E-cigarette puffing patterns associated with high and low nicotine e-liquid strength: effects on toxicant and carcinogen exposure (study protocol)
Journal article
Dawkins, LE, Cox, SA, Kosmider, L, McRobbie, H, Goniewicz, M, Kimber, CF and Doig, M (2016). E-cigarette puffing patterns associated with high and low nicotine e-liquid strength: effects on toxicant and carcinogen exposure (study protocol). BMC Public Health. 16. https://doi.org/10.1186/s12889-016-3653-1
| Authors | Dawkins, LE, Cox, SA, Kosmider, L, McRobbie, H, Goniewicz, M, Kimber, CF and Doig, M |
|---|---|
| Abstract | Background: Contrary to intuition, use of lower strength nicotine e-liquids might not offer reduced health risk if compensatory puffing behaviour occurs. Compensatory puffing (e.g. more frequent, longer puffs) or user behaviour (increasing the wattage) can lead to higher temperatures at which glycerine and propylene glycol (solvents used in e-liquids) undergo decomposition to carbonyl compounds, including the carcinogens formaldehyde and acetaldehyde. This study aims to document puffing patterns and user behaviour associated with using high and low strength nicotine e-liquid and associated toxicant/carcinogen exposure in experienced e-cigarette users (known as vapers herein). Methods/design: A counterbalanced repeated measures design. Participants: Non-tobacco smoking vapers; have used an e-cigarette for ≥3 months; currently using nicotine strength e-liquid ≥12mg/mL and a second or third generation device. Intervention: This study will measure puffing patterns in vapers whilst they use high and low strength nicotine e-liquid under fixed and user-defined settings, each for a week. The 4 counterbalanced conditions are: i) low strength (6mg/mL), fixed settings; ii) low strength user-defined settings; iii) high strength (18mg/mL) fixed settings; iv) high strength user-defined settings. Biomarkers of exposure to toxicants and carcinogens will be measured in urine. In the second phase of this study, toxicant yields will be measured in aerosol generated using a smoking machine operated to replicate the puffing behaviours of each participant. Primary outcomes: i) Puffing patterns (mean puff number, puff duration, inter-puff interval and mL of liquid consumed) and user behaviour (changes to device settings: voltage and air-flow) associated with using high and low strength nicotine e-liquid. ii) Toxicant/carcinogen exposure associated with the puffing patterns/device settings used by our participants. Secondary outcomes: i) Subjective effects. ii) comparisons with toxicant exposure from tobacco smoke (using documented evidence) and with recommended safety limits. Sample size: Twenty participants. Discussion: The findings will have important implications for public health messaging regarding the relative risks and subjective effects associated with using high and low strength nicotine e-liquid, and for policy makers regarding regulations on nicotine concentrations in e-liquids. |
| Keywords | Electronic-cigarette; ENDS; E-cigarettes; Puffing patterns; Puffing topography; E-liquids; Toxicants; Carcinogens |
| Year | 2016 |
| Journal | BMC Public Health |
| Journal citation | 16 |
| Publisher | BioMed Central |
| ISSN | 1471-2458 |
| Digital Object Identifier (DOI) | https://doi.org/10.1186/s12889-016-3653-1 |
| Publication dates | |
| 20 Sep 2016 | |
| Publication process dates | |
| Deposited | 28 Feb 2017 |
| Accepted | 09 Sep 2016 |
| Accepted author manuscript | License File Access Level Open |
Permalink -
https://openresearch.lsbu.ac.uk/item/8722q
Download files
Accepted author manuscript
| Cox et al 2016 24th August#2.docx | ||
| License: CC BY 4.0 | ||
| File access level: Open | ||
167
total views56
total downloads0
views this month0
downloads this month
Export as
Related outputs
Is e-cigarette use associated with persistence or discontinuation of combustible cigarettes? A 24-month longitudinal investigation in young adult binge drinkers.
Martinez-Loredo, V., González-Roz, Alba, Dawkins, L., Singh, Desmond, Murphy, James G and MacKillop, J. (2022). Is e-cigarette use associated with persistence or discontinuation of combustible cigarettes? A 24-month longitudinal investigation in young adult binge drinkers. Nicotine & Tobacco Research. https://doi.org/6530318Cutting down, quitting and motivation to stop smoking by self-reported COVID-19 status: Representative cross-sectional surveys in England.
Cox, S., Tattan-Birch, H., Jackson, S., Dawkins, L., Brown, J. and Shahab, L. (2022). Cutting down, quitting and motivation to stop smoking by self-reported COVID-19 status: Representative cross-sectional surveys in England. Addiction (Abingdon, England). https://doi.org/10.1111/add.16029Drinkers like us? The availability of relatable drinking reduction narratives for people with alcohol use disorders
J. Morris, S. Cox, A. C. Moss and P. Reavey (2022). Drinkers like us? The availability of relatable drinking reduction narratives for people with alcohol use disorders. Addiction Research & Theory. https://doi.org/10.1080/16066359.2022.2099544Toward an ontology of tobacco, nicotine and vaping products.
Cox, S., West, R., Notley, C., Soar, K. and Hastings, J. (2022). Toward an ontology of tobacco, nicotine and vaping products. Addiction (Abingdon, England). https://doi.org/10.1111/add.16010Evaluating the effectiveness of e‐cigarettes compared with usual care for smoking cessation when offered to smokers at homeless centres: Protocol for a multi‐centre cluster randomised controlled trial in Great Britain
Cox, S., Bauld, Linda, Brown, R., Carlise, M., Ford, A., Hajek, P., Li, J., Notley, C., Parrott, S., Pesola, F., Robson, D., Soar, K., Tyler, A., Ward, E. and Dawkins, L. (2022). Evaluating the effectiveness of e‐cigarettes compared with usual care for smoking cessation when offered to smokers at homeless centres: Protocol for a multi‐centre cluster randomised controlled trial in Great Britain. Addiction (Abingdon, England). https://doi.org/10.1111/add.15851Water Consumption Increases Handwriting Speed andVolume Consumed Relates to Increased Finger‑tapping Speed in Schoolchildren
Booth, P., Hunyadvari, N., Dawkins, L., Moore, D., Gentile-Rapinett, G. and Edmonds, C,J. (2021). Water Consumption Increases Handwriting Speed andVolume Consumed Relates to Increased Finger‑tapping Speed in Schoolchildren. Journal of Cognitive Enhancement. https://doi.org/10.1007/s41465-021-00232-5
Dataset: Co-development of mobile phone text messages to support smokers’ quitting by switching to an e-cigarette
Sideropoulos, V., Vangeli, E., Naughton, F, Cox, S., Frings, D., Notley, C., Brown, J., Kimber, C. and Dawkins, L. (2021). Dataset: Co-development of mobile phone text messages to support smokers’ quitting by switching to an e-cigarette. London South Bank University. https://doi.org/10.18744/lsbu.8y92zDevelopment and Testing of Relative Risk-based Health Messages for Electronic Cigarette Products
Kimber, C., Cox, S., Frings, D., Albery, I. and Dawkins, L. (2021). Development and Testing of Relative Risk-based Health Messages for Electronic Cigarette Products. Harm Reduction Journal. 18 (96). https://doi.org/10.1186/s12954-021-00540-1Study protocol for Testing Nicotine Pod Vaping Devices: Are EU-TPD (Tobacco Product Directive) compliant pod-devices sufficiently satisfying to UK smokers?
Kimber, C., Cox, S., Notley, C., Hunter, S., Zaidell, L. and Dawkins, L. (2021). Study protocol for Testing Nicotine Pod Vaping Devices: Are EU-TPD (Tobacco Product Directive) compliant pod-devices sufficiently satisfying to UK smokers? In-principle acceptance in Nicotine and Tobacco Research. https://doi.org/10.17605/OSF.IO/D5N2VExploration of the physical health of dual users of heroin and crack in methadone treatment who inject or have previously injected drugs
Heidebrecht, F., Macleod, M.B. and Dawkins, L. (2021). Exploration of the physical health of dual users of heroin and crack in methadone treatment who inject or have previously injected drugs. Heroin Addiction And Related Clinical Problems.Changes in puffing topography and subjective effects over a 2-week period in e-cigarette naïve smokers: effects of device type and nicotine concentrations
Kimber, C., Soar, K. and Dawkins, L. (2021). Changes in puffing topography and subjective effects over a 2-week period in e-cigarette naïve smokers: effects of device type and nicotine concentrations. Addictive Behaviors. 118, p. 106909. https://doi.org/10.1016/j.addbeh.2021.106909Does the content and source credibility of health and risk messages related to nicotine vaping products have an impact on harm perception and behavioural intentions? A systematic review
Erku, D., Bauld, L., Dawkins, L., Gartner, C., Steadman, K., Noar, S., Shrestha, S. and Morphett, K. (2021). Does the content and source credibility of health and risk messages related to nicotine vaping products have an impact on harm perception and behavioural intentions? A systematic review. Addiction. https://doi.org/10.1111/add.15473Vapers exhibit similar subjective nicotine dependence but lower nicotine reinforcing value compared to smokers
Rycroft, N., Hogarth, L., MacKillop, J. and Dawkins, L. (2020). Vapers exhibit similar subjective nicotine dependence but lower nicotine reinforcing value compared to smokers. Addictive Behaviors. 115, p. 106737. https://doi.org/10.1016/j.addbeh.2020.106737User pathways of e‐cigarette use to support long term tobacco smoking relapse prevention: a qualitative analysis
Notley, C., Ward, E., Dawkins, L. and Holland, R. (2020). User pathways of e‐cigarette use to support long term tobacco smoking relapse prevention: a qualitative analysis. Addiction (Abingdon, England). 116 (3), pp. 596-605. https://doi.org/10.1111/add.15226Tailored interventions to assist smokers to stop smoking using e-cigarettes (TASSE): Study protocol
Kimber, C., Cox, S., Frings, D. and Sideropoulos, V. (2020). Tailored interventions to assist smokers to stop smoking using e-cigarettes (TASSE): Study protocol. Qeios. https://doi.org/10.32388/9rdljaExploring the uptake and use of electronic cigarettes provided to smokers accessing homeless centres: a four-centre cluster feasibility study
Cox, S., Ford, A., Li, Ji., Best, C., Tyler, A., Robson, D., Bauld, L., Hajek, P., Uny, I., Parrott, S. and Dawkins, L. (2020). Exploring the uptake and use of electronic cigarettes provided to smokers accessing homeless centres: a four-centre cluster feasibility study. Journal of Public Health Research. 9 (7). https://doi.org/10.3310/phr09070Study protocol for comparing the subjective effects and nicotine delivery associated with the use of the EU and the US JUUL pod vaping device in UK smokers
Kimber, C., Cox, S., Caitlin, N., Hunter, S., Zaidell, L. and Dawkins, L. (2020). Study protocol for comparing the subjective effects and nicotine delivery associated with the use of the EU and the US JUUL pod vaping device in UK smokers. Nicotine and Tobacco Research (OUP). https://doi.org/10.17605/OSF.IO/5J3EWA cluster feasibility trial to explore the uptake and use of e-cigarettes versus usual care offered to smokers attending homeless centres in Great Britain
Dawkins, L., Bauld, L., Ford, A., Robson, D., Hajek, P., Parrott, S., Best, C., Li, J., Tyler, A., Uny, I. and Cox, S. (2020). A cluster feasibility trial to explore the uptake and use of e-cigarettes versus usual care offered to smokers attending homeless centres in Great Britain. PLoS ONE. https://doi.org/10.1371/journal.pone.0240968Responsibility, normalisation and negotiations of harm: E-cigarette users' opinions and experiences of vaping around children
Ward, E., Dawkins, L., Holland, R. and Notley, C. (2020). Responsibility, normalisation and negotiations of harm: E-cigarette users' opinions and experiences of vaping around children. International Journal of Drug Policy. 88, p. 103016. https://doi.org/10.1016/j.drugpo.2020.103016Reported patterns of vaping to support long-term abstinence from smoking: a cross-sectional survey of a convenience sample of vapers
Gentry, S., Ward, E., Dawkins, L., Holland, R. and Notley, C. (2020). Reported patterns of vaping to support long-term abstinence from smoking: a cross-sectional survey of a convenience sample of vapers. Harm Reduction Journal. 17, p. 70. https://doi.org/10.1186/s12954-020-00418-8Data for: A cluster feasibility trial to explore the uptake and use of e-cigarettes versus usual care offered to smokers attending homeless centres in Great Britain
Dawkins, L., Cox, S., Tyler, A., Bauld, L, Ford, A, Robson, D, Hajek, P, Best, C, Li, J, Uny, I and Parrott, S (2020). Data for: A cluster feasibility trial to explore the uptake and use of e-cigarettes versus usual care offered to smokers attending homeless centres in Great Britain. London South Bank University. https://doi.org/10.18744/lsbu.8q255A qualitative exploration of consumers’ perceived impacts, behavioural reactions, and future reflections of the EU Tobacco Products Directive (2017) as applied to electronic cigarettes
Ward, E, Anholt, C, Gentry, S, Dawkins, L, Holland, R and Notely, C (2020). A qualitative exploration of consumers’ perceived impacts, behavioural reactions, and future reflections of the EU Tobacco Products Directive (2017) as applied to electronic cigarettes. Tobacco Use Insights. 13, pp. 1-9. https://doi.org/10.1177/1179173X20925458Daily exposure to formaldehyde and acetaldehyde and potential health risk associated with use of high and low nicotine e-liquid concentrations
Kosmider, L, Cox, S, Marzena, Z, Jolanta, K, Goniewicz, M, McRobbie, H, Kimber, C and Dawkins, L (2020). Daily exposure to formaldehyde and acetaldehyde and potential health risk associated with use of high and low nicotine e-liquid concentrations. Scientific Reports. 10 (6546). https://doi.org/10.1038/s41598-020-63292-1Measuring the impact of the Capital Card®†, a novel form of contingency management, on substance misuse treatment outcomes: A retrospective evaluation
Moss, A., DeSilva, D., Cox, S., Notley, C. and Nanda, M. (2020). Measuring the impact of the Capital Card®†, a novel form of contingency management, on substance misuse treatment outcomes: A retrospective evaluation. PLoS ONE. 15 (3), p. e0229905. https://doi.org/10.1371/journal.pone.0229905Smoking amongst adults experiencing homelessness: A systematic review of prevalence rates, interventions and the barriers and facilitators to quitting and staying quit
Soar, K., Dawkins, L., Robson, D. and Cox, S. (2020). Smoking amongst adults experiencing homelessness: A systematic review of prevalence rates, interventions and the barriers and facilitators to quitting and staying quit. Journal of Smoking Cessation. 15 (2), pp. 94-108. https://doi.org/10.1017/jsc.2020.11Developing an E-Cigarette Ontology
Cox, Sharon, Notley, Caitlin, West, Robert and Hastings, Janna (2020). Developing an E-Cigarette Ontology. Global Forum of Nicotine. Warsaw 13 - 15 Jun 2019Editorial for special issue: Vulnerable Groups: Addiction Research, Policy and Practice
Cox, S., Moss, A. and Ritter, A. (2020). Editorial for special issue: Vulnerable Groups: Addiction Research, Policy and Practice. Addictive Behaviors.Communicating the Relative Health Risks of E-Cigarettes: An online experimental study exploring the Effects of a Comparative Health Message versus the EU Nicotine Addiction Warnings on Smokers’ and Non-Smokers’ Risk Perceptions and Behavioural Intentions.
Kimber, C., Frings, D., Cox, S., Albery, I. and Dawkins, L. (2020). Communicating the Relative Health Risks of E-Cigarettes: An online experimental study exploring the Effects of a Comparative Health Message versus the EU Nicotine Addiction Warnings on Smokers’ and Non-Smokers’ Risk Perceptions and Behavioural Intentions. Addictive Behaviors. 101, p. 106177. https://doi.org/10.1016/j.addbeh.2019.106177E-cigarettes compared with nicotine replacement therapy within the UK stop smoking services: The TEC RCT
Hajek, P, Phillips-Waller, A, Przulj, D, Pesola, F, Smith, KM, Bisal, N, Li, J, Parrott, S, Sasieni, P, Dawkins, L, Ross, L, Goniewicz, M, Wu, Q and McRobbie, HJ (2019). E-cigarettes compared with nicotine replacement therapy within the UK stop smoking services: The TEC RCT. Health Technology Assessment. 23 (43), pp. vii-81. https://doi.org/10.3310/hta23430A systematic review of smoking, smoking cessation and the homeless: there is a will but is there a way?
Cox, S., Dawkins, L., Robson, D. and Soar, K. (2019). A systematic review of smoking, smoking cessation and the homeless: there is a will but is there a way? Lisbon Addictions Conference 2019. Lisbon 09 - 11 Oct 2019Investigating within-person patterns and trajectories of dual e-cigarette and tobacco use: the TRAJECT mixed methods study protocol
Cox, S., Notley, C., Dawkins, L., Naughton, F., Beard, E., Kimber, C., Ward, E., Holland, R. and Kwasnicka, D. (2019). Investigating within-person patterns and trajectories of dual e-cigarette and tobacco use: the TRAJECT mixed methods study protocol. Society for Research on Nicotine and Tobacco. Oslo 17 - 21 Sep 2019Addiction’s policy on fair authorship and acknowledgment practices
Cox, S., O'Reilly, Jean, West, Robert and Neale, Jo (2019). Addiction’s policy on fair authorship and acknowledgment practices. Addiction. https://doi.org/10.1111/add.14908Cost-effectiveness of e-cigarettes compared with nicotine replacement therapy in stop smoking services in England (TEC study): a randomised controlled trial
Li, J., Hajek, P., Pesola, F., Wu, Q., Phillips-Waller, A., Przuli, D., Myers Smith, K., Bisal, N., Sasieni, P., Dawkins, L., Ross, L., Goniewicz, M., McRobbie, H. and Parrott, S. (2019). Cost-effectiveness of e-cigarettes compared with nicotine replacement therapy in stop smoking services in England (TEC study): a randomised controlled trial. Addiction. 115 (3), pp. 507-517. https://doi.org/10.1111/add.14829Understanding women's feelings about safety and hazards of street drinking in London through interpretative phenomenological analysis
Tyler, A., Moss, A. and Cox, S. (2019). Understanding women's feelings about safety and hazards of street drinking in London through interpretative phenomenological analysis. Addictive Behaviors. 99, p. 106042. https://doi.org/10.1016/j.addbeh.2019.106042