E-cigarette Nicotine Delivery: Data and Learnings from Pharmacokinetic Studies

Objectives: E-cigarettes could potentially play a major role in tobacco harm reduction by delivering nicotine in a vapor containing significantly fewer toxicants than cigarette smoke and may aid smoking behavior changes such as reduction or cessation. Methods: We examined blood nicotine levels in smokers who were non-accustomed to e-cigarette use (Study 1) and accustomed e-cigarette users (Study 2). We compared nicotine levels when participants used a closed modular system e-cigarette to those when participants smoked a cigarette. Results: In Study 1, C-max (geometric mean (CV)) during a 5-minute puffing period (10 puffs, 30 seconds apart) was 13.4 (51.4%) ng/ml for a regular cigarette. The e-cigarette C-max was significantly lower (p <.05) at 2.5 (67.8%) ng/ml. In Study 2, during a 5-minute ad libitum puffing period, cigarette C-max was 7.2 (130.8%) ng/mL, and it was 7.8 (108.2%) ng/mL for the e-cigarette. Conclusions: Our data demonstrate heterogeneity of nicotine deliveries both between products and also with the same products used by different cohorts, eg, accustomed users versus smokers. Such differences must be taken into account when determining the likely behavioral impact, on smoking reduction and cessation, of nicotine delivery data and when planning e-cigarette nicotine pharmacokinetic studies.