Abstract
Over the past decade, new emerging tobacco and nicotine-delivery products have changed the tobacco landscape. Especially, electronic cigarettes (ECs) have been suggested to be considered for tobacco harm reduction, reinforcing the need to identify novel biomarkers of exposure (BoE) specific to the EC use as this would complement exposure assessment and product compliance monitoring. Therefore, a sensitive LC-MS/MS method for the quantification of 1,2-propylene glycol (PG) and glycerol (G), the main e-liquid constituents, was established. PG and G were analyzed in plasma and urine samples from a clinical study comparing five nicotine product user groups, users of combustible cigarettes (CC), electronic cigarettes (EC), heated tobacco products (HTP), oral tobacco (OT), and oral/dermal nicotine delivery products (used for nicotine replacement therapy, NRT) with a control group of non-users (NU). Data demonstrate significantly elevated PG levels in urine and plasma in EC users compared to users of CC, HTP, NRT, OT as well as NU. In addition, PG in plasma and urine of vapers significantly correlated with nicotine (plasma) and total nicotine equivalents (urine), biomarkers reflecting product consumption, emphasizing the high specificity of PG as a BoE for EC consumption. We therefore suggest the use of PG as BoE in urine and/or plasma in order to monitor EC use compliance in exposure assessments.
Highlights
Over decades, the measurement of biomarkers of exposure (BoE) has contributed important data to evaluate the health risk from cigarette smoking [1]
Other relevant urinary biomarkers in tobacco smoke exposure assessment originate from tobacco-specific nitrosamines (TSNAs) (e.g., NNN, NNAL), polycyclic aromatic hydrocarbons (PAHs) (e.g., 1-hydroxypyrene, 3-hydroxybenzo[a]pyrene), aromatic amines, and mercapturic acids of volatile organic compounds (VOCs) (e.g., 3-HPMA, CEMA) [2,4,5,6,7,8,9]
standard deviations (SD): standard deviation, Min: minimum, Max: maximum; ***: Statistically significant from all other groups (p < 0.01). These results clearly demonstrate a separation between electronic cigarettes (ECs) users and other nicotine product user groups in terms of propylene glycol (PG) levels in plasma and urine
Summary
The measurement of biomarkers of exposure (BoE) has contributed important data to evaluate the health risk from cigarette smoking [1]. The tobacco landscape has changed, and a variety of new tobacco and nicotine-delivery products have been developed that pose a potentially reduced risk for the consumer as compared to smoking cigarettes. In 2015, Public Health England suggested to consider electronic cigarettes (ECs) for tobacco harm reduction, as complete switching could help reduce smoking related diseases [10]. They substantiated this claim in their most recent evidence update report in 2021 to which vaping of ECs is positively associated with successfully quitting smoking [11]. To our knowledge, there is as yet no specific BoE to distinguish the use of ECs from the concomitant use of other tobacco/ nicotine products (dual or multiple product use)
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