Risk analysis for the Carcinogen Pulegone in Mint- and Menthol-Flavored e-Cigarettes and Smokeless Tobacco Products.

Introduction:
This text provides an analysis of the health risks associated with the carcinogen pulegone, which is found in mint- and menthol-flavored e-cigarettes and smokeless tobacco products. The study calculates the margin of exposure (MOE) for pulegone in these products and compares it with the FDa's safety threshold. The text also examines the limitations of the study and its implications for regulatory policies.

Key Points:

* Pulegone is a carcinogen found in oil extracts of mint plants, including peppermint, spearmint, and pennyroyal.
* The FDa banned synthetic pulegone as a food additive in 2018 due to its carcinogenic properties.
* The CDC detected substantial amounts of pulegone in mint- and menthol-flavored e-cigarette liquids and smokeless tobacco products.
* The MOE for pulegone in e-cigarette liquids and smokeless tobacco products is below the safety threshold of 10,000, indicating a health risk.
* Daily pulegone exposure from e-cigarettes is higher than menthol cigarette use across all user groups.
* Extrapolation of MOEs derived from oral toxicity studies to inhalation exposure is a common practice among regulatory agencies.
* The study's limitations include considering only five e-liquids and one smokeless tobacco product, and following the FDa's risk assessment procedures, which are based on animal data.

Main Message:
The study's findings suggest that users of mint- and menthol-flavored e-cigarettes and smokeless tobacco products are exposed to pulegone levels higher than the FDa considers acceptable for intake of synthetic pulegone in food. The MOEs for all the products analyzed are below the accepted MOE threshold of 10,000 for carcinogens, indicating a health risk. Therefore, the FDa should address these concerns before suggesting mint- and menthol-flavored e-cigarettes and smokeless tobacco products as alternatives for people who use combustible tobacco products. The study highlights the need for further research on the health risks associated with pulegone exposure and the importance of regulatory policies in protecting public health.

Jabba SV, Jordt SE. Risk analysis for the Carcinogen Pulegone in Mint- and Menthol-Flavored e-Cigarettes and Smokeless Tobacco Products. JaMa internal medicine. 2019;179(12):1721-1723. doi:10.1001/jamainternmed.2019.3649