Abstract
IntroductionElectronic cigarette (ECIG) use or vaping has become popular globally. While the question “Is vaping safer than smoking?” continues, it is becoming clearer that one of the most dangerous components of E-liquids are the flavorings. Since the oral cavity is the first anatomical site to be assaulted by ECIG aerosol, the aim of this study is to test the hypothesis that flavored ECIG aerosols or E-liquids pose a more detrimental effect on the growth of commensal oral streptococcal bacteria compared to flavorless aerosols or E-liquids.MethodsKirby Bauer assays and 24-h planktonic growth curves were used to compare the effects of flavorless vs. flavored (tobacco, menthol, cinnamon, strawberry and blueberry) ECIG-generated aerosols and E-liquids on the growth of four common strains of oral commensal bacteria (Streptococcus gordonii, Streptococcus intermedius, Streptococcus mitis and Streptococcus oralis).ResultsKirby Bauer assays revealed inhibition of growth for all bacteria tested when exposed to 100% menthol, cinnamon or strawberry flavors. In contrast, 5% flavor in E-liquid had no effect. When exposed to 100 puffs of ECIG-generated aerosol ± flavors (≈ 0.05% flavor in brain heart infusion media) or an equivalent amount of E-liquid ± flavors, twenty-four hour planktonic growth curves indicated no effect on growth for all streptococci tested. Subsequent twenty-four hour planktonic growth curves testing the effects of E-liquid ± flavors (0.0625, 0.125, 0.25, 0.3125, 0.625, and 1.25% flavor in brain heart infusion media) revealed dose-dependent inhibition of growth, particularly for menthol, cinnamon and strawberry), for all bacteria tested.ConclusionThese results support the hypothesis that flavored E-liquids are more detrimental to the growth of oral commensal bacteria than unflavored E-liquids. The streptococci tested in this study are early colonizers and part of the foundation of oral biofilms and dental plaque. Disturbances in the composition and growth of these primary colonizers is crucial to the development of a healthy dental plaque and host-bacteria interactions. E-liquids and their aerosols containing flavoring agents alter the growth of these bacteria. Such perturbations of pioneering oral communities pose a potential risk to the health of the oral cavity and, ultimately, health in general.
Highlights
Electronic cigarette (ECIG) use or vaping has become popular globally.While the question “Is vaping safer than smoking?” continues, it is becoming clearer that one of the most dangerous components of E-liquids are the flavorings
Control (CDC) found that ECIG usage among high school students rose from 1.5%, in 2011 to 27.5% in 2019 (Jamal et al, 2017, 2011–2016; Center for Disease Control and Prevention, 2019a)
We evaluate the effects of various commercially available E-liquid flavorings on the growth of the four aforementioned early commensal bacterial colonizers
Summary
Electronic cigarette (ECIG) use or vaping has become popular globally.While the question “Is vaping safer than smoking?” continues, it is becoming clearer that one of the most dangerous components of E-liquids are the flavorings. Since E-liquid components, including flavoring agents are readily available for purchase online, this allows users to make their own E-liquid mixtures, in any proportions they choose, prior to vaping. Such freedom and “do it yourself ” approach to vaping allows for extreme contents of flavors and other illicit constituents in inhaled aerosols, exacerbating the potential to develop vapingrelated injuries and hospitalizations (Center for Disease Control and Prevention, 2019b; Fonseca Fuentes et al, 2019). In contrast to the decreasing nicotine usage from cigarettes among teens observed throughout the early 2000’s, nicotine usage is returning to levels not seen since the height of smoking popularity in the mid 1970’s; and many attribute this to a meteoric rise in ECIG popularity (Pampel and Aguilar, 2008; Center for Disease Control and Prevention, 2019a)
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