A biomonitoring assessment of secondhand exposures to electronic cigarette emissions.

BACKGROUND: Electronic cigarette (e-cigarette) conventions regularly bring together thousands of users around the world. In these environments, secondhand exposures to high concentrations of e-cigarette emissions are prevalent. Some biomarkers for tobacco smoke exposure may be used to characterize secondhand e-cigarette exposures in such an environment. METHODS: Participants who did not use any tobacco product attended four separate e-cigarette events for approximately six hours. Urine and saliva samples were collected from participants prior to the event, immediately after the event, 4-h after the event, and the next morning (first void). Urine samples from 34 participants were analyzed for cotinine, trans-3'-hydroxycotinine, S-(3-hydroxypropyl)-N-acetylcysteine (3-HPMA), S-carboxyethyl-N-acetylcysteine (CEMA), select tobacco-specific nitrosamines (TSNAs), and 8-isoprostane. Saliva samples were analyzed for cotinine and trans-3'-hydroxycotinine. RESULTS: Data from 28 of 34 participants were used in the data analysis. Creatinine-adjusted urinary cotinine concentrations increased up to 13-fold and peaked 4-h after completed exposure (range of adjusted geometric means [AGMs] = 0.352-2.31 µg/g creatinine). Salivary cotinine concentrations were also the highest 4-h after completed exposure (range of AGMs = 0.0373-0.167 ng/mL). Salivary cotinine and creatinine-corrected concentrations of urinary cotinine, trans-3'-hydroxycotinine, CEMA, and 3-HPMA varied significantly across sampling times. Urinary and salivary cotinine, urinary trans-3'-hydroxycotinine, and urinary 3-HPMA concentrations also varied significantly across events. CONCLUSION: Secondhand e-cigarette exposures lasting six hours resulted in significant changes in exposure biomarker concentrations of both nicotine and acrolein but did not change exposure to tobacco-specific nitrosamines. Additional research is needed to understand the relationship between biomarker concentrations and environmental concentrations of toxicants in e-cigarette emissions.

Air monitoring at large public electronic cigarette events.

BACKGROUND: Electronic cigarette (e-cigarette) conventions bring hundreds to thousands of e-cigarette users together socially regularly across the world. E-cigarette secondhand exposures to chemicals in this environment, likely the public setting with the highest concentration of e-cigarette secondhand aerosol, have not been characterized. METHODS: Air sampling for formaldehyde, acetaldehyde, acrolein, nicotine, and propylene glycol was conducted at three e-cigarette conventions and one smaller event from April 2016 to March 2017 in three states in the Southeastern United States. Volunteers attended the events as members of the public and wore backpacks containing air sampling pumps. Control sampling was conducted when venues were crowded for non-e-cigarette events. Additional control sampling was conducted in two venues when they were empty. RESULTS: Formaldehyde and acetaldehyde concentrations during e-cigarette events were comparable to background concentrations. The median formaldehyde concentrations during events, crowded control events, and empty control events were 12.0, 10.5, and 12.5 µg/m3, respectively. The median acetaldehyde concentrations during events, crowded control events, and empty control events were 9.7, 15.5, and 3.5 µg/m3, respectively. Propylene glycol and nicotine were not detected during control sampling. The median nicotine concentration during events was 1.1 µg/m3. The median propylene glycol concentration during events was 305.5 µg/m3. CONCLUSION: Results indicate e-cigarette secondhand exposures are sources of elevated nicotine and propylene glycol exposures. Secondhand exposures to e-cigarettes did not contain consistently elevated concentrations of formaldehyde or acetaldehyde. Additional research is needed to characterize exposures via inhalation to propylene glycol at concentrations measured in this study.

Elevated Nicotine Dependence Scores among Electronic Cigarette Users at an Electronic Cigarette Convention.

Electronic cigarette (e-cigarette) conventions are trade shows held across the globe to promote e-cigarette products and provide a venue for users to socialize. E-cigarette users that attend these events likely represent the most intensive e-cigarette user group. No study has characterized addiction and behavior characteristics in this population. We surveyed 131 e-cigarette users attending a large Southeastern e-cigarette convention in Fall 2015. All questions from the Fagerstrom Test for Nicotine Dependence (FTND), select questions from the Penn State Electronic Cigarette Dependence Index, and novel user behavior questions were included. In total, 25 questions were included in the survey. FTND scores were calculated for each respondent who answered all six FTND questions (n = 117). Fisher's Exact Chi square test was used to assess the relationship between addiction and behavior characteristics and FTND scores. Most respondents were classified as moderately dependent (score 5-7, 45.3% of respondents). Length of use, waking at night to use an e-cigarette, strength of cravings, strength of urges over the past week, and frequency of visiting e-cigarette blogs were significantly associated with FTND scores. E-cigarettes users have average FTND scores higher than tobacco smokers. Scores were not significantly associated with prior tobacco cigarette use. Characteristics associated with tobacco smokers' nicotine addiction, such as waking at night to smoke and strength of cravings experienced, are relevant to e-cigarette users. E-cigarettes do not contain the magnitude of toxicants in tobacco cigarettes, but e-cigarettes may produce new chemical exposures evidenced by the adverse health effects reported by some respondents.