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Toxicology of flavoring- and cannabis-containing e-liquids used in electronic delivery systems

Federal government websites often end in. The site is secure. Preview improvements coming to the PMC website in October Learn More or Try it out now. Electronic cigarettes e-cigarettes were introduced in the United States in and by they were the most popular tobacco product amongst youth and had overtaken use of regular tobacco cigarettes. E-cigarettes are used to aerosolize a liquid e-liquid that the user inhales. Flavorings in e-liquids is a primary reason for youth to initiate use of e-cigarettes.

Evidence is growing in the scientific literature that inhalation of some flavorings is not without risk of harm. In this review, 67 original articles primarily cellular in vitro on the toxicity of flavored e-liquids were identified in the PubMed and Scopus databases and evaluated critically.

At least 65 individual flavoring ingredients in e-liquids or aerosols from e-cigarettes induced toxicity in the respiratory tract, cardiovascular and circulatory systems, skeletal system, and skin. Cinnamaldehyde was most frequently reported to be cytotoxic, followed by vanillin, menthol, ethyl maltol, ethyl vanillin, benzaldehyde and linalool.

Additionally, modern e-cigarettes can be modified to aerosolize cannabis as dried plant material or a concentrated extract. The U. Vitamin E acetate, a diluent and thickening agent in cannabis-based products, was strongly linked to the EVALI outbreak in epidemiologic and laboratory studies; however, e-liquid chemistry is highly complex, and more than one mechanism of lung injury, ingredient, or thermal breakdown product may be responsible for toxicity.

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