title: Cherry-flavoured electronic cigarettes expose users to the inhalation irritant, benzaldehyde.
abstract: Many non-cigarette tobacco products, including e-cigarettes, contain various flavourings, such as fruit flavours. Although many flavourings used in e-cigarettes are generally recognised as safe when used in food products, concerns have been raised about the potential inhalation toxicity of these chemicals. Benzaldehyde, which is a key ingredient in natural fruit flavours, has been shown to cause irritation of respiratory airways in animal and occupational exposure studies. Given the potential inhalation toxicity of this compound, we measured benzaldehyde in aerosol generated in a laboratory setting from flavoured e-cigarettes purchased online and detected benzaldehyde in 108 out of 145 products. The highest levels of benzaldehyde were detected in cherry-flavoured products. The benzaldehyde doses inhaled with 30 puffs from flavoured e-cigarettes were often higher than doses inhaled from a conventional cigarette. Levels in cherry-flavoured products were >1000 times lower than doses inhaled in the workplace. While e-cigarettes seem to be a promising harm reduction tool for smokers, findings indicate that using these products could result in repeated inhalation of benzaldehyde, with long-term users risking regular exposure to the substance. Given the uncertainty surrounding adverse health effects stemming from long-term inhalation of flavouring ingredients such as benzaldehyde, clinicians need to be aware of this emerging risk and ask their patients about use of flavoured e-cigarettes.
authors.affiliation: Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland Department of General and Inorganic Chemistry, Medical University of Silesia, Katowice, Poland.
authors.forename: Leon
authors.initials: L
authors.lastname: Kosmider
authors.affiliation: Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland Department of General and Inorganic Chemistry, Medical University of Silesia, Katowice, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Sobczak
authors.affiliation: Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Prokopowicz
authors.affiliation: Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Kurek
authors.affiliation: Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland.
authors.forename: Marzena
authors.initials: M
authors.lastname: Zaciera
authors.affiliation: Department of General and Inorganic Chemistry, Medical University of Silesia, Katowice, Poland.
authors.forename: Jakub
authors.initials: J
authors.lastname: Knysak
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Smith
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors.forename: Maciej L
authors.initials: ML
authors.lastname: Goniewicz
mesh_terms: D000280:Administration, Inhalation; D001547:Benzaldehydes / Q000009:adverse effects* / Q000032:analysis; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects* / Q000706:statistics & numerical data; D005421:Flavoring Agents / Q000009:adverse effects* / Q000032:analysis; D006801:Humans; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D001547:Benzaldehydes; D005421:Flavoring Agents; C032175:benzaldehyde
keywords: Drug induced Lung Disease; Inhaler devices; Tobacco and the lung; Tobacco control
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