Abstract
BackgroundElectronic nicotine delivery systems (ENDS; e-cigarettes), consisting of a battery, heating element and e-liquid, have evolved significantly with wide variation in design, components, operating powers, and chemical constituents. Generated aerosols have been reported to contain potentially toxic substances. We conducted a systematic review to assess what is known about the presence of toxicants in ENDS aerosols in order to inform how system design could mitigate risk.MethodsArticles reporting on or evaluating design characteristics of ENDS and aerosol constituents were included and summarized.ResultsThe search identified 2,305 articles, of which 92 were included after full-text review. Findings were grouped into 6 major categories of potentially harmful chemicals: carbonyls, volatile organic chemicals, trace elements, reactive oxygen species and free radicals, polycyclic aromatic hydrocarbons, and tobacco-specific nitrosamines. In general, higher concentrations of aerosol toxicants are associated with increased power or voltage. Aerosol toxicants are also associated with e-liquid flavoring agents existing as primary ingredients or as products of thermal degradation.ConclusionsImproved ENDS design can reduce toxicant levels. Additional research is needed to develop a framework for optimizing system characteristics to minimize exposure, especially with respect to heating power and e-liquids. Both manufacturers and regulatory agencies have roles in reducing toxicants and potential health risks from ENDS.
Highlights
Electronic nicotine delivery systems (ENDS) consist of a battery, a heating element, and liquid (“e-liquid”)
Findings were grouped into 6 major categories of potentially harmful chemicals: carbonyls, volatile organic chemicals, trace elements, reactive oxygen species and free radicals, polycyclic aromatic hydrocarbons, and tobacco-specific nitrosamines
Aerosol toxicants are associated with e-liquid flavoring agents existing as primary ingredients or as products of thermal degradation
Summary
Electronic nicotine delivery systems (ENDS) consist of a battery, a heating element (usually consisting of a coil and wick), and liquid (“e-liquid”). The aerosols produced by ENDS have been reported to contain potentially toxic substances, which the user inhales [7]. No reviews have summarized the literature relating to the impact of ENDS design on all identified aerosol toxicants. Potential toxicants originate from eliquid components, degradation of ENDS materials, and reactions between the device and eliquid delivering chemicals such as VOCs, trace elements [12], and carbonyls such as formaldehyde, acrolein [13], and acetaldehyde [14]. Electronic nicotine delivery systems (ENDS; e-cigarettes), consisting of a battery, heating element and e-liquid, have evolved significantly with wide variation in design, components, operating powers, and chemical constituents. We conducted a systematic review to assess what is known about the presence of toxicants in ENDS aerosols in order to inform how system design could mitigate risk
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