Abstract
Electronic nicotine delivery systems/devices (ENDS) such as electronic cigarettes (e-cigarettes) have been made available globally, with the intent to reduce tobacco smoking. To make these products more appealing to young adults, many brands have added flavoring agents. However, these flavoring agents are shown to progressively result in lung toxicity when inhaled via e-cigarettes. While recent federal regulations have banned the sale of flavored e-cigarettes other than tobacco or menthol flavors, concerns have been raised about the health effects of even these flavors. In this review, we evaluate the current toxicological data with regard to effects upon exposure in animal models and in vitro cell culture for these popular flavorants. We have tabulated the current e-cigarette products containing these most common flavors (menthol, mint, and tobacco) in the market. We have also indicated the prevalence of tobacco and menthol-flavor use among e-cigarette users and highlighted the possible challenges and benefits that will result from new federal regulations.
Highlights
E-cigarettes are a diverse group of products which allow for the inhalation of nicotine
Menthol cigarettes are popular in adolescents as a result of reinforcement and nicotine dependence and e-cigarette use in youth and young adults continues
Future regulation of e-cigarettes needs to take into consideration the health effects of both tobacco and menthol flavors and any ban that would include menthol flavors with specific injurious chemicals would need to be in combination with a ban of menthol/mint cigars and cigarettes
Summary
E-cigarettes are a diverse group of products which allow for the inhalation of nicotine. Finding: Regardless of e-cig vapor nicotine content, cells viability was reduced along with increased necrosis and apoptosis due to presence of substituents and tobacco flavors in test samples.
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