HEALTH RISK ASSESSMENT AND TOXICITY ANALYSIS OF ELECTRONIC CIGARETTES
Keywords:
electronic cigarettes, nicotine, chemical flavours, smoking, vaping, cardiovascular, respiratory, toxicologyAbstract
Electronic cigarettes (e-cigarettes) have emerged as widely used alternatives to conventional tobacco products, particularly among adolescents and young adults, due to perceptions of reduced harm, appealing flavours, and ease of access. This review critically examines the toxicological profile of electronic cigarettes, focusing on their chemical composition, biological effects, and public health implications. E-cigarette aerosols typically contain nicotine, propylene glycol, glycerol, flavouring agents, vitamin E derivatives, and trace metals such as nickel, chromium, lead, and tin. Thermal degradation of e-liquids during heating can generate toxic aldehydes, including formaldehyde, acetaldehyde, and acrolein, which pose respiratory and cardiovascular risks. Experimental, clinical, and epidemiological evidence indicates associations between e-cigarette use and adverse outcomes such as lung injury (EVALI), oxidative stress, inflammation, endothelial dysfunction, increased cardiovascular risk, and potential carcinogenic effects. While e-cigarettes may expose users to fewer toxicants than conventional cigarettes, their long-term health effects remain insufficiently understood, especially in vulnerable populations such as adolescents and individuals with pre-existing respiratory disease.
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Przewozniak K, Przepiórka I, Cedzynska M. Are electronic nicotine delivery systems (ENDS) an effective aid in smoking cessation: a critical look. Tob Induc Dis. 2019;17(1).
Birdsey J. Tobacco product use among US middle and high school students-National Youth Tobacco Survey, 2023. MMWR Morb Mortal Wkly Rep. 2023;72. doi:10.15585/mmwr.mm7244a1.
Park-Lee E. Notes from the field: e-cigarette and nicotine pouch use among middle and high school students—United States, 2024. MMWR Morb Mortal Wkly Rep. 2024;73. doi:10.15585/mmwr.mm7335a3.
Tran LN, Rao G, Robertson NE, Hunsaker HC, Chiu EY, Poulin BA, Madl AK, Pinkerton KE, Britt RD, Nguyen TB. Quantification of free radicals from vaping electronic cigarettes containing nicotine salt solutions with different organic acid types and concentrations. Chem Res Toxicol. 2024;37(6):991-999.
Aherrera A, Lin JJ, Chen R, Tehrani M, Schultze A, Borole A, Tanda S, Goessler W, Rule AM. Metal concentrations in e-cigarette aerosol samples: a comparison by device type and flavour. Environ Health Perspect. 2023;131(12):127004. doi:10.1289/EHP11921.
Talih S, Salman R, Soule E, El-Hage R, Karam E, Karaoghlanian N, El-Hellani A, Saliba N, Shihadeh A. Electrical features, liquid composition and toxicant emissions from ‘pod-mod’-like disposable electronic cigarettes. Tob Control. 2022;31(5):667-670.
Subramaniam GA, Nolan L, Huntley K, Corbin M, Crenshaw K, Mandell T, Linton J, Blackeney Q. National Institute on Drug Abuse: dissemination of scientific knowledge to improve adolescent health. Child Adolesc Psychiatr Clin N Am. 2023;32(1):157-167.
Yagi BF, Lushniak B, Miller BJ. Appropriate for the protection of the public health: why we need electronic nicotine delivery system product standards. Food Drug Law J. 2023;78:16-28.
North C, Loukas A, Harrell MB, Pasch KE, Marti CN, Wilkinson AV. Most commonly used vaping brands by 18–25-year-old young adults in Texas-Spring 2023. PLoS One. 2024;19(5):e0300454.
Balasekarreddy C, Awen B, Sreekanth N, Ramalingam P. Validated HPLC method for determination of lamivudine and stavudine in their formulations. Pharmanest. 2010;1:22-28.
Daynard R. Public health consequences of e-cigarettes: a consensus study report of the National Academies of Sciences, Engineering, and Medicine. J Public Health Policy. 2018;39(4):500-502. doi:10.1057/s41271-018-0132-1.
Konda RK, Chandu BR, Sekhar KBC. An improved HPLC-UV method for the estimation of irinotecan in bulk and tablet dosage form. Int J Pharm. 2011;2(3):188-191.
Tang MS, Tang YL. Can electronic-cigarette vaping cause cancer? J Cancer Biol. 2021;2(3):68-70.
Vindhyal MR, Ndunda P, Munguti C, Vindhyal S, Okut H. Impact on cardiovascular outcomes among e-cigarette users: a review from National Health Interview Surveys. J Am Coll Cardiol. 2019;73(9 Suppl 2):11.
Eaton DL, Kwan LY, Stratton K, National Academies of Sciences Engineering and Medicine. Toxicology of e-cigarette constituents. In: Public health consequences of e-cigarettes. Washington (DC): National Academies Press; 2018.
Hiremath P, Patange RP, Salunkhe JA, Mohite VR, Pawar A, Mulani A. Maternal tobacco use and risk for congenital anomalies. Int J Community Med Public Health. 2019;6:1472-1475. doi:10.18203/2394-6040.ijcmph20191032.
Sanaka S, Chandu BR, Nama S. The behaviour and toxicity of nanoparticles. Int J Adv Pharm Biol Chem. 2012;1:315-324.
Vargees C, Stroup AM, Niznik T, Dunn D, Wyatt R, Hoetger C, Taleb ZB, Cohn AM, Cobb CO, Fetterman JL. Patterns of use, perceptions, and cardiopulmonary health risks of cigar products: a systematic review. BMC Public Health. 2023;23(1):2357. doi:10.1186/s12889-023-17216-z.
Chen-Sankey J, La Capria K, Glasser A, Padon AA, Moran MB, Wagoner KG, Jackson KM, Berg CJ. Associations between e-cigarette marketing exposure and vaping nicotine and cannabis among US adults, 2021. Addict Behav. 2024;157:108090. doi:10.1016/j.addbeh.2024.108090.
Vennela B, Shirisha V, Rao CB, Gullapalli V, Batsala M. Current and future strategies for therapy of pancreatic cancer. Int J Res Pharm Med. 2012;2(3):728-740.
Beutel MW, Harmon TC, Novotny TE, Mock J, Gilmore ME, Hart SC, Traina S, Duttagupta S, Brooks A, Jerde CL, Hoh E. A review of environmental pollution from the use and disposal of cigarettes and electronic cigarettes: contaminants, sources, and impacts. Sustainability. 2021;13(23):12994. doi:10.3390/su132312994.
Papaefstathiou E, Stylianou M, Agapiou A. Main and side stream effects of electronic cigarettes. J Environ Manage. 2019;238:10-17. doi:10.1016/j.jenvman.2019.01.030.
Schober W, Szendrei K, Matzen W, Osiander-Fuchs H, Heitmann D, Schettgen T, Jörres RA, Fromme H. Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers. Int J Hyg Environ Health. 2014;217(6):628-637. doi:10.1016/j.ijheh.2013.11.003.
Rubinstein ML, Delucchi K, Benowitz NL, Ramo DE. Adolescent exposure to toxic volatile organic chemicals from e-cigarettes. Pediatrics. 2018;141(4). doi:10.1542/peds.2017-3557.
Staudt MR, Salit J, Kaner RJ, Hollmann C, Crystal RG. Altered lung biology of healthy never smokers following acute inhalation of e-cigarettes. Respir Res. 2018;19(1):78. doi:10.1186/s12931-018-0778-z.
Nocella C, Biondi-Zoccai G, Sciarretta S, Peruzzi M, Pagano F, Loffredo L, Pignatelli P, Bullen C, Frati G, Carnevale R. Impact of tobacco versus electronic cigarette smoking on platelet function. Am J Cardiol. 2018;122(9):1477-1481. doi:10.1016/j.amjcard.2018.07.029.
Nama S, Chandu BR, Awen BZ, Khagga M. Development and validation of a new RP-HPLC method for the determination of aprepitant in solid dosage forms. Trop J Pharm Res. 2011;10(4):489-495.
Hwisa NT, Gindi S, Rao CB, Katakam P, Chandu BR. Evaluation of antiulcer activity of Picrasma quassioides Bennett aqueous extract in rodents. Vedic Res Int Phytomedicine. 2013;1:27-31
Kala S, Juyal D. Investigating the Synergistic Potential of Combination of Natural Penetration Enhancers and a Synthetic Drug in Animal Model for Improved Transdermal Delivery. Indian Journal of Animal Research. 2025 Feb 1;59(2).
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