Should we worry about children’s exposure to third-hand by-products generated from electronic nicotine delivery systems?

Introduction:
This article discusses the potential dangers of third-hand exposure to chemicals generated by electronic nicotine delivery systems (ENDS), such as e-cigarettes. While much is known about the health effects of first-hand and second-hand smoke from traditional cigarettes, less is known about the long-term effects of ENDS on users and non-users. The authors outline the potential impact of third-hand exposure, which occurs when residual chemicals from ENDS use settle on surfaces and clothing, and can be inhaled or ingested.

Key Points:

* approximately 7% of former smokers have quit tobacco smoking by switching to ENDS.
* however, a high number of young adults become addicted to nicotine by using ENDS products.
* The safety of ENDS is in question, especially with the recent vaping-associated pulmonary injury outbreak and growing evidence of potential harmful effects.
* Most people are not aware of the potential impact of third-hand exposure, which can occur in homes, vehicles, and other indoor locations where ENDS have been used.
* The vapor from ENDS contains a variety of chemicals, including propylene glycol (PG), vegetable glycerin (VG), glycerol, flavors, and nicotine.
* a recent study found that third-hand ENDS vapor reduced lung inflammatory responses and altered immune responses and organ development in young mice.
* Certain populations, such as infants and patients with underlying kidney disease, may be more susceptible to the effects of third-hand ENDS exposure.
* The authors call for further research to determine the safety of ENDS and the potential impact of third-hand exposure, particularly in children.

Main Message:
The potential dangers of third-hand exposure to chemicals generated by ENDS are a significant concern, particularly for children and other vulnerable populations. While more research is needed, it is clear that the use of ENDS is not without risk, and users and non-users alike should be aware of the potential dangers. Regulators should take these risks into account when considering the safety and regulation of ENDS products.

Nath S, Geraghty P. Should we worry about children’s exposure to third-hand by-products generated from electronic nicotine delivery systems? ERJ open research. 2020;6(2). doi:10.1183/23120541.00194-2020