Giuseppina Massaro

Keyword(s):

Carbon Monoxide ◽

Electronic Cigarettes ◽

Heating System ◽

Toxic Chemicals ◽

Exhaled Breath ◽

Medium Term ◽

Tobacco Harm Reduction ◽

Heating Systems ◽

Stop Smoking ◽

Exhaled Carbon Monoxide

Cigarette smoke releases several toxic chemicals and carcinogens including carbon monoxide (CO). This study examined the levels of exhaled CO in smokers switching to electronic cigarettes (e-Cigs) or a tobacco heating system (THS) and their level of compliance six months after switching. On the basis of their own preferences, 40 male smokers unwilling or unable to stop smoking were switched to e-Cigs or THSs for six months (20 subjects in each group). Nicotine addiction and levels of carbon monoxide in the exhaled breath (eCO) were measured at baseline (the latter also at six months). The Shapiro Wilk test, graphical methods, Student T test or Mann–Whitney test were used to assess the normal distribution of variables and differences between the two groups after six months. The two groups showed no difference at baseline, but a significant higher addiction score in smokers choosing THS. E-Cig and THS showed significant reduced levels of eCO (both %COHb and COppm) after six months, which were within the range of non-smoker status. Reduced levels of %COHb did not significantly differ between the two groups, whilst the THS group had a significantly lower reduction in levels of COppm vs the e-Cig group (p < 0.05). Both e-Cigs and THSs are capable of significantly reducing eCO at least in the medium term, hence constituting a viable tobacco harm reduction approach in smokers who are unwilling or unable to stop smoking.

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Carbon monoxide poisoning

Emergency Medicine Australasia ◽

10.1046/j.1442-2026.2000.0162a.x ◽

2000 ◽

Vol 12 (4) ◽

pp. 354-357

Author(s):

David R Smart ◽

Paul D Mark

Keyword(s):

Carbon Monoxide ◽

Carbon Monoxide Poisoning

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