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Published in: Current Allergy and Asthma Reports 11/2017

01-11-2017 | Allergies and the Environment (M Hernandez, Section Editor)

Electronic Cigarettes: Their Constituents and Potential Links to Asthma

Authors: Phillip W. Clapp, Ilona Jaspers

Published in: Current Allergy and Asthma Reports | Issue 11/2017

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Abstract

Purpose of Review

Vaping is gaining popularity in the USA, particularly among teens and young adults. While e-cigs are commonly represented as safer alternatives to tobacco cigarettes, little is known regarding the health effects of their short- or long-term use, especially in individuals with pre-existing respiratory diseases such as asthma. Flavored e-cig liquids (e-liquids) and e-cig aerosols contain airway irritants and toxicants that have been implicated in the pathogenesis and worsening of lung diseases. In this review, we will summarize existing data on potential health effects of components present in e-cig aerosols, such as propylene glycol, vegetable glycerin, nicotine, and flavorings, and discuss their relevance in the context of asthma.

Recent Findings

Recent survey data indicate that adolescents with asthma had a higher prevalence of current e-cig use (12.4%) compared to their non-asthmatics peers (10.2%) and conveyed positive beliefs about tobacco products, especially e-cigs. Similarly, a study conducted among high school students from Ontario, Canada, indicated a greater likelihood of e-cig use in asthmatics as compared to their non-asthmatic peers. Availability of different flavorings is often cited as the main reason among youth/adolescents for trying e-cigs or switching from cigarettes to e-cigs. Occupational inhalation of some common food-safe flavoring agents is reported to cause occupational asthma and worsen asthmatic symptoms. Moreover, workplace inhalation exposures to the flavoring agent diacetyl have caused irreversible obstructive airway disease in healthy workers. Additionally, recent studies report that thermal decomposition of propylene glycol (PG) and vegetable glycerin (VG), the base constituents of e-liquids, produces reactive carbonyls, including acrolein, formaldehyde, and acetaldehyde, which have known respiratory toxicities. Furthermore, recent nicotine studies in rodents reveal that prenatal nicotine exposures lead to epigenetic reprogramming in the offspring, abnormal lung development, and multigenerational transmission of asthmatic-like symptoms.

Summary

Comparisons of the toxicity and health effects of e-cigs and conventional cigarettes often focus on toxicants known to be present in cigarette smoke (CS) (i.e., formaldehyde, nitrosamines, etc.), as well as smoking-associated clinical endpoints, such as cancer, bronchitis, and chronic obstructive pulmonary disease (COPD). However, this approach disregards potential toxicity of components unique to flavored e-cigs, such as PG, VG, and the many different flavoring chemicals, which likely induce respiratory effects not usually observed in cigarette smokers.
Literature
1.
go back to reference Organization WH. WHO global report on mortality attributable to tobacco. 2012. Organization WH. WHO global report on mortality attributable to tobacco. 2012.
2.
go back to reference Courtney R. The health consequences of smoking—50 years of progress: a report of the surgeon general, 2014 US Department of Health and Human Services Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 20141081 pp. Online (grey literature): http://www/. surgeongeneral. gov/library/reports/50-years-of-progress. Drug Alcohol Rev. 2015;34(6):694–5.CrossRef Courtney R. The health consequences of smoking—50 years of progress: a report of the surgeon general, 2014 US Department of Health and Human Services Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 20141081 pp. Online (grey literature): http://​www/​.​ surgeongeneral. gov/library/reports/50-years-of-progress. Drug Alcohol Rev. 2015;34(6):694–5.CrossRef
3.
go back to reference Garrett BE, Dube S, Trosclair A, Caraballo R, Pechacek T. Cigarette smoking-United States, 1965–2008. MMWR Surveill Summ. 2011;60:109–13. Garrett BE, Dube S, Trosclair A, Caraballo R, Pechacek T. Cigarette smoking-United States, 1965–2008. MMWR Surveill Summ. 2011;60:109–13.
4.
go back to reference Eaton DK, Kann L, Kinchen S, Shanklin S, Flint KH, Hawkins J, et al. Youth risk behavior surveillance—United States, 2011. Morb Mortal Wkly Rep Surveill Summ. 2012;61(4):1–162. Eaton DK, Kann L, Kinchen S, Shanklin S, Flint KH, Hawkins J, et al. Youth risk behavior surveillance—United States, 2011. Morb Mortal Wkly Rep Surveill Summ. 2012;61(4):1–162.
7.
go back to reference Elders MJ, Perry CL, Eriksen MP, Giovino GA. The report of the Surgeon General: preventing tobacco use among young people. Am J Public Health. 1994;84(4):543–7. Elders MJ, Perry CL, Eriksen MP, Giovino GA. The report of the Surgeon General: preventing tobacco use among young people. Am J Public Health. 1994;84(4):543–7.
13.
go back to reference • Sleiman M, Logue JM, Montesinos VN, Russell ML, Litter MI, Gundel LA, et al. Emissions from electronic cigarettes: key parameters affecting the release of harmful chemicals. Environ Sci Technol. 2016;50(17):9644–51. https://doi.org/10.1021/acs.est.6b01741. This study quantified potentially toxic compounds in e-cig aerosol emissions and identified key parameters affecting toxic compound generation, including heating coil configuration and applied voltage. PubMedCrossRef • Sleiman M, Logue JM, Montesinos VN, Russell ML, Litter MI, Gundel LA, et al. Emissions from electronic cigarettes: key parameters affecting the release of harmful chemicals. Environ Sci Technol. 2016;50(17):9644–51. https://​doi.​org/​10.​1021/​acs.​est.​6b01741. This study quantified potentially toxic compounds in e-cig aerosol emissions and identified key parameters affecting toxic compound generation, including heating coil configuration and applied voltage. PubMedCrossRef
14.
go back to reference Zezima K. Cigarettes without smoke or regulation. New York Times. 2009;1. Zezima K. Cigarettes without smoke or regulation. New York Times. 2009;1.
15.
go back to reference •• McNeill A, Brose L, Calder R, Hitchman S, Hajek P, McRobbie H. E-cigarettes: an evidence update. Public Health England. 2015;3. A government report by Public Health England (PHE), an agency of England’s Department of Health, which estimates that e-cigs are 95% less harmful to your health than normal cigarettes and supports the use of e-cigs as effective tobacco cessation and reduction aids. •• McNeill A, Brose L, Calder R, Hitchman S, Hajek P, McRobbie H. E-cigarettes: an evidence update. Public Health England. 2015;3. A government report by Public Health England (PHE), an agency of England’s Department of Health, which estimates that e-cigs are 95% less harmful to your health than normal cigarettes and supports the use of e-cigs as effective tobacco cessation and reduction aids.
16.
go back to reference • Zhu SH, Zhuang YL, Wong S, Cummins SE, Tedeschi GJ. E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys. BMJ. 2017;358:j3262. https://doi.org/10.1136/bmj.j3262. This study used survey data from the largest representative sample of e-cig users among the US population to show that that e-cig use is not only associated with a higher smoking cessation rate at the individual user level but also at the population level. PubMedPubMedCentralCrossRef • Zhu SH, Zhuang YL, Wong S, Cummins SE, Tedeschi GJ. E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys. BMJ. 2017;358:j3262. https://​doi.​org/​10.​1136/​bmj.​j3262. This study used survey data from the largest representative sample of e-cig users among the US population to show that that e-cig use is not only associated with a higher smoking cessation rate at the individual user level but also at the population level. PubMedPubMedCentralCrossRef
17.
go back to reference • Polosa R, Morjaria J, Caponnetto P, Caruso M, Strano S, Battaglia E, et al. Effect of smoking abstinence and reduction in asthmatic smokers switching to electronic cigarettes: evidence for harm reversal. Int J Environ Res Public Health. 2014;11(5):4965–77. https://doi.org/10.3390/ijerph110504965. A retrospective study which identifies improvements in asthma control, airway hyper-responsiveness, and pulmonary function in asthmatic smokers who quit or dramatically reduced their tobacco consumption by switching to e-cigs. PubMedPubMedCentralCrossRef • Polosa R, Morjaria J, Caponnetto P, Caruso M, Strano S, Battaglia E, et al. Effect of smoking abstinence and reduction in asthmatic smokers switching to electronic cigarettes: evidence for harm reversal. Int J Environ Res Public Health. 2014;11(5):4965–77. https://​doi.​org/​10.​3390/​ijerph110504965. A retrospective study which identifies improvements in asthma control, airway hyper-responsiveness, and pulmonary function in asthmatic smokers who quit or dramatically reduced their tobacco consumption by switching to e-cigs. PubMedPubMedCentralCrossRef
18.
go back to reference Polosa R, Morjaria JB, Caponnetto P, Caruso M, Campagna D, Amaradio MD, et al. Persisting long term benefits of smoking abstinence and reduction in asthmatic smokers who have switched to electronic cigarettes. Discov Med. 2016;21(114):99–108.PubMed Polosa R, Morjaria JB, Caponnetto P, Caruso M, Campagna D, Amaradio MD, et al. Persisting long term benefits of smoking abstinence and reduction in asthmatic smokers who have switched to electronic cigarettes. Discov Med. 2016;21(114):99–108.PubMed
20.
go back to reference •• Fedele DA, Barnett TE, Dekevich D, Gibson-Young LM, Martinasek M, Jagger MA. Prevalence of and beliefs about electronic cigarettes and hookah among high school students with asthma. Ann Epidemiol. 2016;26(12):865–9. https://doi.org/10.1016/j.annepidem.2016.10.004. This study used 2014 Florida Youth Tobacco Survey data ( n = 32,921) to assess current cigarette, hookah, and e-cig use among high school students with and without asthma. Adolescents with asthma had a higher prevalence of current hookah and e-cig use, reported positive beliefs about tobacco products, and were more likely to live with individuals who used cigarettes, hookah, and e-cig compared with their peers. PubMedCrossRef •• Fedele DA, Barnett TE, Dekevich D, Gibson-Young LM, Martinasek M, Jagger MA. Prevalence of and beliefs about electronic cigarettes and hookah among high school students with asthma. Ann Epidemiol. 2016;26(12):865–9. https://​doi.​org/​10.​1016/​j.​annepidem.​2016.​10.​004. This study used 2014 Florida Youth Tobacco Survey data ( n = 32,921) to assess current cigarette, hookah, and e-cig use among high school students with and without asthma. Adolescents with asthma had a higher prevalence of current hookah and e-cig use, reported positive beliefs about tobacco products, and were more likely to live with individuals who used cigarettes, hookah, and e-cig compared with their peers. PubMedCrossRef
21.
go back to reference •• Choi K, Bernat D. E-cigarette use among Florida youth with and without asthma. Am J Prev Med. 2016;51(4):446–53. https://doi.org/10.1016/j.amepre.2016.03.010. A study which used the 2012 Florida Youth Tobacco Survey data ( n = 36,085) to assess the prevalence of e-cig use among asthmatic youth and examine the associations between e-cig use, susceptibility to cigarette smoking, and asthma attack. The authors conclude that e-cig use is more common among asthmatic youth and is associated with increased susceptibility to cigarette smoking. PubMedPubMedCentralCrossRef •• Choi K, Bernat D. E-cigarette use among Florida youth with and without asthma. Am J Prev Med. 2016;51(4):446–53. https://​doi.​org/​10.​1016/​j.​amepre.​2016.​03.​010. A study which used the 2012 Florida Youth Tobacco Survey data ( n = 36,085) to assess the prevalence of e-cig use among asthmatic youth and examine the associations between e-cig use, susceptibility to cigarette smoking, and asthma attack. The authors conclude that e-cig use is more common among asthmatic youth and is associated with increased susceptibility to cigarette smoking. PubMedPubMedCentralCrossRef
22.
go back to reference •• Larsen K, GEJ F, Boak A, Hamilton HA, Mann RE, Irving HM, et al. Looking beyond cigarettes: are Ontario adolescents with asthma less likely to smoke e-cigarettes, marijuana, waterpipes or tobacco cigarettes? Respir Med. 2016;120:10–5. https://doi.org/10.1016/j.rmed.2016.09.013. This study used the 2013 Ontario Student Drug Use and Health Survey data ( n = 6,159 high school students) to determine whether asthmatic students in Ontario smoke cigarettes, waterpipes, marijuana, or e-cig more or less than those without asthma. Students with asthma have higher odds of using e-cigs but not cigarettes, waterpipes, or marijuana, when compared to their non-asthmatic peers. PubMedCrossRef •• Larsen K, GEJ F, Boak A, Hamilton HA, Mann RE, Irving HM, et al. Looking beyond cigarettes: are Ontario adolescents with asthma less likely to smoke e-cigarettes, marijuana, waterpipes or tobacco cigarettes? Respir Med. 2016;120:10–5. https://​doi.​org/​10.​1016/​j.​rmed.​2016.​09.​013. This study used the 2013 Ontario Student Drug Use and Health Survey data ( n = 6,159 high school students) to determine whether asthmatic students in Ontario smoke cigarettes, waterpipes, marijuana, or e-cig more or less than those without asthma. Students with asthma have higher odds of using e-cigs but not cigarettes, waterpipes, or marijuana, when compared to their non-asthmatic peers. PubMedCrossRef
23.
go back to reference •• Cho JH, Paik SY. Association between electronic cigarette use and asthma among high school students in South Korea. PLoS One. 2016;11(3):e0151022. https://doi.org/10.1371/journal.pone.0151022. This cross-sectional study investigated the association between e-cig use and asthma in 35,904 high school students. The authors report that e-cig users have an increased association with asthma and are more likely to have had days absent from school due to severe asthma symptoms. PubMedPubMedCentralCrossRef •• Cho JH, Paik SY. Association between electronic cigarette use and asthma among high school students in South Korea. PLoS One. 2016;11(3):e0151022. https://​doi.​org/​10.​1371/​journal.​pone.​0151022. This cross-sectional study investigated the association between e-cig use and asthma in 35,904 high school students. The authors report that e-cig users have an increased association with asthma and are more likely to have had days absent from school due to severe asthma symptoms. PubMedPubMedCentralCrossRef
24.
go back to reference •• Boulay ME, Henry C, Bosse Y, Boulet LP, Morissette MC. Acute effects of nicotine-free and flavour-free electronic cigarette use on lung functions in healthy and asthmatic individuals. Respir Res. 2017;18(1):33. https://doi.org/10.1186/s12931-017-0518-9. A crossover, placebo-controlled study investigating the effects of a 1-h acute vaping session of nicotine- and flavor-free e-liquid on the pulmonary functions and respiratory mechanics of healthy and asthmatic individuals. Acute exposure to propylene glycol and glycerin aerosol in a controlled environment does not significantly impact pulmonary function or symptoms in both healthy and asthmatic subjects. PubMedPubMedCentralCrossRef •• Boulay ME, Henry C, Bosse Y, Boulet LP, Morissette MC. Acute effects of nicotine-free and flavour-free electronic cigarette use on lung functions in healthy and asthmatic individuals. Respir Res. 2017;18(1):33. https://​doi.​org/​10.​1186/​s12931-017-0518-9. A crossover, placebo-controlled study investigating the effects of a 1-h acute vaping session of nicotine- and flavor-free e-liquid on the pulmonary functions and respiratory mechanics of healthy and asthmatic individuals. Acute exposure to propylene glycol and glycerin aerosol in a controlled environment does not significantly impact pulmonary function or symptoms in both healthy and asthmatic subjects. PubMedPubMedCentralCrossRef
28.
go back to reference • Wang P, Chen W, Liao J, Matsuo T, Ito K, Fowles J, et al. A device-independent evaluation of carbonyl emissions from heated electronic cigarette solvents. PLoS One. 2017;12(1):e0169811. https://doi.org/10.1371/journal.pone.0169811. Quantitation of toxic volatile carbonyl compounds produced when vaping propylene glycol and glycerin under precisely controlled temperatures in the absence of nicotine and flavor additives. PubMedPubMedCentralCrossRef • Wang P, Chen W, Liao J, Matsuo T, Ito K, Fowles J, et al. A device-independent evaluation of carbonyl emissions from heated electronic cigarette solvents. PLoS One. 2017;12(1):e0169811. https://​doi.​org/​10.​1371/​journal.​pone.​0169811. Quantitation of toxic volatile carbonyl compounds produced when vaping propylene glycol and glycerin under precisely controlled temperatures in the absence of nicotine and flavor additives. PubMedPubMedCentralCrossRef
29.
go back to reference Yao Y, Liang W, Zhu L, Duan Y, Jin Y, He L. Relationship between the concentration of formaldehyde in the air and asthma in children: a meta-analysis. Int J Clin Exp Med. 2015;8(6):8358–62.PubMedPubMedCentral Yao Y, Liang W, Zhu L, Duan Y, Jin Y, He L. Relationship between the concentration of formaldehyde in the air and asthma in children: a meta-analysis. Int J Clin Exp Med. 2015;8(6):8358–62.PubMedPubMedCentral
32.
go back to reference Prieto L, Gutierrez V, Cervera A, Linana J. Airway obstruction induced by inhaled acetaldehyde in asthma: repeatability relationship to adenosine 5′-monophosphate responsiveness. J Investig Allergol Clin Immunol. 2002;12(2):91–8.PubMed Prieto L, Gutierrez V, Cervera A, Linana J. Airway obstruction induced by inhaled acetaldehyde in asthma: repeatability relationship to adenosine 5′-monophosphate responsiveness. J Investig Allergol Clin Immunol. 2002;12(2):91–8.PubMed
34.
go back to reference Benowitz NL, Hukkanen J, Jacob III P. Nicotine chemistry, metabolism, kinetics and biomarkers. Nicotine psychopharmacology. Springer; 2009. p. 29–60. Benowitz NL, Hukkanen J, Jacob III P. Nicotine chemistry, metabolism, kinetics and biomarkers. Nicotine psychopharmacology. Springer; 2009. p. 29–60.
35.
go back to reference D’alessandro A, Boeckelmann I, Hammwhöner M, Goette A. Nicotine, cigarette smoking and cardiac arrhythmia: an overview. Eur J Prev Cardiol. 2012;19(3):297–305.PubMedCrossRef D’alessandro A, Boeckelmann I, Hammwhöner M, Goette A. Nicotine, cigarette smoking and cardiac arrhythmia: an overview. Eur J Prev Cardiol. 2012;19(3):297–305.PubMedCrossRef
36.
go back to reference Kershbaum A, Bellet S, Dickstein ER, Feinbergl J. Effect of cigarette smoking and nicotine on serum free fatty acids based on a study in the human subject and the experimental animal. Circ Res. 1961;9:631–8.PubMedCrossRef Kershbaum A, Bellet S, Dickstein ER, Feinbergl J. Effect of cigarette smoking and nicotine on serum free fatty acids based on a study in the human subject and the experimental animal. Circ Res. 1961;9:631–8.PubMedCrossRef
37.
go back to reference Kershbaum A, Osada H, Pappajohn DJ, Bellet S. Effect of nicotine on the mobilization of free fatty acids from adipose tissue in vitro. Experientia. 1969;25(2):128.PubMedCrossRef Kershbaum A, Osada H, Pappajohn DJ, Bellet S. Effect of nicotine on the mobilization of free fatty acids from adipose tissue in vitro. Experientia. 1969;25(2):128.PubMedCrossRef
38.
go back to reference Carlson LA, Orö L. The effect of nicotinic acid on the plasma free fatty acids demonstration of a metabolic type of sympathicolysis. J Intern Med. 1962;172(6):641–5. Carlson LA, Orö L. The effect of nicotinic acid on the plasma free fatty acids demonstration of a metabolic type of sympathicolysis. J Intern Med. 1962;172(6):641–5.
40.
go back to reference Wright S, Zhong J, Zheng H, Larrick J. Nicotine inhibition of apoptosis suggests a role in tumor promotion. FASEB J. 1993;7(11):1045–51.PubMed Wright S, Zhong J, Zheng H, Larrick J. Nicotine inhibition of apoptosis suggests a role in tumor promotion. FASEB J. 1993;7(11):1045–51.PubMed
41.
go back to reference Walker LM, Preston MR, Magnay JL, Thomas PB, El Haj AJ. Nicotinic regulation of c-fos and osteopontin expression in human-derived osteoblast-like cells and human trabecular bone organ culture. Bone. 2001;28(6):603–8.PubMedCrossRef Walker LM, Preston MR, Magnay JL, Thomas PB, El Haj AJ. Nicotinic regulation of c-fos and osteopontin expression in human-derived osteoblast-like cells and human trabecular bone organ culture. Bone. 2001;28(6):603–8.PubMedCrossRef
43.
go back to reference Whitley D, Goldberg SP, Jordan WD. Heat shock proteins: a review of the molecular chaperones. J Vasc Surg. 1999;29(4):748–51.PubMedCrossRef Whitley D, Goldberg SP, Jordan WD. Heat shock proteins: a review of the molecular chaperones. J Vasc Surg. 1999;29(4):748–51.PubMedCrossRef
44.
go back to reference Doolittle DJ, Winegar R, Lee CK, Caldwell WS, Hayes AW, Donald deBethizy J. The genotoxic potential of nicotine and its major metabolites. Mutat Res Genet Toxicol. 1995;344(3–4):95–102.CrossRef Doolittle DJ, Winegar R, Lee CK, Caldwell WS, Hayes AW, Donald deBethizy J. The genotoxic potential of nicotine and its major metabolites. Mutat Res Genet Toxicol. 1995;344(3–4):95–102.CrossRef
52.
go back to reference Kalra R, Singh SP, Kracko D, Matta SG, Sharp BM, Sopori ML. Chronic self-administration of nicotine in rats impairs T cell responsiveness. J Pharmacol Exp Ther. 2002;302(3):935–9.PubMedCrossRef Kalra R, Singh SP, Kracko D, Matta SG, Sharp BM, Sopori ML. Chronic self-administration of nicotine in rats impairs T cell responsiveness. J Pharmacol Exp Ther. 2002;302(3):935–9.PubMedCrossRef
53.
go back to reference Sopori ML, Kozak W, Savage SM, Geng Y, Soszynski D, Kluger MJ, et al. Effect of nicotine on the immune system: possible regulation of immune responses by central and peripheral mechanisms. Psychoneuroendocrinology. 1998;23(2):189–204.PubMedCrossRef Sopori ML, Kozak W, Savage SM, Geng Y, Soszynski D, Kluger MJ, et al. Effect of nicotine on the immune system: possible regulation of immune responses by central and peripheral mechanisms. Psychoneuroendocrinology. 1998;23(2):189–204.PubMedCrossRef
54.
go back to reference Sopori ML, Kozak W, Savage SM, Geng Y, Kluger MJ. Nicotine-induced modulation of T cell function. Implications for inflammation and infection. Adv Exp Med Biol. 1998;437:279–89.PubMedCrossRef Sopori ML, Kozak W, Savage SM, Geng Y, Kluger MJ. Nicotine-induced modulation of T cell function. Implications for inflammation and infection. Adv Exp Med Biol. 1998;437:279–89.PubMedCrossRef
55.
go back to reference Sopori ML, Kozak W. Immunomodulatory effects of cigarette smoke. J Neuroimmunol. 1998;83(1–2):148–56.PubMedCrossRef Sopori ML, Kozak W. Immunomodulatory effects of cigarette smoke. J Neuroimmunol. 1998;83(1–2):148–56.PubMedCrossRef
57.
go back to reference Mishra NC, Rir-Sima-Ah J, Langley RJ, Singh SP, Pena-Philippides JC, Koga T, et al. Nicotine primarily suppresses lung Th2 but not goblet cell and muscle cell responses to allergens. J Immunol. 2008;180(11):7655–63.PubMedPubMedCentralCrossRef Mishra NC, Rir-Sima-Ah J, Langley RJ, Singh SP, Pena-Philippides JC, Koga T, et al. Nicotine primarily suppresses lung Th2 but not goblet cell and muscle cell responses to allergens. J Immunol. 2008;180(11):7655–63.PubMedPubMedCentralCrossRef
65.
go back to reference Dai H, Hao J. Flavored electronic cigarette use and smoking among youth. Pediatrics. 2016;138:e20162513.PubMedCrossRef Dai H, Hao J. Flavored electronic cigarette use and smoking among youth. Pediatrics. 2016;138:e20162513.PubMedCrossRef
66.
67.
go back to reference Padon AA, Maloney EK, Cappella JN. Youth-targeted e-cigarette marketing in the US. Tob Regul Sci. 2017;3(1):95–101.PubMedCrossRef Padon AA, Maloney EK, Cappella JN. Youth-targeted e-cigarette marketing in the US. Tob Regul Sci. 2017;3(1):95–101.PubMedCrossRef
73.
go back to reference •• Farsalinos KE, Kistler KA, Gillman G, Voudris V. Evaluation of electronic cigarette liquids and aerosol for the presence of selected inhalation toxins. Nicotine Tob Res. 2015;17(2):168–74. https://doi.org/10.1093/ntr/ntu176. This study found that diacetyl and acetyl propionyl, known respiratory toxicants, were present in a large proportion of sweet-flavored e-cig liquids. The authors conclude that the use of many of the products evaluated would result in exposures that exceed NIOSH-defined safety levels. PubMedCrossRef •• Farsalinos KE, Kistler KA, Gillman G, Voudris V. Evaluation of electronic cigarette liquids and aerosol for the presence of selected inhalation toxins. Nicotine Tob Res. 2015;17(2):168–74. https://​doi.​org/​10.​1093/​ntr/​ntu176. This study found that diacetyl and acetyl propionyl, known respiratory toxicants, were present in a large proportion of sweet-flavored e-cig liquids. The authors conclude that the use of many of the products evaluated would result in exposures that exceed NIOSH-defined safety levels. PubMedCrossRef
74.
go back to reference Alert N. Preventing Lung Disease in Workers Who Use or Make Flavorings. NIOSH Publication No. 2004-110. 2003. Alert N. Preventing Lung Disease in Workers Who Use or Make Flavorings. NIOSH Publication No. 2004-110. 2003.
75.
go back to reference Lopez-Saez MP, Carrillo P, Huertas AJ, Fernandez-Nieto M, Lopez JD. Occupational asthma and dermatitis induced by eugenol in a cleaner. J Investig Allergol Clin Immunol. 2015;25(1):64–5.PubMed Lopez-Saez MP, Carrillo P, Huertas AJ, Fernandez-Nieto M, Lopez JD. Occupational asthma and dermatitis induced by eugenol in a cleaner. J Investig Allergol Clin Immunol. 2015;25(1):64–5.PubMed
82.
go back to reference Sanchez-Perez J, Garcia-Diez A. Occupational allergic contact dermatitis from eugenol, oil of cinnamon and oil of cloves in a physiotherapist. Contact Dermatitis. 1999;41(6):346–7.PubMedCrossRef Sanchez-Perez J, Garcia-Diez A. Occupational allergic contact dermatitis from eugenol, oil of cinnamon and oil of cloves in a physiotherapist. Contact Dermatitis. 1999;41(6):346–7.PubMedCrossRef
83.
go back to reference De Benito V, Alzaga R. Occupational allergic contact dermatitis from cassia (Chinese cinnamon) as a flavouring agent in coffee. Contact Dermatitis. 1999;40(3):165.PubMed De Benito V, Alzaga R. Occupational allergic contact dermatitis from cassia (Chinese cinnamon) as a flavouring agent in coffee. Contact Dermatitis. 1999;40(3):165.PubMed
85.
go back to reference •• Kosmider L, Sobczak A, Prokopowicz A, Kurek J, Zaciera M, Knysak J, et al. Cherry-flavoured electronic cigarettes expose users to the inhalation irritant, benzaldehyde. Thorax. 2016;71(4):376–7. https://doi.org/10.1136/thoraxjnl-2015-207895. This study measured benzaldehyde, a known respiratory irritant, in aerosol generated from flavored e-cigs purchased online. Benzaldehyde was detected in 108 out of 145 products. PubMedPubMedCentralCrossRef •• Kosmider L, Sobczak A, Prokopowicz A, Kurek J, Zaciera M, Knysak J, et al. Cherry-flavoured electronic cigarettes expose users to the inhalation irritant, benzaldehyde. Thorax. 2016;71(4):376–7. https://​doi.​org/​10.​1136/​thoraxjnl-2015-207895. This study measured benzaldehyde, a known respiratory irritant, in aerosol generated from flavored e-cigs purchased online. Benzaldehyde was detected in 108 out of 145 products. PubMedPubMedCentralCrossRef
88.
go back to reference Leikauf GD. 12 formaldehyde and other aldehydes. Environmental toxicants: human exposures and their health effects. 2000:409. Leikauf GD. 12 formaldehyde and other aldehydes. Environmental toxicants: human exposures and their health effects. 2000:409.
89.
go back to reference Leikauf GD. Mechanisms of aldehyde-induced bronchial reactivity: role of airway epithelium. Res Rep Health Eff Inst. 1992;49:1–35. Leikauf GD. Mechanisms of aldehyde-induced bronchial reactivity: role of airway epithelium. Res Rep Health Eff Inst. 1992;49:1–35.
93.
go back to reference Spurlock BW, Dailey TM. Shortness of (fresh) breath--toothpaste-induced bronchospasm. N Engl J Med. 1990;323(26):1845–6.PubMed Spurlock BW, Dailey TM. Shortness of (fresh) breath--toothpaste-induced bronchospasm. N Engl J Med. 1990;323(26):1845–6.PubMed
94.
go back to reference Subiza J, Subiza JL, Valdivieso R, Escribano PM, Garcia R, Jerez M, et al. Toothpaste flavor-induced asthma. J Allergy Clin Immunol. 1992;90(6 Pt 1):1004–6.PubMedCrossRef Subiza J, Subiza JL, Valdivieso R, Escribano PM, Garcia R, Jerez M, et al. Toothpaste flavor-induced asthma. J Allergy Clin Immunol. 1992;90(6 Pt 1):1004–6.PubMedCrossRef
98.
go back to reference •• Tierney PA, Karpinski CD, Brown JE, Luo W, Pankow JF. Flavour chemicals in electronic cigarette fluids. Tob Control. 2016;25(e1):e10–5. https://doi.org/10.1136/tobaccocontrol-2014-052175. This study quantified flavoring chemicals in 30 popular e-cig liquids. Many of the e-liquids contained aldehyde flavoring agents that made up 1 to 4% of the total e-liquid volume. The authors conclude that concentrations of some flavor chemicals in e-cigs are sufficiently high for inhalation exposure by vaping to be of toxicological concern. PubMedCrossRef •• Tierney PA, Karpinski CD, Brown JE, Luo W, Pankow JF. Flavour chemicals in electronic cigarette fluids. Tob Control. 2016;25(e1):e10–5. https://​doi.​org/​10.​1136/​tobaccocontrol-2014-052175. This study quantified flavoring chemicals in 30 popular e-cig liquids. Many of the e-liquids contained aldehyde flavoring agents that made up 1 to 4% of the total e-liquid volume. The authors conclude that concentrations of some flavor chemicals in e-cigs are sufficiently high for inhalation exposure by vaping to be of toxicological concern. PubMedCrossRef
99.
go back to reference Berridge MJ, Lipp P, Bootman MD. Signal transduction. The calcium entry pas de deux. Science. 2000;287(5458):1604–5.PubMedCrossRef Berridge MJ, Lipp P, Bootman MD. Signal transduction. The calcium entry pas de deux. Science. 2000;287(5458):1604–5.PubMedCrossRef
112.
go back to reference Facchinetti F, Patacchini R. The rising role of TRPA1 in asthma. Open Drug Discov J. 2010;2(1):71–80.CrossRef Facchinetti F, Patacchini R. The rising role of TRPA1 in asthma. Open Drug Discov J. 2010;2(1):71–80.CrossRef
113.
go back to reference • Yang H, Li S. Transient receptor potential ankyrin 1 (TRPA1) channel and neurogenic inflammation in pathogenesis of asthma. Med Sci Monit. 2016;22:2917–23. This review discusses how activation of TRPA1 expressed in C-fiber nociceptors promotes neurogenic inflammation in asthma. PubMedPubMedCentralCrossRef • Yang H, Li S. Transient receptor potential ankyrin 1 (TRPA1) channel and neurogenic inflammation in pathogenesis of asthma. Med Sci Monit. 2016;22:2917–23. This review discusses how activation of TRPA1 expressed in C-fiber nociceptors promotes neurogenic inflammation in asthma. PubMedPubMedCentralCrossRef
129.
go back to reference Silverman RA, Hasegawa K, Egan DJ, Stiffler KA, Sullivan AF, Camargo CA. Multicenter study of cigarette smoking among adults with asthma exacerbations in the emergency department, 2011–2012. Respir Med. 2017;125:89–91.PubMedCrossRef Silverman RA, Hasegawa K, Egan DJ, Stiffler KA, Sullivan AF, Camargo CA. Multicenter study of cigarette smoking among adults with asthma exacerbations in the emergency department, 2011–2012. Respir Med. 2017;125:89–91.PubMedCrossRef
Metadata
Title
Electronic Cigarettes: Their Constituents and Potential Links to Asthma
Authors
Phillip W. Clapp
Ilona Jaspers
Publication date
01-11-2017
Publisher
Springer US
Published in
Current Allergy and Asthma Reports / Issue 11/2017
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-017-0747-5

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