Electronic Cigarettes: Toxicity and Addiction

Bashir M. Rezk*, Merhan E. Y. Khedr, Suresh C. Sikka, Wayne J. G. Hellstrom and Asim B. Abdel-Mageed

Electronic Cigarettes: Toxicity and Addiction

Cigarette smoking remains a leading cause of preventable disease and premature death in the United States and other countries.  Approximately, 2.5 million were non-smokers who died from heart disease or lung cancer caused by exposure to secondhand smoke (SHS). Generally, smoking causes 20% of deaths in the United States each year. Premature death from complications of smoking is approximately 50%. Electronic cigarettes [also known as e-cigarettes and electronic nicotine delivery systems (ENDS)] are battery-operated devices designed to deliver flavored nicotine to users in a vapor, as a substitute to conventional cigarettes, cigars, and pipes.

In May 2016, the National Institute of Drug Abuse (NIDA) reported that, the Food and Drug Administration (FDA) has finalized new regulations to prohibit minors from buying e-cigarettes in person or online. FDA now regulates the manufacturing, import, packaging, labeling, advertising, promotion, sale, and distribution of ENDS.

E-cigarettes usually contain major ingredients such as propylene glycol, glycerol, ethylene glycol and polyethylene glycol mixed with concentrated flavors, and optionally, a variable percentage of nicotine. These include tobacco specific nitrosoamines such as N-nitrosonicotine, N-nitrosoanabasine, N-nitrosoanabatine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, or tobacco-specific impurities such as cotinine, anabasine, and myosmine.

The e-cigarette aerosol also contained metals such as silver, iron, nickel, aluminum, silicate, chromium, lead, tin, and cadmium.12 The concentrations of these elements in e-cigarettes aerosol were higher than or equal to the corresponding concentrations in conventional cigarette smoke.12 Evaluating the potential harm associated with e-cigarette use requires detailed analysis of various aspects of these products and their metabolites, including their toxicological profiles.

Toxicol Forensic Med Open J. 2016; 1(2): e16-e18. doi: 10.17140/TFMOJ-1-e007