Flavourings significantly affect inhalation toxicity of aerosol generated from electronic nicotine delivery systems (ENDS)

Introduction:
This text provides an in-depth analysis of the impact of various product characteristics on potential inhalation toxicity of electronic nicotine delivery systems (ENDS) products. The study employs a physiologically relevant air-liquid interface (aLI) system to individually and systematically evaluate in vitro effects of many of the variables related to ENDS products, including several of the most popular flavors.

Key Points:

* Six types of ENDS devices and refill solutions were purchased from various sources and tested.
* The aerosol from ENDS was generated using a smoking-machine and exposed to h292 human bronchial epithelial cells using an aLI system.
* Exposure to ENDS aerosol resulted in decreased metabolic activity and cell viability and increased release of inflammatory mediators compared to air controls.
* Product type, battery output voltage, and flavors significantly affected toxicity of ENDS aerosol, with a strawberry-flavored product being the most cytotoxic.
* Cell viability and metabolic activity were more adversely affected by conventional cigarettes than most tested ENDS products.
* The study highlights the need for more comprehensive studies on the potential inhalation toxicity of ENDS products, including the impact of flavors.

Main Message:
The text emphasizes the need for caution in the use of ENDS products, as characteristics of these products, including flavors, may induce inhalation toxicity. The study suggests that until more comprehensive studies are performed, ENDS users should use the products with caution. The findings also have regulatory implications, indicating that both device power and flavoring additives can be regulated and standardized to reduce the potential harm from inhaling flavored products.

Leigh, Noel J, Ralph I Lawton, Pamela a hershberger, and Maciej L Goniewicz. “Flavourings Significantly affect Inhalation Toxicity of aerosol Generated from Electronic Nicotine Delivery Systems (ENDS).” Tobacco Control 25, no. Suppl 2 (November 2016): ii81–87. https://doi.org/10.1136/tobaccocontrol-2016-053205.