The role of E-liquid vegetable glycerin and exhaled aerosol on cue reactivity to tank-based electronic nicotine delivery systems (ENDS)
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Electronic nicotine delivery systems (ENDS or e-cigarettes) share salient features of combustible smoking, such as inhalation and exhalation behaviors, and evidence indicates that first- and second-generation ENDS generalize as smoking cues. The present study examined whether newer, tank-based third-generation ENDS (“mods”) also evoke smoking urges, and whether enhancing the visibility of exhaled aerosol clouds—by increasing the e-liquid vegetable glycerin (VG) content—strengthens the cue salience of ENDS.
The objective was to assess the role of exhaled aerosol clouds on ENDS cue potency using a standardized laboratory paradigm designed to mimic real-world exposures.
Using a mixed design, young adult smokers (n = 50; mean age 26.5 years; ≥ 5 cigarettes/day) observed a study confederate drinking bottled water (control cue) and vaping an ENDS mod containing e-liquid with either high (73%) or low (0%) VG. Participants completed the Brief Questionnaire on Smoking Urges (BQSU) and visual analog scales (VAS) assessing cigarette and e-cigarette desire pre- and post-cue exposure.
Increasing the e-liquid content of VG enhanced the size and visibility of the exhaled aerosol clouds and evoked a greater increase in smoking desire and a more sustained increase in e-cigarette desire relative to the low VG cue. Both cues elicited increases in smoking urges. These results remained after controlling for sex, prior ENDS experience, recent smoking behavior, and menthol preference.
Observation of tank-based ENDS use generalizes as a smoking cue and its cue salience is strengthened by increasing the e-liquid content of VG to enhance the visibility of the exhaled aerosol cloud.
KeywordsElectronic cigarettes Electronic nicotine delivery systems Urge Cues Vegetable glycerin Mods Vaping
Appreciation is extended to Patrick McNamara for protocol assistance, Luke Newell, Eric Giger, and Jennan Qato for research support, and Tony Pace, Pace Engineering Concepts, Milwaukee, WI, for e-liquid preparation and quality control.
This study was supported by R56-DA044210, T32-DA043469, and Department of Psychiatry and Behavioral Neuroscience Research Faculty Fund.
Compliance with ethical standards
The study was fully approved by the University of Chicago Institutional Review Board.
Conflict of interest
Dr. King has received funding from the National Institutes of Health and from Pfizer, Inc., has provided past consultation to Lundbeck and the US Food and Drug Administration, and has served on a health advisory board to Pfizer Inc. Dr. Cao has provided consultation to the US Food and Drug Administration. AV and MH have no conflicts of interest to declare.
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