Nicotine absorption during electronic cigarette use among regular users.

Jessica M Yingst,Travis T Nichols,John P Richie,Stephen J Wilson,Thomas T Eissenberg,Jill Williams,Shari Hrabovsky,Andrea L Hobkirk,Susan Veldheer,Neil Trushin,Jonathan Foulds,Michael Cummings

doi:10.1371/journal.pone.0220300

Abstract

BackgroundThe capability of electronic cigarette devices (e-cigs) to deliver nicotine is key to their potential to replace combustible cigarettes. We compared nicotine delivery and subjective effects associated with the use of two classes of e-cigarettes and cigarettes.Methods14 e-cigarette users were instructed to vape their own e-cigarette device every 20 seconds for 10 minutes while blood was drawn at 1, 2, 4, 6, 8, 10,12, and 15 minutes after initiating vaping. Users rated withdrawal symptoms and side effects before and after vaping. E-cigarette devices were classified as first-generation (same size as cigarette, no activation button) or advanced (larger than cigarette with an activation button). Separately, 10 cigarette smokers completed a similar protocol. Fisher’s Exact Test and two-sided t-tests were used as appropriate to determine differences in outcomes between first-generation e-cigarette users, advanced e-cigarette users, and smokers.ResultsCompared to first-generation devices, advanced devices were associated with greater serum nicotine Cmax (ng/ml) (11.5 v. 2.8, p = 0.0231) and greater nicotine boost (ng/ml) (10.8 v. 1.8, p = 0.0177). Overall, e-cigarettes users experienced a significant reduction in withdrawal and craving, although there were no significant differences between users of first-generation and advanced devices. Comparing e-cigarettes overall to cigarettes, cigarettes were associated with greater Cmax (25.9 v. 9.0, p = 0.0043) and greater nicotine boost (21.0 v. 8.2, p = 0.0128).ConclusionsAdvanced e-cigarettes delivered significantly more nicotine than first-generation devices but less than combustible cigarettes. Overall, e-cigarette use was associated with a reduction in withdrawal and craving with no reported side effects. The wide variation in nicotine absorption from different e-cigarette devices should be considered in studies of e-cigarettes for smoking cessation.

Highlights

Tobacco use, combustible cigarette smoking, remains the leading cause of premature death in the United States [1]
Compared to first-generation devices, advanced devices were associated with greater serum nicotine Cmax (11.5 v. 2.8, p = 0.0231) and greater nicotine boost (10.8 v. 1.8, p = 0.0177)
E-cigarettes users experienced a significant reduction in withdrawal and craving, there were no significant differences between users of first-generation and advanced devices

Summary

Introduction

Combustible cigarette smoking, remains the leading cause of premature death in the United States [1]. As the FDA works to design and implement regulations that will reduce the addictiveness and potential harms associated with combustible cigarette smoking, attention has shifted towards the role of a new tobacco product, generally referred to as an electronic cigarette (e-cigarette). The rate and amount of nicotine absorption from e-cigarettes is likely to influence both their ability to replace combustible cigarette use and their dependence potential. Studies have reported that approximately a quarter of e-cigarette users are first-generation users while about three quarters of users use advanced devices, including modified devices [5, 7, 8]. The capability of electronic cigarette devices (e-cigs) to deliver nicotine is key to their potential to replace combustible cigarettes. We compared nicotine delivery and subjective effects associated with the use of two classes of e-cigarettes and cigarettes

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