E-Cigarette Solution and Health Effects

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E-Cigarette Solution and Health Effects

Components of Electronic Cigarette solutions generally include nicotine, flavoring chemicals, and other additives (including those unknown and/or unadvertised to the user).1 Currently, there are no federal quality standards to ensure the accuracy of e-cigarette constituents as advertised or labeled. Refillable cartridges allow the user to deliver other psychoactive substances, including marijuana.24 Numerous toxicants and carcinogens have been found in e-cigarette solutions, including aldehydes, tobacco-specific nitrosamines, metals, tobacco alkaloids, and polycyclic aromatic hydrocarbons.25,26 E-cigarette solution has also been shown to be cytotoxic to human embryonic stem cells.27

Nicotine is the major psychoactive component of e-cigarette solution.1 There are often wide discrepancies between the labeled amount and actual nicotine content within the solution.2 Reported nicotine concentration in e-cigarette solution ranges widely28,29 and, depending on how the product is used, can be comparable to or exceed the amount of nicotine in a single conventional cigarette.30 Nicotine is a highly addictive drug that can have lasting damaging effects on adolescent brain development and has been linked to a variety of adverse health outcomes, especially for the developing fetus.30,31 Nicotine has neurotoxic effects on the developing brain.32,33 In early adolescence, executive function and neurocognitive processes in the brain have not fully developed or matured. Adolescents are more likely to engage in experimentation with substances such as cigarettes, and they are also physiologically more vulnerable to addiction.34 The earlier in childhood an individual uses nicotine-containing products, the stronger the addiction and the more difficult it is to quit.35 The vast majority of adult smokers initiated tobacco use by 18 years of age.31

E-cigarette solutions are often flavored, with thousands of unique flavors advertised.36,37 Popular options include fruit, candy, and dessert flavors and are appealing to children and youth.36,37 Availability of flavors is among the most prominently cited reasons for youth e-cigarette use.38–40 Studies reveal that candy- or fruit-flavored e-cigarettes are more appealing than tobacco flavors to adolescents and young adults.41,42 Furthermore, adolescents perceive that e-cigarettes with flavors are less harmful than those with tobacco flavors,41 creating a potential misperception that e-cigarettes with flavors do not contain nicotine.8 Many of the flavoring chemicals contain aldehydes, known respiratory irritants, in sufficient concentrations to be of toxicologic concern.37 Flavorings (other than menthol) have been banned in conventional cigarettes since the Family Smoking Prevention and Tobacco Control Act of 2009 because flavoring encourages youth experimentation and regular use and results in addiction.16,43,44.u2022eney7485yyWEEEEDD