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

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.

Population prevalence and predictors of self-reported exposure to court-ordered, tobacco-related corrective statements

ObjectiveTo describe the population prevalence and predictors of self-reported exposure to court-ordered tobacco-related corrective statements in 2017–2018, when they were first implemented in newspapers and on television.MethodsNationally representative data from the 2018 Health Information National Trends Survey were used (n=3504). Frequencies and weighted proportions were calculated for seeing any corrective statement and for each of the five court-ordered corrective statements. Weighted, multivariable logistic regression was used to examine sociodemographic and smoking status predictors of reported exposure to any corrective statement.ResultsIn 2018, an estimated 40.6% of US adults had seen messages in newspapers or on television in the past 6 months stating that a federal court has ordered tobacco companies to make statements about the dangers of smoking cigarettes. Reported exposure to topic-specific statements ranged from 11.4% (manipulation of cigarette design) to 34.7% (health effects). Those with a high school education were significantly less likely than those with a college degree to report seeing the statements (OR=0.69, CI 0.50 to 0.95) and current smokers were significantly more likely than never smokers to report seeing them (OR=1.68, CI 1.12 to 2.53).ConclusionsIn the first 6 months of corrective statement implementation, an estimated 40.6% of US adults reported at least one exposure to any corrective statement, and current smokers were more likely than never smokers to report exposure. Traditional media channels can be effective for tobacco-related message dissemination; however, they may fail to reach more than half of the adult population without additional targeted communication efforts.