Biomarkers of exposure and potential harm in exclusive users of electronic cigarettes and current, former, and never smokers.

Introduction:
This text provides an overview of a cross-sectional study that aimed to assess biomarkers of exposure (BoE) and biomarkers of potential harm (BoPh) in individuals who exclusively use electronic cigarettes (ECs), individuals who smoke, former smokers, and never smokers. The study used commercially available ECs and cigarettes and assessed participants' compliance with EC use and smoking abstinence.

Key Points:

* The study enrolled 213 participants, including 99 Vuse users, 40 smokers, 37 former smokers, and 37 never smokers.
* Compliance with EC use and smoking abstinence was assessed using a haemoglobin adduct of acrylonitrile (CEVal) in the Vuse user and former smoker groups.
* The study measured eight urinary tobacco toxicant BoE, including hMPMa, 3-hPMa, 3-Oh-B[a]P, MhBMa, total NNN, S-PMa, total NNaL, and TNeq.
* The study also measured seven BoPh, including 8-epi-PGF2α Type III, 11-dTX B2, COhb, sICaM-1, FeNO, FEV1%pred, and CIMT.
* The study found significantly lower levels of all BoE in CEVal-compliant participants who exclusively use Vuse ECs compared with participants who smoke.
* The study also found significantly lower levels of three BoPh, including COhb, sICaM-1, and 11-dTX B2, in CEVal-compliant participants who exclusively use Vuse ECs compared with participants who smoke.
* The study had some limitations, including the cross-sectional study design, which did not allow for repeated assessments of the same subjects over time.

Main Message:
The study provides evidence that individuals who exclusively use ECs are exposed to lower levels of tobacco smoke toxicants and have lower levels of certain BoPh compared with individuals who smoke. These findings support the role of ECs in tobacco harm reduction strategies. however, the study also highlights the need for further research to confirm these findings and to better understand the long-term health effects of EC use. Overall, the study suggests that ECs may be a less harmful alternative to smoking, but more research is needed to confirm their safety and efficacy in reducing tobacco-related harm.

haswell LE, Gale N, Brown E, et al. Biomarkers of exposure and potential harm in exclusive users of electronic cigarettes and current, former, and never smokers. Internal and emergency medicine. Published online May 30, 2023. doi:10.1007/s11739-023-03294-9