Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects
Self-titration is well documented in the tobacco literature. The extent to which e-cigarette users (vapers) self-titrate is unknown.
This study explored the effects of high and low nicotine strength liquid on puffing topography, nicotine delivery and subjective effects in experienced vapers.
Eleven experienced male vapers completed 60 min of ad libitum vaping under low (6 mg/mL) and high (24 mg/mL) nicotine liquid conditions in two separate sessions. Measurements included puffing topography (puff number, puff duration, volume of liquid consumed) and changes in plasma nicotine levels, craving, withdrawal symptoms, self-reported hit, satisfaction and adverse effects.
Liquid consumption and puff number were higher and puff duration longer, in the low nicotine strength condition (all ps < 0.01). The mean difference in nicotine boost from baseline in the low condition was 8.59 (7.52) ng/mL, 16.99 (11.72) ng/mL and 22.03 (16.19) ng/mL at 10, 30 and 60 min, respectively. Corresponding values for the high condition were 33.77 (34.88) ng/mL, 35.48 (28.31) ng/mL and 43.57 (34.78) ng/mL (ps < 0.05). There were no statistically significant differences between conditions in self-reported craving, withdrawal symptoms, satisfaction, hit or adverse effects.
Vapers engaged in compensatory puffing with lower nicotine strength liquid, doubling their consumption. Whilst compensatory puffing was sufficient to reduce craving and withdrawal discomfort, self-titration was incomplete with significantly higher plasma nicotine levels in the high condition.
KeywordsNicotine Titration E-cigarette Puffing topography Compensation
- Etter J-F (2015) Explaining the effects of electronic cigarettes on craving for tobacco in recent quitters. Drug Alcohol Depend 148:102–108, ISSN 0376–8716, http://dx.doi.org/10.1016/j.drugalcdep.2014.12.030 (0)
- Farsalinos KE, Spyrou A, Stefopoulos C, Tsimopoulou K, Kourkoveli P, Tsiapras D et al (2015) Nicotine absorption from electronic cigarette use: comparison between experienced consumers (vapers) and naïve users (smokers). Sci Rep 5:11269. doi:10.1038/srep11269 CrossRefPubMedPubMedCentralGoogle Scholar
- Farsalinos, KE., Yannovits, N., Sarri, R., Voudris, V. & Poulas, K. (2016). Protocol proposal for, and evaluation of, consistency in nicotine delivery from the liquid to the aerosol of electronic cigarettes atomizers: regulatory implications. Addiction, online ahead of print. Doi: 10.1111/add.13299
- Ramôa CP, Hiler MM, Spindle TR, Lopez AA, Karaoghlanian N, Lipato T, et al. (2015). Electronic cigarette nicotine delivery can exceed that of combustible cigarettes: a preliminary report. Tob ControlGoogle Scholar
- Russell MA, Jarvis M, Iyer R, Feyerabend C (1980) Relation of nicotine yield of cigarettes to blood nicotine concentrations in smokers. Br Med J 280(6219):972–976Google Scholar
- Talih S, Balhas Z, Eissenberg T, Salman R, Karaoghlanian N, El Hellani A, et al. (2014) Effects of user puff topography, device voltage, and liquid nicotine concentration on electronic cigarette nicotine yield: measurements and model predictions. Nicotine Tob Res 17(2):150–157Google Scholar