E-Cigarette Toxicology

Abstract

Since the spread of tobacco from the Americas hundreds of years ago, tobacco cigarettes and, more recently, alternative tobacco products have become global products of nicotine addiction. Within the evolving alternative tobacco product space, electronic cigarette (e-cigarette) vaping has surpassed conventional cigarette smoking among adolescents and young adults in the United States and beyond. This review describes the experimental and clinical evidence of e-cigarette toxicity and deleterious health effects. Adverse health effects related to e-cigarette aerosols are influenced by several factors, including e-liquid components, physical device factors, chemical changes related to heating, and health of the e-cigarette user (e.g., asthmatic). Federal, state, and local regulations have attempted to govern e-cigarette flavors, manufacturing, distribution, and availability, particularly to underaged youths. However, the evolving e-cigarette landscape continues to impede timely toxicological studies and hinder progress made toward our understanding of the long-term health consequence of e-cigarettes.

Keywords: cardiovascular; electronic cigarettes; respiratory; toxicology; vaping.

Figure 1

E-cigarettes: a historical timeline. Abbreviations: CDC, US Centers for Disease Control and Prevention; e-cigarette, electronic cigarette; EVALI, e-cigarette-or vaping-associated lung injury; FDA, US Food and Drug Administration; PMTA, premarket tobacco application.

Figure 2

Observed breakdown products of propylene glycol and glycerol.

Figure 3

Separate factors influencing the toxicity of cigarettes and e-cigarettes as nicotine-delivery devices.