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Concept: Propylene glycol

448

Electronic cigarettes (e-cigarettes) are generally recognized as a safer alternative to combusted tobacco products, but there are conflicting claims about the degree to which these products warrant concern for the health of the vapers (e-cigarette users). This paper reviews available data on chemistry of aerosols and liquids of electronic cigarettes and compares modeled exposure of vapers with occupational safety standards.

Concepts: Medicine, Smoking, Tobacco, Cigarette, Nicotine, Electronic cigarette, Propylene glycol, Cigarettes

167

To study the effects of varying lipid concentrations, lipid and oil ratio, and the addition of propylene glycol and lecithin on the long-term physical stability of nanostructured lipid nanocarriers (NLC), skin hydration, and transepidermal water loss.

Concepts: Effect, Effects unit, Propylene glycol

155

Electronic cigarettes, or e-cigarettes - battery-operated nicotine-delivery devices that mimic the look and feel of smoking by vaporizing a liquid solution such as propylene glycol - appeared in European and American markets less than a decade ago. Sales have reached $650 million a year in Europe and are projected to reach $1.7 billion in the United States in 2013. Though these figures are a small fraction of sales figures for traditional cigarettes, e-cigarettes represent a substantial market achievement; indeed, some people predict that they may eventually eclipse tobacco cigarettes. But e-cigarettes are the subject of a public health dispute that . . .

Concepts: United States, Smoking, Tobacco, Tobacco smoking, Cigarette, Nicotine, Electronic cigarette, Propylene glycol

148

Vitrification of endothelial cells (MHECT-5) has not previously been compared with controlled slow freezing methods under standardized conditions. To identify the best cryopreservation technique, we evaluated vitrification and standardized controlled-rate -1°C/minute cell freezing in a -80°C freezer and tested four cryoprotective agents (CPA), namely dimethyl sulfoxide (DMSO), ethylene glycol (EG), propylene glycol (PG), and glycerol (GLY), and two media, namely Dulbecco’s modified Eagle medium Ham’s F-12 (DMEM)and K+-modified TiProtec (K+TiP), which is a high-potassium-containing medium. Numbers of viable cells in proliferation were evaluated by the CellTiter 96® AQueous One Solution Cell Proliferation Assay (Promega Corporation, Mannheim, Germany). To detect the exact frozen cell number per cryo vial, DNA content was measured by using Hoechst 33258 dye prior to analysis. Thus, results could be evaluated unconstrained by absolute cell number. Thawed cells were cultured in 25 cm2 cell culture flasks to confluence and examined daily by phase contrast imaging. With regard to cell recovery immediately after thawing, DMSO was the most suitable CPA combined with K+TiP in vitrification (99 ±0.5%) and with DMEM in slow freezing (92 ±1.6%). The most viable cells in proliferation after three days of culture were obtained in cells vitrificated by using GLY with K+TiP (308 ±34%) and PG with DMEM in slow freezing (280 ±27%).

Concepts: Ethylene glycol, Ethylene, Diol, Propylene glycol, Dimethyl sulfoxide, Glycerol, Cryobiology, Cryoprotectant

64

In 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.

Concepts: Smoking, Tobacco, Cigarette, Nicotine, Adolescence, Electronic cigarette, Propylene glycol, Cigarettes

63

Use of electronic cigarettes has grown exponentially over the past few years, raising concerns about harmful emissions. This study quantified potentially toxic compounds in the vapor and identified key parameters affecting emissions. Six principal constituents in three different refill “e-liquids” were propylene glycol (PG), glycerin, nicotine, ethanol, acetol, and propylene oxide. The latter, with mass concentrations of 0.4-0.6%, is a possible carcinogen and respiratory irritant. Aerosols generated with vaporizers contained up to 31 compounds, including nicotine, nicotyrine, formaldehyde, acetaldehyde, glycidol, acrolein, acetol, and diacetyl. Glycidol is a probable carcinogen not previously identified in the vapor, and acrolein is a powerful irritant. Emission rates ranged from tens to thousands of nanograms of toxicants per milligram of e-liquid vaporized, and they were significantly higher for a single-coil vs a double-coil vaporizer (by up to an order of magnitude for aldehydes). By increasing the voltage applied to a single-coil device from 3.3 to 4.8 V, the mass of e-liquid consumed doubled from 3.7 to 7.5 mg puff(-1) and the total aldehyde emission rates tripled from 53 to 165 μg puff(-1), with acrolein rates growing by a factor of 10. Aldehyde emissions increased by more than 60% after the device was reused several times, likely due to the buildup of polymerization byproducts that degraded upon heating. These findings suggest that thermal degradation byproducts are formed during vapor generation. Glycidol and acrolein were primarily produced by glycerin degradation. Acetol and 2-propen-1-ol were produced mostly from PG, while other compounds (e.g., formaldehyde) originated from both. Because emissions originate from reaction of the most common e-liquid constituents (solvents), harmful emissions are expected to be ubiquitous when e-cigarette vapor is present.

Concepts: Ethanol, Smoking, Tobacco, Cigarette, Nicotine, Electronic cigarette, Propylene glycol, Glycerol

44

The heating of the fluids used in electronic cigarettes (“e-cigarettes”) used to create “vaping” aerosols is capable of causing a wide range of degradation reaction products. We investigated formation of benzene (an important human carcinogen) from e-cigarette fluids containing propylene glycol (PG), glycerol (GL), benzoic acid, the flavor chemical benzaldehyde, and nicotine.

Concepts: Cigarette, Nicotine, Electronic cigarette, Propylene glycol

38

Exhaled aerosols were collected following the use of two leading U.S. commercial electronic cigarettes (e-cigarettes) and a conventional cigarette by human subjects and analyzed for phenolics, carbonyls, water, glycerin and nicotine using a vacuum-assisted filter pad capture system. Exhaled breath blanks were determined for each subject prior to each product use and aerosol collection session. Distribution and mass balance of exhaled e-cigarette aerosol composition was greater than 99.9% water and glycerin, and a small amount (<0.06%) of nicotine. Total phenolic content in exhaled e-cigarette aerosol was not distinguishable from exhaled breath blanks, while total phenolics in exhaled cigarette smoke were significantly greater than in exhaled e-cigarette aerosol and exhaled breaths, averaging 66 µg/session (range 36 to 117 µg/session). The total carbonyls in exhaled e-cigarette aerosols were also not distinguishable from exhaled breaths or room air blanks. Total carbonyls in exhaled cigarette smoke was significantly greater than in exhaled e-cigarette aerosols, exhaled breath and room air blanks, averaging 242 µg/session (range 136 to 352 µg/session). These results indicate that exhaled e-cigarette aerosol does not increase bystander exposure for phenolics and carbonyls above the levels observed in exhaled breaths of air.

Concepts: Smoking, Tobacco, Cigarette, Nicotine, Electronic cigarette, Propylene glycol, Glycerol, Cigarettes

34

The reasons for using electronic nicotine delivery systems (ENDS) are poorly understood and are primarily documented by expensive cross-sectional surveys that use preconceived close-ended response options rather than allowing respondents to use their own words. We passively identify the reasons for using ENDS longitudinally from a content analysis of public postings on Twitter. All English language public tweets including several ENDS terms (e.g., “e-cigarette” or “vape”) were captured from the Twitter data stream during 2012 and 2015. After excluding spam, advertisements, and retweets, posts indicating a rationale for vaping were retained. The specific reasons for vaping were then inferred based on a supervised content analysis using annotators from Amazon’s Mechanical Turk. During 2012 quitting combustibles was the most cited reason for using ENDS with 43% (95%CI 39-48) of all reason-related tweets cited quitting combustibles, e.g., “I couldn’t quit till I tried ecigs,” eclipsing the second most cited reason by more than double. Other frequently cited reasons in 2012 included ENDS’s social image (21%; 95%CI 18-25), use indoors (14%; 95%CI 11-17), flavors (14%; 95%CI 11-17), safety relative to combustibles (9%; 95%CI 7-11), cost (3%; 95%CI 2-5) and favorable odor (2%; 95%CI 1-3). By 2015 the reasons for using ENDS cited on Twitter had shifted. Both quitting combustibles and use indoors significantly declined in mentions to 29% (95%CI 24-33) and 12% (95%CI 9-16), respectively. At the same time, social image increased to 37% (95%CI 32-43) and lack of odor increased to 5% (95%CI 2-5), the former leading all cited reasons in 2015. Our data suggest the reasons people vape are shifting away from cessation and toward social image. The data also show how the ENDS market is responsive to a changing policy landscape. For instance, smoking indoors was less frequently cited in 2015 as indoor smoking restrictions became more common. Because the data and analytic approach are scalable, adoption of our strategies in the field can inform follow-up survey-based surveillance (so the right questions are asked), interventions, and policies for ENDS.

Concepts: Smoking, Tobacco, Cigarette, Nicotine, Electronic cigarette, Propylene glycol, Cigarettes, Amazon Mechanical Turk

33

IMPORTANCE Electronic cigarette (e-cigarette) use is increasing rapidly among adolescents, and e-cigarettes are currently unregulated. OBJECTIVE To examine e-cigarette use and conventional cigarette smoking. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional analyses of survey data from a representative sample of US middle and high school students in 2011 (n = 17 353) and 2012 (n = 22 529) who completed the 2011 and 2012 National Youth Tobacco Survey. EXPOSURES Ever and current e-cigarette use. MAIN OUTCOMES AND MEASURES Experimentation with, ever, and current smoking, and smoking abstinence. RESULTS Among cigarette experimenters (≥1 puff), ever e-cigarette use was associated with higher odds of ever smoking cigarettes (≥100 cigarettes; odds ratio [OR] = 6.31; 95% CI, 5.39-7.39) and current cigarette smoking (OR = 5.96; 95% CI, 5.67-6.27). Current e-cigarette use was positively associated with ever smoking cigarettes (OR = 7.42; 95% CI, 5.63-9.79) and current cigarette smoking (OR = 7.88; 95% CI, 6.01-10.32). In 2011, current cigarette smokers who had ever used e-cigarettes were more likely to intend to quit smoking within the next year (OR = 1.53; 95% CI, 1.03-2.28). Among experimenters with conventional cigarettes, ever use of e-cigarettes was associated with lower 30-day (OR = 0.24; 95% CI, 0.21-0.28), 6-month (OR = 0.24; 95% CI, 0.21-0.28), and 1-year (OR = 0.25; 95% CI, 0.21-0.30) abstinence from cigarettes. Current e-cigarette use was also associated with lower 30-day (OR = 0.11; 95% CI, 0.08-0.15), 6-month (OR = 0.11; 95% CI, 0.08-0.15), and 1-year (OR = 0.12; 95% CI, 0.07-0.18) abstinence. Among ever smokers of cigarettes (≥100 cigarettes), ever e-cigarette use was negatively associated with 30-day (OR = 0.61; 95% CI, 0.42-0.89), 6-month (OR = 0.53; 95% CI, 0.33-0.83), and 1-year (OR = 0.32; 95% CI, 0.18-0.56) abstinence from conventional cigarettes. Current e-cigarette use was also negatively associated with 30-day (OR = 0.35; 95% CI, 0.18-0.69), 6-month (OR = 0.30; 95% CI, 0.13-0.68), and 1-year (OR = 0.34; 95% CI, 0.13-0.87) abstinence. CONCLUSIONS AND RELEVANCE Use of e-cigarettes was associated with higher odds of ever or current cigarette smoking, higher odds of established smoking, higher odds of planning to quit smoking among current smokers, and, among experimenters, lower odds of abstinence from conventional cigarettes. Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among US adolescents.

Concepts: Smoking, Tobacco, Tobacco smoking, Cigarette, Nicotine, Electronic cigarette, Propylene glycol, Cigarettes