Evaluating Nicotine Levels Selection and Patterns of Electronic Cigarette use in a Group of “Vapers” Who Had Achieved Complete Substitution of Smoking
Konstantinos E. Farsalinos, Giorgio Romagna, Dimitris Tsiapras, Stamatis Kyrzopoulos, Vassilis Voudris
Nicotine levels appear to play an important role in achieving and maintaining smoking cessation in the group of motivated subjects studied. High nicotine-containing liquids were used while few mild and temporary side effects were reported. Proposals about regulation should consider the pragmatic use patterns of ECs, especially in consumers who have completely substituted smoking.
42% of participants reported quitting smoking during the first month of EC use.
Liquids with nicotine concentration >15 mg/mL were used by 74% of users at initiation of EC use, while 16.2% had to increase the initial nicotine levels in order to achieve complete smoking abstinence.
64.9% reported that from the time of smoking cessation to the time of the interview (8 months median duration of EC use) they reduced the nicotine concentration they were consuming.
The vast majority of participants reported better exercise capacity and improved olfactory and gustatory senses.
Perceived EC dependency was significantly lower compared to smoking.
Nicotine levels in electronic cigarettes
Maciej L. Goniewicz, Tomasz Kuma, Michal Gawron, Jakub Knysak, Leon Kosmider
Conclusion: “E-cigarettes (ECs) generate vapor that contains nicotine, but EC brands and models differ in their efficacy and consistency of nicotine vaporization. In ECs, which vaporize nicotine effectively, the amount inhaled from 15 puffs is lower compared with smoking a conventional cigarette.”
Protocol proposal for, and evaluation of, consistency in nicotine delivery from the liquid to the aerosol of electronic cigarettes atomizers: regulatory implications
Konstantinos E. Farsalinos, Nikoletta Yannovits, Theoni Sarri, Vassilis Voudris, Konstantinos Poulas
Electronic cigarettes that use tank‐type atomizers appear to deliver nicotine in more consistent quantities (within the acceptable limits for medicinal nebulizers and similar to the nicotine inhaler) than electronic cigarettes that use cartomizers.
The protocol for testing nicotine delivery consistency described in this paper could be used effectively for regulatory purposes.
Might limiting liquid nicotine concentration result in more toxic electronic cigarette aerosols?
Soha Talih, Rola Salman, Rachel El-Hage, Ebrahim Karam, Nareg Karaoghlanian, Ahmad El-Hellani, Najat Saliba, Thomas Eissenberg, Alan Shihadeh
Thus, if users seek a given nicotine yield, regulatory limits on nicotine concentration may have the unintended consequence of increasing exposure to aerosol and respiratory toxicants. This outcome demonstrates that attempting to control ECIG nicotine yield by regulating one factor at a time may have unintended health effects and highlights the need to consider multiple factors and outcomes simultaneously when designing regulations.
Reported patterns of vaping to support long-term abstinence from smoking: a cross-sectional survey of a convenience sample of vapers
Sarah Victoria Gentry, Emma Ward, Lynne Dawkins, Richard Holland, Caitlin Notley
Most attempts at smoking cessation result in relapse, and smokers generally make multiple quit attempts before succeeding.
Qualitative research suggests e-cigarettes can meet many of the needs of ex-smokers by substituting physical, psychological, social, cultural and identity-related aspects of tobacco addiction.
According to a time-series analysis of data from the Smoking Toolkit study, in which repeated cross-sectional surveys are conducted with a representative sample of households in England, increasing prevalence of e-cigarette use in current smokers was predictive of higher success rates of quit attempts.
Most participants were self-reported long-term abstinent smokers (86.3%).
Those who start on a low self-reported nicotine e-liquid concentration (strength) will be more likely to relapse to tobacco smoking than those starting on a higher nicotine e-liquid, after controlling for cigarettes per day (CPD) before cessation.
Results suggest a change in flavour choices over the course of vaping initiation and uptake. There was a reduction in the proportion of people using a tobacco flavour, and increase in the proportion using a fruit/sweet/food flavour, from initial to current flavour choice
According to the 2017 ASH-A survey, among current users, fruit flavours were the most popular.