Electronic cigarette menthol flavoring is associated with increased inhaled micro and sub-micron particles and worse lung function in combustion cigarette smokers.

Introduction:
This text presents a study investigating the impact of menthol flavoring in electronic cigarettes (ECs) on inhaled particle quantity and lung function. The study utilizes a robotic system called hUMITIPaa to analyze the particle count and size of EC aerosols, and performs a retrospective analysis of the COPDGene study to complement the preclinical findings.

Key Points:

* The study finds that the addition of menthol flavoring to ECs leads to enhanced particle count, specifically for larger particle sizes.
* The use of menthol-flavored ECs is associated with worse clinical outcomes, including reduced FEV1 and FEV1/FVC, even after adjustment for age, gender, race, pack-years of smoking, and use of nicotine or cannabis-containing vaping products.
* The hUMITIPaa system provides a more appropriate preclinical tool for inhalation toxicology of ECs compared to existing state-of-the-art models.
* The study demonstrates the importance of considering the physical and chemical characteristics of EC aerosols in assessing their potential health effects.
* The use of menthol-flavored ECs may have multiple harmful consequences for the lungs due to the increased aerosolization of EC aerosol quantity.
* Limitations of the study include the lack of analysis of particles less than 300 nm, focus on physical characteristics only, and the use of menthol-flavored combustion cigarettes as a potential confounder in the clinical study.

Main Message:
The study highlights the negative impact of menthol-flavored ECs on lung function and inhaled particle quantity, providing new evidence to support the regulation of these products. The utilization of hUMITIPaa as a predictive technology can identify the pulmonary toxicity potential of ECs when the chemical formulation of e-liquid has been modified. The findings emphasize the importance of considering both the physical and chemical characteristics of EC aerosols in assessing their potential health effects and the need for further research to establish a robust relation between menthol-flavored ECs and altered lung function.

Chandra D, Bogdanoff RF, Bowler RP, Benam Kh. Electronic cigarette menthol flavoring is associated with increased inhaled micro and sub-micron particles and worse lung function in combustion cigarette smokers. Respiratory research. 2023;24(1):108. doi:10.1186/s12931-023-02410-9