Traces of Tobacco-Specific Nitrosamines Found in Some E-Liquids But Not in Aerosol Samples

Photo: The researchers used a second-generation e-cig that probably looks like this.

It's great to see the Greeks are winning the battle in electronic cigarette research. Doctor Farsalinos and his formidable team are once again kicking pro-tobacco propagandists' butts with their latest findings.

Here's how they did it...

First, the team selected three brands of e-juices from the market. They prepared testing samples in their liquid and aerosol forms and checked them for levels of tobacco-specific nitrosamines (TSNAs).

Three 100-puff sets from each liquid were trapped in filter pads and were subsequently analyzed for the presence of TSNAs. The expected levels of TSNAs (calculated based on the liquid consumption) were compared with the measured levels in the aerosol.

Next, the researchers prepared a control sample of flavored e-juice and deliberately added a cocktail solution of known nitrosamines to it.

Farsalinos and his team measured the levels of N-nitrosonornicotine (NNN), N-nitrosoanatabine (NAT), N-nitrosoanabasine (NAB), and 4-(methylnitrosamino)1-(3-pyridyl)-1-butanone (NNK) (if found) in each e-juice, including the spiked sample. Thousands of carcinogens are found in tobacco smoke, but these four were likely chosen because they have clearly identifiable markers that make them particularly easy to find and measure.

Here's a quick rundown of the levels of nitrosamines found by the FDA in nicotine gums, nicotine patches, e-cigarette liquids, and analog cigarettes. Image via The Ashtray Blog.

And, this is what the researchers found out...

Only NAB was found at trace levels in two commercial liquids (1.2 and 2.3 ng/g), while the third contained 1.5 ng/g NAB and 7.7 ng/g NNN. The 100-puff sets resulted in 336–515 mg liquid consumption, with no TSNAs being detected in the aerosol.

Tests done on the three e-liquid samples revealed that they're not completely free from the taint of TSNAs. The nicotine juice was likely contaminated during the extraction process. The researchers acknowledge that these "trace amounts" don't present an immediate danger to vapers and the people around them.

Here's the reason why the TSNAs were totally absent in aerosol samples:

Due to the very low levels of TSNAs in the commercial liquids, the respective aerosol samples contained, as expected, no TSNAs above the LOD [limit of detection].

When someone vapes e-juice that's been tainted with TSNAs, what happens to the nitrosamines? Well, they'll likely be absorbed into the bloodstream and end up in your lungs, brain, liver and kidneys. These carcinogenic compounds remain in your body for a little while before they're expelled through the excretory system.

Photo: This electronic cigarette may have trace amounts of tobacco-specific nitrosamines in it.

Read The Research Team's Concluding Statements

In their conclusion, the researchers stated that "exposure of EC users to TSNAs can be accurately assessed based on the levels present in the liquid, without the need to analyze the aerosol." The following text from the research paper of Farsalinos, et al expounds on this statement:

The levels of TSNAs in the EC liquids are minimal and by far lower compared to tobacco. This is probably attributed to the use of pharmaceutical grade nicotine that most manufacturers claim to use. This grade of nicotine is highly purified to remove the majority of impurities, including TSNAs.

However, there were no published reports evaluating if additional TSNAs can be formed during EC aerosol production. This is important since ECs are used in aerosol and not in liquid form, and heating is involved in the evaporation process.

The study herein verifies that the levels present in the aerosol are similar to those present in the liquid. Therefore, the analysis of TSNAs levels in the liquid would be enough to estimate the exposure of consumers to these substances, without the need to perform more complex and expensive analyses in the aerosol.

Do E-cigs Really Help You Stop Smoking?

You know how they always say that e-cigs has helped many people quit their smoking habit? Well, it seems there's scientific evidence to support that claim. In 2013, a group of researchers did a 12-month randomized controlled study on 300 smokers who had no plans of quitting. Here are the results of the study:

Declines in cig/day use and eCO levels were observed at each study visits in all three study groups (p<0.001 vs baseline), with no consistent differences among study groups. Smoking reduction was documented in 22.3% and 10.3% at week-12 and week-52 respectively. Complete abstinence from tobacco smoking was documented in 10.7% and 8.7% at week-12 and week-52 respectively.

The takeaway from this technical mumbo-jumbo is that a significant number of smokers who participated in the study went on to completely abstain from tobacco after a year of using e-cigarettes in a controlled manner. It's interesting to note that these smokers didn't want to quit at the time they began the study. You can just imagine how much more effective the process could have been if they asked smokers who wanted to quit in the first place.

The significant reduction in cigarette consumption and the enduring tobacco abstinence aren't the only good things to come out of this study. Participants also reported a substantial decrease in side effects and fewer withdrawal symptoms.

Two years after, another group of researchers came along with the same intent: find proof that e-cigarettes have the potential to help smokers reduce their nicotine intake and ultimately end their nicotine addiction altogether.

It should be noted that at the end of T8 follow-up about 53% of participants were still abstinent from tobacco cigarettes (only e-cig users); this cessation rate is higher than the 21% obtained by Adriaens and colleagues at the same time interval. In light of this result, it could be considered that the technical, behavioural, and psychological support offered in our medically assisted training was able to offer a quicker and efficient intervention to help the participants.

All in all, smokers - whether they wanted to quit or not - will eventually stop their smoking habit when they undergo a medically assisted training program on e-cigarette use. The cravings disappear, withdrawal symptoms are less severe, and no overdose incidents are observed. A large number of smokers gradually ended their nicotine dependence and showed significantly fewer biomarkers of cigarette combustion products in the body.