Journal
TOBACCO CONTROL
Volume 31, Issue E1, Pages E3-E9Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/tobaccocontrol-2021-056582
Keywords
carcinogens; electronic nicotine delivery devices; toxicology; global health
Funding
- National Institute of Environmental Health Sciences [R01ES029741-01]
- Food and Drug Administration Centre for Tobacco Products
- UCR Graduate Division
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This study compared mint/menthol-flavoured e-cigarettes from JUUL and Puff, finding that mint oils in Puff products may pose a higher cancer risk due to the presence of WS-23 and pulegone. WS-23 showed higher cytotoxicity in Puff fluids, suggesting that using pure menthol instead of mint oils in e-cigarette products may help reduce cancer risk.
Background The Food and Drug Administration (FDA) has recently banned flavours from pod-style electronic cigarettes (e-cigarettes), except for menthol and tobacco. JUUL customers have quickly discovered that flavoured disposable e-cigarettes from other manufacturers, such as Puff, are readily available. Our goal was to compare flavour chemicals, synthetic coolants and pulegone in mint-flavoured/menthol-flavoured e-cigarettes from JUUL and Puff, evaluate the cytotoxicity of the coolants and perform a cancer risk assessment for pulegone, which is present in both JUUL pods and disposable Puff products. Methods Identification and quantification of chemicals were performed using gas chromatography/mass spectrometry. Cytotoxicity of the coolants was evaluated with BEAS-2B cells using the MTT 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The cancer risk of pulegone was calculated using the margin of exposure (MOE). Results Menthol was the dominant flavour chemical (>1 mg/mL) in all products from both manufacturers. Minor flavour chemicals (<1 mg/mL) differed in the JUUL and Puff fluids and may produce flavour accents. The concentrations of WS-3 and WS-23 were higher in Puff than in JUUL. WS-23 was cytotoxic in the MTT assay at concentrations 90 times lower than concentrations in Puff fluids. The risk of cancer (MOE<10 000) was greater for mint than for menthol products and greater for Puff than for JUUL. Conclusions Switching from flavoured JUUL to Puff e-cigarettes may expose users to increased harm due to the higher levels of WS-23 and pulegone in Puff products. Cancer risk may be reduced in e-cigarettes by using pure menthol rather than mint oils to produce minty-flavoured e-cigarette products.
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