AAAR 35th Annual Conference October 17 - October 21, 2016 Oregon Convention Center Portland, Oregon, USA
Abstract View
Harms and Risks of Nicotine: Implications for Electronic Cigarette Use
NEAL BENOWITZ, Gideon St. Helen, University of California San Francisco
Abstract Number: 71 Working Group: Electronic Cigarettes - Health Effects
Abstract Electronic cigarettes (EC) generate an aerosol containing nicotine, propylene glycol, vegetable glycerin and flavorants. Based on studies of inhaled and exhaled aerosol, more than 90% of inhaled nicotine is systemically retained. The nicotine pharmacokinetic profile looks like a combination of pulmonary and upper airway absorption. The systemic dose of nicotine is highly variable, depending on the EC device, but can be similar to that from cigarette smoking. With ad libitum use nicotine is intermittently dosed resulting in a more sustained blood level profile in contrast to the peaks and troughs seen with cigarette smoking. The major safety concerns for nicotine are addiction, cardiovascular disease and reproductive disorders. Most of the cardiovascular harm from smoking is thought to derive from combustion products, including oxidant chemicals, volatile organic compounds, particulates and carbon monoxide. Nicotine produces hemodynamic effects related to catecholamine release, and may also contribute to an adverse lipid profile, insulin resistance and cardiac arrhythmias. Epidemiologic studies with smokeless tobacco, which delivers nicotine but not combustion products, suggest that nicotine can contribute to acute cardiovascular events, including sudden death, in people with cardiovascular disease. Short term use of nicotine appears to pose little risk. Based on animal studies nicotine probably has adverse effects on fetal brain and lung development, and may contribute tp some complications of pregnancy. While nicotine use is not entirely safe, the risk of nicotine delivered by ECs is undoubtedly much less than the risk of cigarette smoking.