Volume 216 - Issue 8
Chemical analysis of fresh and aged Australian e‐cigarette liquids
Authors: Alexander Larcombe, Sebastien Allard and Benjamin Mullins
Med J Aust 2022; 216 (8): 430-430. || doi: 10.5694/mja2.51481
Published online: 2 May 2022
Published online: 2 May 2022
In reply
In reply: We thank the Mendelsohn and Wodak1 for their interest and assessment of our study.2 We would like to respond with clarifying information.
We challenge the statement that “frequent vaping is largely confined to smokers”. While this may be true for older smokers, considerable evidence exists that vaping in non‐smokers and adolescents is rapidly increasing, that younger vapers are unlikely to use e‐cigarettes for smoking cessation,3 and that e‐cigarette use increases the risk of tobacco smoking.4 The argument that vaping is safer than smoking is moot for these users.
The authors state “the risk to human health depends on the level of exposure”. We agree and, therefore, we made no definitive statements as to whether the chemicals detected would have an impact on health. Many assumptions are required for such a statement, as there is no “typical” e‐cigarette user. It is obvious that multiple factors (device type/settings, puff volume/frequency, e‐liquid composition etc) affect the volume of chemicals inhaled. Hence our call for more research in this area.
We also agree (and state) that e‐cigarette aerosol analysis is important. It is likely that aerosols will contain a wider array of potentially toxic chemicals generated by thermal degradation of excipients and other ingredients.5 E‐liquid analysis provides valuable information in that chemicals identified are very likely to also be present in the aerosols.
The authors’ dismissal of the effect of flavouring chemicals is alarming, considering the mounting evidence of the toxicity of many flavourants.6 Dismissing other chemicals because they are at “low or very low levels” is also concerning given a lack of evidence for the health effects of heating and repeatedly inhaling many e‐liquid chemicals over long periods. Further, the Public Health England endorsement of e‐cigarette safety and efficacy has been widely questioned by many leading organisations, including the British Medical Association, the American Lung Association, and the World Health Organization.7
Mendelsohn and Wodak are disappointed that we did not state any competing interests. We openly declare the funders of the project and reiterate that there are no competing interests. The funders played no role in study design, execution, data analysis or interpretation.
Competing interests
No relevant disclosures.
Acknowledgements
The study on which this letter is based was funded by the Lung Foundation Australia, the Minderoo Foundation, Cancer Council Western Australia, and the Scottish Masonic Charitable Foundation. The authors received no salaries, fees or honoraria from the funders. The funders were not involved in any aspect of the submitted letter.
References
- Mendelsohn CP, Wodak AD. Chemical analysis of fresh and aged Australian e‐cigarette liquids [letter]. Med J Aust 2022; 216: 431.
- Larcombe A, Allard S, Pringle P, et al. Chemical analysis of fresh and aged Australian e‐cigarette liquids. Med J Aust 2022; 216: 27‐32. https://www.mja.com.au/journal/2022/216/1/chemical‐analysis‐fresh‐and‐aged‐australian‐e‐cigarette‐liquids
- Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2019 [Cat. No. PHE 270]. https://www.aihw.gov.au/reports/illicit‐use‐of‐drugs/national‐drug‐strategy‐household‐survey‐2019/contents/summary (viewed Mar 2022).
- Glantz SA, Bareham DW. E‐cigarettes: use, effects on smoking, risks, and policy implications. Annu Rev Public Health 2018; 39: 215‐235.
- Uchiyama S, Noguchi M, Sato A, et al. Determination of thermal decomposition products generated from e‐cigarettes. Chem Res Toxicol 2020; 33: 576‐583.
- Marques P, Piqueras L, Sanz MJ. An updated overview of e‐cigarette impact on human health. Respir Res 2021; 22: 151.
- McKee M, Capewell S. Evidence about electronic cigarettes: a foundation built on rock or sand? BMJ 2015; 351: h4863.
Linked content
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MJA Research: Chemical analysis of fresh and aged Australian e‐cigarette liquids
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MJA Letter: Chemical analysis of fresh and aged Australian e‐cigarette liquids