October 5, 2014

Stanton A. Glantz, PhD

Nonsmokers around e-cigs absorb nicotine at levels similar to passive cigarette smokers: Smoke-free should also be ecig-free

Esteve Fernández' group has just published an important paper, "Cigarettes vs. e-cigarettes:Passive exposure at home measured by means of airborne marker and biomarkers," that found elevated levels of airborne nicotine in homes of e-cigarette users that, while not as high as in cigarette smoekrs' homes was significantly elevated over that observed in nonsmokers' homes.  More important, the levels of salivary and urinary cotinine, measures of absorbed nicotine was elevated to similar levels in bystanders in both the e-cigarette and cigarette users' homes.
This paper shows in real world enviornments, that bystanders are bystanders are taking nicotine into their bodies (and, by inference, the other pollutants that e-cigas put into the air) as a result of passive exposure.
This paper, together with earlier research (from chamber studies), provides a compelling case for including e-cigarettes in clean indoor air laws and for people to prohibit their use in smokefree homes.
Here is the abstract:
Background: There is scarce evidence about passive exposure to th evapour released or exhaled from electronic cigarettes (e-cigarettes) under real conditions. The aim of this study is to characterise passive exposure to nicotine from e-cigarettes' vapour and conventional cigarettes' smoke at home among non-smokers  under real-use conditions.
Methods: We conducted an observational study with 54 non-smoker volunteers from different homes: 25 living at home with conventional smokers, 5 living with nicotine e-cigarette users, and 24 from control homes (not using conventional cigarettes neither e-cigarettes). We measured airborne nicotine at home and biomarkers (cotinine in saliva and urine). We calculated geometric mean (GM) and geometric standard deviations (GSD).  We also performed ANOVA and Student's t tests for the log-transformed data.  We used Bonferroni-corrected t-tests to control the family error rate for multiple comparisons at 5%.
Results: The GMs of airborne nicotine were 0.74 μg/m3 (GSD 4.05)  in the smokers’ homes, 0.13 μg/m3 (GSD 2.4) in the e-cigarettes users’ homes, and 0.02 μg/m3 (GSD 3.51) in the control homes. The GMs of salivary cotinine were 0.38 ng/ml (GSD 2.34) in the smokers’ homes, 0.19 ng/ml (GSD 2.17) in the e-cigarettes users’ homes, and 0.07 ng/ml (GSD 1.79) in the control homes. Salivary cotinine concentrations of the non-smokers exposed to e-cigarette's vapour at home (all exposed >2 h/day) were statistically significant different that those found in non-smokers exposed to second-hand smoke  >2 h/day and in non-smokers from control homes.
Conclusions: The airborne markers weres tatistically higher in conventional cigarette homes than in e-cigarettes homes (5.7 times higher). However, concentrations of both biomarkers among non-smokers exposed to conventional cigarettes and e-cigarettes’ vapour were statistically similar (only 2 and 1.4t imes higher, respectively). The levels of airborne nicotine and cotinine concentrations in the homes with e-cigarette users were higher than control homes (differences statistically significant). Our results show that non-smokers passively exposed to e-cigarettes absorb nicotine.
The full paper, published in Environmental Research is available here.



It is worth noting that Esteve Fernández' paper "Cigarettes vs. e-cigarettes:Passive exposure at home measured by means of airborne marker and biomarkers," measured the indoor airborne concentration of nicotine using a method that is designed to collect nicotine in the gas phase and NOT the particulate phase.
While nicotine that is emitted into the indoor air from conventional cigarettes, has been determined to reside primarily in the gas phase, nicotine emitted by e-cigarettes is expected to reside primarily in the particulate phase. Thus, the indoor air concentrations of nicotine in the homes with e-cigarettes users is likely to be substantially underestimated in this paper. This is also true for the indoor air nicotine concentrations from e-cigarettes that is reported in the Czogala (2013) paper, which also used a method that is designed to collect nicotine in the gas phase NOT the particulate phase. I raised this issue in a paper delivered in Hong Kong this summer and for which ASHRAE published the following Journal article "The Hazards of E-Cigarettes" http://www.iee-sf.com/pdf/ASHRAEJOffermann.pdf" title="http://www.iee-sf.com/pdf/ASHRAEJOffermann.pdf";http://www.iee-sf.com/pd...
To better understand the total amount of nicotine emitted into indoor air from e-cigarettes (gas and particulate phase), we have developed a method to simultaneously collect nicotine in both the gas and particulate phases and currently are seeking funding to conduct precision and accuracy tests of this new method.
Bud Offermann PE CIH
Indoor Environmental Engineering
1448 Pine Street, Suite 103
San Francisco, CA 94109
E-mail: mailto:[email protected]";Offermann@IEE-SF.com
Web Site: http://www.IEE-SF.com" title="http://www.IEE-SF.com";http://www.IEE-SF.com

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