Summary
Introduction:
This text provides a scoping review of existing literature on biomarkers of exposure from electronic nicotine delivery systems (ENDS) use and identifies gaps in existing knowledge. The review compares biomarkers of exposure between exclusive ENDS users, non-users, exclusive cigarette smokers, dual users, and cigarette smokers who switched to ENDS.
Key Points:
* The review identified 27 studies that met the inclusion criteria and compared biomarkers of exposure between different user groups.
* Exclusive ENDS users have elevated levels of biomarkers of certain volatile organic compounds (VOCs), metals, and propylene glycol compared to non-users.
* Biomarkers of most VOCs are lower in ENDS users compared to cigarette smokers, and cigarette smokers who switch to ENDS consistently show reductions in VOC biomarkers.
* Evidence comparing metal exposures from exclusive ENDS use, cigarette smoking, and dual use is mixed and depends on the metal.
* ENDS and e-liquid characteristics, as well as use patterns, may be associated with elevated exposure to VOCs and metals.
* additional rigorous, controlled studies can assess biomarker exposures from ENDS use and inform the overall risk-benefit of ENDS use for different user populations.
Main Message:
The review suggests that while exclusive ENDS users have elevated levels of certain biomarkers of exposure compared to non-users, biomarkers of most VOCs are lower in ENDS users compared to cigarette smokers. however, evidence regarding metal exposures from ENDS use is mixed, and ENDS and e-liquid characteristics, as well as use patterns, may be associated with elevated exposure to VOCs and metals. Therefore, additional rigorous, controlled studies are needed to inform the overall risk-benefit of ENDS use for different user populations.
Citation
hiler M, Weidner aS, hull LC, Kurti aN, Mishina EV. Systemic biomarkers of exposure associated with ENDS use: a scoping review. Tobacco control. 2023;32(4):480-488. doi:10.1136/tobaccocontrol-2021-056896
