Characterization of Volatile Organic Compound Metabolites in Cigarette Smokers, Electronic Nicotine Device Users, Dual Users, and Nonusers of Tobacco.

Introduction:
This text provides an analysis of the Cardiovascular Injury due to Tobacco Use (CITU) study, which aims to evaluate cardiovascular toxicity caused by tobacco use and assess the role of volatile organic compounds (VOCs) in the causation of harm. The study includes both nonusers of tobacco and users of tobacco products, including cigarette smokers, ENDS users, and users of other tobacco products. This summary will highlight the study design, major points, and main message regarding the relationship between tobacco product use and VOC metabolites.

Key Points:

* The CITU study is a two-site, observational, cross-sectional study that enrolled 465 healthy participants aged 21-45 years.
* Participants were grouped into four tobacco product use categories: nonusers of tobacco, sole ENDS users, cigarette smokers, and dual users.
* VOC metabolite measurements were conducted using a modified version of the mass spectrometry method developed by the Centers for Disease Control and Prevention.
* Cigarette smokers and dual users had significantly elevated levels of most VOC metabolites compared to nonusers of tobacco.
* Sole ENDS users had significantly lower levels of most VOC metabolites compared to cigarette smokers and dual users, but higher levels of certain reactive aldehydes, such as acrolein, compared to nonusers of tobacco.
* The sensitivity analysis showed that the observed differences in VOC metabolite measures persisted after controlling for degree of nicotine exposure and time since last tobacco product use.
* Dual users had similar levels of all VOC metabolites, except for PGa, PhEMa, and 3Mha + 4Mha, compared to cigarette smokers.

Main Message:
The main message of this study is that sole ENDS use may be associated with lower VOC exposure compared to cigarette smoking, but further study is required to determine the potential health effects of higher levels of certain reactive aldehydes, such as acrolein, in ENDS users compared with nonusers of tobacco. additionally, ENDS use in conjunction with other tobacco products may not significantly reduce exposure to VOC, but sole use does generally reduce some VOC exposure and warrants more in-depth studies.

Keith RJ, Fetterman JL, Orimoloye Oa, et al. Characterization of Volatile Organic Compound Metabolites in Cigarette Smokers, Electronic Nicotine Device Users, Dual Users, and Nonusers of Tobacco. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2020;22(2):264-272. doi:10.1093/ntr/ntz021