Users of Cherry-Flavored E-Cigarettes May Be Exposed to Higher Levels of Respiratory Irritant

Presence of benzaldehyde in vapor from 108 products studied has important implications for consumers, clinicians

BUFFALO, N.Y. — An analysis of 145 different electronic-cigarette flavoring products reveals that many e-cigarette users may be exposed to a potentially harmful chemical. In a research letter published online today in the peer-reviewed journal Thorax, a research team led by Maciej Goniewicz, PhD, PharmD, of Roswell Park Comprehensive Cancer Center reports that high levels of the respiratory irritant benzaldehyde were detected in the vapor from most of the flavored nicotine products they studied, with the highest concentrations in vapor from cherry-flavored products.

Benzaldehyde is a compound used in many foods and cosmetic products. While it appears to be safe when ingested or applied on the skin, it has been shown to cause airway irritation in animals and humans, and may have different effects when heated and inhaled, as when used in vaping.

The authors, who include researchers from the Institute of Occupational Medicine and Environmental Health and the Medical University of Silesia, both in Poland, measured benzaldehyde levels for 145 different flavored nicotine products using an automatic smoking simulator and calculated daily exposure to users from 163 e-cigarette puffs. Their analysis detected benzaldehyde in the vapor from 108 (74%) of the flavored products studied, and found concentrations of the chemical that were 43 times higher in cherry-flavored products than in other flavors.

Dr. Goniewicz, the paper’s senior author and Assistant Professor of Oncology in Roswell Park’s Department of Health Behavior, notes that this research was focused on a single toxicant and should be interpreted as a first step in understanding the potential health effects from flavored e-cigarettes.

“This analysis reveals some very important implications,” he says. “Health care professionals should be asking patients not just whether they smoke tobacco cigarettes but also whether they vape e-cigarettes, and whether they are using flavored products. For e-cigarette users, it’s important that they pay attention to how the products are affecting them. If they notice irritation, maybe a cough or sore throat, when they use e-cigarettes, they might want to consider switching to a different flavoring. And it’s also important to keep these findings in perspective. The potential harm, if any, from inhaling flavored e-cigarettes would probably not even approach the dangerous, deadly effects of tobacco. It will be important to follow this work up with studies that assess the long-term effects and chronic toxicity of e-cigarette flavorings in humans.”

The study, “Cherry-flavoured electronic cigarettes expose users to the inhalation irritant, benzaldehyde,” is available online at thorax.bmj.com.

This research was supported by grants from the Medical University of Silesia, the Institute of Occupational and Environmental Health and the National Institute on Drug Abuse (NIDA), an agency within the National Institutes of Health (award no. R01DA037446).

Some of the authors are employees of an institute that performs outsourcing for the industrial sector, including manufacturers of e-cigarettes. One author has accepted personal fees from the eSmoking Institute in Poland, and nonfinancial support from a manufacturer of electronic cigarettes, and another author received an award funded by a manufacturer of smoking-cessation medications. These outside activities had no influence on the design, conduct, manuscript preparation, statistical analysis or other aspects of this research.

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