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. 2025 Jan 1:266:112508.
doi: 10.1016/j.drugalcdep.2024.112508. Epub 2024 Nov 28.

Dose by design: How limits on nicotine flux and puff duration affect the abuse liability of electronic nicotine delivery systems

Rose S Bono  1 , Augustus M White  1 , Rabia Imran  2 , Gabrielle T Maldonado  2 , Thokozeni Lipato  3 , Andrew J Barnes  4 , Caroline O Cobb  2
Affiliations

Dose by design: How limits on nicotine flux and puff duration affect the abuse liability of electronic nicotine delivery systems

Rose S Bono et al. Drug Alcohol Depend. .

Abstract

Introduction: Electronic nicotine delivery system (ENDS) product standards for nicotine flux (nicotine emitted/second), combined with limiting puff duration, could control nicotine dose and support ENDS regulations. We assessed behavioral and subjective abuse liability indices for ENDS varying in nicotine flux with fixed puff duration among people who smoke.

Methods: This within-subjects study included 32 adults who smoked cigarettes. Own-brand cigarettes (OB) and four unflavored ENDS were evaluated: no-flux (0μg/s), low-flux (36.01μg/s), cigarette-like-flux (90.03μg/s), and high-flux (180.06μg/s), with ENDS puff duration limited to 2s. Outcomes from behavioral economic choice tasks included demand intensity (drug purchase task [DPT]), cross-price elasticity (cross-product DPT), puffs earned (progressive ratio task [PRT]), and breakpoint (cross-product PRT). Subjective effects were nicotine abstinence symptoms (NAS), aversive effects, product liking, and sensation. Condition differences were analyzed using linear mixed models.

Results: All ENDS were associated with significantly lower demand intensity, puffs earned, NAS suppression, and liking compared to OB, yet would serve as OB substitutes. Low-flux ENDS were a significantly stronger OB substitute than cigarette-like-flux ENDS, and were associated with more puffs earned than no and high-flux ENDS. Compared with other ENDS, high-flux ENDS generally reduced NAS more, were less pleasant, tasted worse and produced more intense harshness/irritancy and throat hit.

Conclusions: ENDS abuse liability and substitution potential varies by nicotine dose, which could be controlled via product standards integrating nicotine flux and puff duration. ENDS that exceed a cigarette nicotine dose may not be necessary to encourage transition from cigarettes to ENDS.

Keywords: Abuse liability; Clinical laboratory; Electronic nicotine delivery systems; Nicotine flux; Subjective effects.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
Session timeline Abbreviations. eCO: exhaled carbon monoxide. ENDS: electronic nicotine delivery system. Min: minutes. OB: own-brand cigarette. Physio: Physiological. Asterisks (*) represent approximate times of product administration.
Figure 2.
Figure 2.
Overview of significant differences in subjective effects across ENDS conditions (N=32) Abbreviations. No: no-flux ENDS. Low: low-flux ENDS. Cig-like: Cigarette-like-flux ENDS. High: high-flux ENDS. This figure provides a summary of the significance and direction of pairwise differences (assessed using Wald tests following linear mixed effects regression) in subjective effects between ENDS flux conditions (p<0.05). Upward arrows (↑) in dark gray-shaded cells indicate that scores for the ENDS flux condition in the first row is significantly higher on a given item than the ENDS flux condition listed in the second row; for example, the no-flux ENDS was associated with significantly greater ratings of “Anxious” than the high-flux ENDS. Down arrows (↓) in light gray-shaded cells indicate that scores for the ENDS flux condition in the first row are significantly lower on a given item than the ENDS flux condition listed in the second row. Blank cells indicate no significant difference between the two conditions.
Figure 3.
Figure 3.
Sensation intensity and sensation liking for own-brand cigarettes and ENDS varying in nicotine flux (N=32)
See this image and copyright information in PMC

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