Analytical Assessment of e-Cigarettes Emerging Issues in Analytical Chemistry Series Editor Brian F. Thomas AMSTERDAM(cid:129)BOSTON(cid:129)HEIDELBERG(cid:129)LONDON NEWYORK(cid:129)OXFORD(cid:129)PARIS(cid:129)SANDIEGO SANFRANCISCO(cid:129)SINGAPORE(cid:129)SYDNEY(cid:129)TOKYO Analytical Assessment of e-Cigarettes From Contents to Chemical and Particle Exposure Profiles Konstantinos E. Farsalinos Onassis Cardiac Surgery Center, Athens, Greece and University of Patras, Patras, Greece I. Gene Gillman Enthalpy Analytical, Inc., Durham, NC, United States Stephen S. Hecht University of Minnesota, Minneapolis, MN, United States Riccardo Polosa University of Catania, Catania, Italy Jonathan Thornburg RTI International, Research Triangle Park, NC, United States AMSTERDAM(cid:129)BOSTON(cid:129)HEIDELBERG(cid:129)LONDON NEWYORK(cid:129)OXFORD(cid:129)PARIS(cid:129)SANDIEGO SANFRANCISCO(cid:129)SINGAPORE(cid:129)SYDNEY(cid:129)TOKYO Elsevier Radarweg29,POBox211,1000AEAmsterdam,Netherlands TheBoulevard,LangfordLane,Kidlington,OxfordOX51GB,UnitedKingdom 50HampshireStreet,5thFloor,Cambridge,MA02139,UnitedStates Copyrightr2017ElsevierInc.Allrightsreserved. PublishedincooperationwithRTIPressatRTIInternational,anindependent,nonprofitresearchinstitute thatprovidesresearch,development,andtechnicalservicestogovernmentandcommercialclientsworldwide (www.rti.org).RTIPressisRTI’sopen-access,peer-reviewedpublishingchannel.RTIInternationalisatrade nameofResearchTriangleInstitute. 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BritishLibraryCataloguing-in-PublicationData AcataloguerecordforthisbookisavailablefromtheBritishLibrary LibraryofCongressCataloging-in-PublicationData AcatalogrecordforthisbookisavailablefromtheLibraryofCongress ISBN:978-0-12-811241-0 ForInformationonallElsevierpublications visitourwebsiteathttps://www.elsevier.com Publisher:JohnFedor AcquisitionEditor:KathrynMorrissey EditorialProjectManager:AmyClark ProductionProjectManager:PaulPrasadChandramohan CoverDesigner:MathewLimbert TypesetbyMPSLimited,Chennai,India To my parents, Efthymios and Penelopi, for their devotion to family values and to the intellectual and social education of myself and my siblings. K. E. Farsalinos LIST OF CONTRIBUTORS N.L. Benowitz University of Calilfornia, San Francisco, San Francisco, CA, United States K.E. Farsalinos OnassisCardiacSurgeryCenter,Athens,GreeceandUniversityofPatras, Patras,Greece I. Gene Gillman Enthalpy Analytical, Inc., Durham, NC, United States S.S. Hecht University of Minnesota, Minneapolis, MN, United States R. Polosa University of Catania, Catania, Italy J. Thornburg RTI International, Research Triangle Park, NC, United States FOREWORD Cigarette smoking has had a devastating effect on public health world- wide over the past 100 years and will continue to do so throughout the current century unless there is a substantial reduction in the prevalence of smoking. Compulsive smoking is driven by addiction to nicotine, but most of the harm from smoking is caused by exposure to tobacco combustion products. For many years, tobacco researchers and policy experts have entertained the idea that a clean source of nicotine that could be inhaled and provide similar rewarding effects as a cigarette might entice smokers away from cigarette smoking and lead either to quitting smoking or to long-term nicotine use without incurring the harm from tobacco combustion toxicants. e-Cigarettes are nicotine delivery devices that deliver nicotine with- out combusting tobacco. These are battery-powered devices that heat a liquid composed of propylene glycol and/or vegetable glycerin, nico- tine, and flavoring to form a vapor which rapidly aerosolizes and is inhaled like cigarette smoke. e-Cigarettes could be beneficial to public health if they help smokers quit smoking and possibly (at least for some health effects) reduce harm for those who smoke fewer cigarettes while using e-Cigarettes. On the other hand, there are several concerns about adverse effects of e-Cigarette use on a population level, includ- ing attracting youth and serving as a gateway to nicotine addiction and cigarette smoking, dual use with cigarettes resulting in lower rates of quitting smoking, renormalizing nicotine use and undermining smoke-free air legislation, and/or diverting smokers from proven smok- ing cessation treatment sessions. One of the determinants of the net effect of e-Cigarettes on public health is the benefit versus harms, including the direct toxicity of e-Cigarette use. Assessing the toxicity of e-Cigarettes requires an understanding of the design and variability in device components and constituents of e-liquids and aerosols, both chemicals and particulates. Biomarkers of exposure to e-Cigarette toxicants in people are critical for extrapolating machine-tested e-Cigarette emission findings to actual human exposures. xii Foreword This volume brings together a number of expert e-Cigarette researchers to explore the contents, chemical and particulate emissions, and human exposure to e-Cigarette constituents, as well as regulatory issues related to e-Cigarettes. The authors are Dr. Konstantinos Farsalinos, a cardiologist who has conducted research on e-Cigarette use epidemiology, the nature of e-Cigarette emissions, and cardiovas- cular effects of e-Cigarettes; Dr. I. Gene Gillman, an analytical chem- ist who has measured constituents of e-Cigarette aerosols; Dr. Jonathan Thornburg, an aerosol physicist who has studied e-Cigarette aerosol composition; Dr. Stephen Hecht, a toxicologist who has pio- neered research on biomarkers of exposure to tobacco constituents; and Dr. Riccardo Polosa, a pulmonary physician who has conducted clinical trials of e-Cigarettes for smoking cessation and reduction, and has studied pulmonary effects of e-Cigarette use. These researchers present a highly informative review of the current state of understand- ing of the contents and toxicant properties of e-Cigarettes as of 2016. The material in this book will be of great interest to researchers and regulators addressing the health consequences of e-Cigarette use. N.L. Benowitz Professor of Medicine and Bioengineering & Therapeutic Sciences Chief, Division of Clinical Pharmacology University of California, San Francisco San Francisco, CA, United States October 2016 11 CHAPTER Introduction to e-Cigarettes K.E. Farsalinos INTRODUCTION e-Cigarettes were recently invented and developed as an alternative-to- smoking method of nicotine intake. They are electronic devices with three main parts: a battery, an atomizer composed of a wick and metal coil, and a liquid (“e-liquid”) stored inside the atomizer. The function is to aerosolize the liquid, producing a visible aerosol which the user inhales. This is achieved by heating the metal coil inside the atomizer by an electrical current from the battery. e-Cigarettes are commonly called electronic nicotine-delivery devices (ENDS). However, because they can be used with non-nicotine e-liquids, the term ENDS is inaccu- rate and does not represent the whole spectrum of e-Cigarette devices and use patterns. INVENTION AND EVOLUTION OF e-CIGARETTES e-Cigarettes were invented by Hon Lik, a pharmacist from China. The initial patent was filed in 2004 in China and in 2005 in the United States Patent Office (application number 10/587,707).1 The patent was published in 2007. The principle of e-Cigarette function, the evapora- tion of liquid and delivery of aerosol to the user, can be tracked back to patents published decades earlier. In 1930, a patent was published by the US Patent Office describing an electric vaporizer “for holding medicinal compounds which are electrically or otherwise heated to produce vapors for inhalation.”2 Another patent in 1934 described a therapeutic apparatus that was “adapted for transforming volatile liquid medicaments into vapors or into mists of exceedingly fine parti- cles.”3 A similar patent was published in 1936.4 These cases referred to vaporization for therapeutic applications. However, a patent filed by Herbert A. Gilbert and published in 1965 was titled “Smokeless AnalyticalAssessmentofe-Cigarettes.DOI:http://dx.doi.org/10.1016/B978-0-12-811241-0.00001-2 Copyright©2017ElsevierInc.Allrightsreserved. 2 AnalyticalAssessmentofe-Cigarettes non-tobacco cigarette” and described a battery-operated device “to provide a safe and harmless means for and method of smoking by replacing burning tobacco and paper with heated, moist, flavored air.”5 The term e-Cigarette includes a very diverse line of products, with different design, functional, and performance characteristics. Although there is still no consensus on terminology, the products available on the market are mainly of three types (Fig. 1.1).6 1. First-generation (“cigalike”) devices have similar size, shape, and appearance as tobacco cigarettes. They consist of a small lithium battery and a cartomizer. The battery can be either disposable Figure 1.1 Types of e-Cigarettes. First generation: (A) disposable cigalike; (B) rechargeable cigalike and replacementprefilledcartomizers.Secondgeneration:(C)eGo-typebattery;(D)tank-typeatomizers;(E)tank- type atomizer with replacement coil and wick head. Third generation: (F) box-shape variable-wattage battery device;(G)tank-typeatomizerwithreplacementhead;(H)rebuildableatomizer.