Comparison of Nicotine and Toxicant Exposure in Users of Electronic Cigarettes and Combustible Cigarettes

Introduction:
This text provides an analysis of the Population assessment of Tobacco and health (PaTh) Study, which examines the relationship between tobacco use and health among never, current, or recent former tobacco product users in the US noninstitutionalized adult civilian population. The study focuses on biomarkers of exposure to tobacco-related toxicants that are addictive or potentially harmful to human health.

Key Points:

* The study examined 50 biomarkers of exposure to tobacco-related toxicants, including nicotine metabolites, tobacco-specific nitrosamines (TSNas), metals, polycyclic aromatic hydrocarbons (Pahs), and volatile organic compounds (VOCs).
* The study compared biomarkers of exposure among four current tobacco user groups: exclusive users of e-cigarettes (e-cigarette-only users), exclusive users of combusted tobacco cigarettes (cigarette-only smokers), dual users of combusted tobacco cigarettes and e-cigarettes (dual users), and never tobacco product users (reference group).
* The study found that e-cigarette-only users had significantly lower geometric mean concentrations of all TSNas, most Pahs, and most VOCs compared with cigarette-only smokers.
* Dual users exhibited higher concentrations of exposure to nearly all biomarkers compared with cigarette-only smokers.
* Several biomarkers measured in this study are metabolites of known carcinogens as well as respiratory, cardiovascular, and/or reproductive/developmental toxicants.
* The study did not evaluate the association between exposure and disease among exclusive e-cigarette users or dual users.
* The study suggests that users of e-cigarettes should be aware that these products are sources of exposure to toxicants that are linked to illness, but the degree to which such e-cigarette-related toxicant exposures affect disease incidence merits further research.

Main Message:
The study highlights the importance of understanding the health effects of e-cigarette use and the need for further research to evaluate the association between exposure and disease among exclusive e-cigarette users or dual users. The findings suggest that using combusted tobacco cigarettes alone or in combination with e-cigarettes is associated with higher concentrations of potentially harmful tobacco constituents in comparison with using e-cigarettes alone. Therefore, it is crucial to regulate e-cigarettes and other tobacco products to protect public health.

Goniewicz, Maciej L., Danielle M. Smith, Kathryn C. Edwards, Benjamin C. Blount, Kathleen L. Caldwell, Jun Feng, Lanqing Wang, et al. “Comparison of Nicotine and Toxicant Exposure in Users of Electronic Cigarettes and Combustible Cigarettes.” JaMa Network Open 1, no. 8 (December 14, 2018): e185937. https://doi.org/10.1001/jamanetworkopen.2018.5937.