Cardiopulmonary Toxicity of Electronic Nicotine Delivery Systems
Although electronic nicotine delivery systems (ENDS) are widely used by youth and young adults, the toxicity
and the health effects of these products remain unclear. Many types of devices with varying constituents have
been introduced into the market, making it difficult to ascribe toxicity to a specific class of products or to study
their long-term health effects. ENDS produce volatile organic compounds (VOCs) such as formaldehyde and
acrolein, which are generated by the thermal degradation of e-liquids containing propylene glycol:vegetable
glycerin (PG:VG) and may lead to adverse health effects. Nevertheless, the dependence of VOC generation on
e-liquid composition and constituents, nicotine and other ingredients has not been studied, and the contributions
of different constituents to the potential harmful effects of e-cigarettes remain unclear. Therefore, within the
framework of a regulatory context, we plan to study the cardiovascular and pulmonary toxicity of e-cigarette
aerosols over a wide range of operating conditions and use patterns to provide rigorous and comprehensive data
pertinent to the regulation of new and emerging devices by the US Food and Drug Administration (FDA). Based
on our previous work, we propose that device-specific cardiovascular and pulmonary effects of e-cigarettes are
in large part mediated by the extent of VOCs generation and toxicity, which are modified by co-exposure to
nicotine and other e-liquid ingredients as well as individual use patterns.