Abstract
We identified the most popular electronic cigarette (EC) refill fluids using an Internet survey and local and online sales information, quantified their flavor chemicals, and evaluated cytotoxicities of the fluids and flavor chemicals. “Berries/Fruits/Citrus” was the most popular EC refill fluid flavor category. Twenty popular EC refill fluids were purchased from local shops, and the ingredient flavor chemicals were identified and quantified by gas chromatography-mass spectrometry. Total flavor chemical concentrations ranged from 0.6 to 27.9 mg/ml, and in 95% of the fluids, total flavor concentration was greater than nicotine concentration. The 20 most popular refill fluids contained 99 quantifiable flavor chemicals; each refill fluid contained 22 to 47 flavor chemicals, most being esters. Some chemicals were found frequently, and several were present in most products. At a 1% concentration, 80% of the refill fluids were cytotoxic in the MTT assay. Six pure standards of the flavor chemicals found at the highest concentrations in the two most cytotoxic refill fluids were effective in the MTT assay, and ethyl maltol, which was in over 50% of the products, was the most cytotoxic. These data show that the cytotoxicity of some popular refill fluids can be attributed to their high concentrations of flavor chemicals.
Highlights
Information on adverse health effects of electronic cigarette (EC) comes from several sources
The online survey and identification of the top-selling refill fluids in local and Internet shops showed that EC users prefer “Berries/Fruit/Citrus” flavors with “Sweet”, “Candy”, “Bakery/Dessert”, and “Breakfast Cereal” being popular
Identification of the popular flavor categories enables research to focus on those that are most relevant to EC users
Summary
Information on adverse health effects of ECs comes from several sources. Adverse systemic effects, including inflammatory lung and digestive diseases, have been linked to EC use in case reports[5]. A systematic review on EC health effects collated data on EC flavor chemicals that have cytotoxic effects as well as information on particles, harmful metals, tobacco specific nitrosamines, and toxic carbonyl-containing degradation products[6]. In an in vitro study, EC refill fluids varied in their cytotoxicities when tested with embryonic and adult cells; products with high concentrations of flavor chemicals were often the most toxic[8]. Existing data suggest that high concentrations of flavor chemicals in EC may harm users. Www.nature.com/scientificreports survey and data from local and Internet vape shops, (2) identified and quantified the flavor chemicals in 20 popular refill fluids, (3) established which of the popular fluids are cytotoxic, and (4) identified the flavor chemical ingredients that are individually cytotoxic at concentrations found in the popular refill fluids
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