Is a Harmful Level of Nicotine Exhaled When Vaping?

Is a harmful level of nicotine exhaled when vaping?

Is a harmful level of nicotine exhaled when vaping?

Check out this answer from Consensus:

The current body of research suggests that the level of nicotine exhaled by e-cigarette users is relatively low, especially when compared to traditional cigarette smokers. However, the potential for increased frequency and intensity of use with higher nicotine concentrations in e-cigarettes raises concerns about overall nicotine exposure. Further research is needed to fully understand the long-term implications of vaping on both users and bystanders, as well as its impact on indoor air quality and public health1 2 3 4 5.


The Impact of Vaping on Nicotine Exposure in Exhaled Breath

The advent of electronic cigarettes (e-cigarettes) has introduced a new dimension to nicotine consumption and its subsequent environmental impact. Recent studies have focused on the levels of nicotine exhaled by individuals using e-cigarettes and the potential passive exposure to bystanders. This article synthesizes findings from multiple research papers to address the question of whether vaping results in a harmful level of nicotine being exhaled.

A study utilizing ion mobility spectrometry (IMS) after liquid-liquid microextraction (LLME) found that the nicotine levels in the exhaled breath of e-cigarette users were significantly lower than those of traditional cigarette smokers. Specifically, experienced smokers of conventional cigarettes exhaled about 220 ng of nicotine per puff, whereas e-cigarette users exhaled only 32 ng. Furthermore, the nicotine concentration in oral fluids of passive vapers was between 8 and 14 µg L^(-1), which is considerably lower than that found in passive smokers of rolling tobacco or classical yellow blend cigarettes1.

Another research effort explored the associations between the nicotine concentration in e-cigarettes and subsequent smoking behaviors in adolescents. The study revealed that higher nicotine concentrations in e-cigarettes were associated with increased frequency and intensity of both smoking and vaping at a 6-month follow-up. This suggests that while the immediate exhalation of nicotine may be lower in e-cigarette users, the use of high-nicotine e-cigarettes could lead to greater overall nicotine consumption due to more frequent use2.

Investigations into the influence of e-cigarette vaping on indoor air quality revealed that vaping doubled the indoor concentrations of particles smaller than 10 µm, which likely originated from the e-liquid ingredients. However, the increases in nicotine and formaldehyde concentrations were small compared to other studies of indoor atmospheres or health regulatory thresholds. Notably, no significant changes were observed in the concentrations of exhaled breath on vaping versus non-vaping days, indicating that the amount of nicotine exhaled by vapers may not be substantial3.

An experimental method to determine the concentration of nicotine in exhaled breath after e-cigarette use found that over 99% of the nicotine was retained by participants when the aerosol was inhaled, and an average of 86% was retained when the aerosol was held in the mouth only. The concentrations of nicotine detected in exhaled breath were low, ranging from 1.8 to 1786 ppb, suggesting that the level of nicotine exhaled by vapers is minimal4.

Research on self-titration by experienced e-cigarette users showed that users engaged in compensatory puffing with lower nicotine strength liquid, doubling their consumption. While this behavior was sufficient to reduce craving and withdrawal discomfort, higher plasma nicotine levels were observed in the condition with high nicotine strength liquid. This indicates that while vapers can adjust their usage to manage nicotine intake, the actual nicotine retention in the body may vary depending on the strength of the e-liquid5.


Is a harmful level of nicotine exhaled when vaping?

Neal Benowitz, MD has answered Uncertain

An expert from University of California, San Francisco in Smoking, Pharmacology, Medicine

  1. The amount of nicotine varies tremendously by the type of device and the behavior of the vaper. High power devices generate large amounts of aerosol, much of which may exhaled, such as in cloud chasing. Low power devices generate small amounts of aerosol, and very little is exhaled.
  2. Nicotine that is exhaled quickly leaves particles and enters the environment as a gas, then deposits on surfaces. Nicotine can be found on surfaces in homes and business where people vape. Non-nicotine users who lives with vapers have measurable but low levels of cotinine (the main metabolite of nicotine) in their blood. 
  3. Whether low levels of nicotine in the air or on surfaces causes human disease is unclear. Thirdhand tobacco smoke (THS) can aggravate allergies and respiratory conditions, but THS contains many other toxicants in addition to nicotine.


Is a harmful level of nicotine exhaled when vaping?

Paweł Kubica has answered Unlikely

An expert from Gdansk University of Technology in Analytical Chemistry

According to the:

J.N. Newton, M. Dockrell, T. Marczylo, Making sense of the latest evidence on electronic cigarettes, The Lancet, 391, 10121, p639-642

British Medical Association. E-cigarettes: balancing risks and opportunities. London: British Medical Association, 2017

“Passive exposure to EC aerosol is likely to pose a negligible health risk to bystanders”

It is unlikely to be harmful.


Is a harmful level of nicotine exhaled when vaping?

Mathieu C Morissette has answered Uncertain

An expert from Université Laval in Cell Biology

Very few data on this matter.

Vapers do exhale nicotine and it can remain in suspension in the room and be detected and quantified (PMID 30560536).

Variables affecting the amount of nicotine in the air are/can be severals: nicotine concentration in the e-liquid (from 0 to >30mg/ml); vaping intensity; room size; ventilation; distance between primary and secondary vaper; etc

Can it be harmfull? Acutely, very unlikely. However, chronic nicotine exposure does have adverse effects, especially in young individuals. We also have to consider that secondary vapers could, over time, develop low grade nicotine addiction that could make them more susceptible to start vaping or smoking. However, this remains a hypothesis.


Is a harmful level of nicotine exhaled when vaping?

Rebecca S Williams has answered Uncertain

An expert from University of North Carolina at Chapel Hill in Public Health, Cancer

There is insufficient research evidence to answer this question at this time, particularly in a general sense without context (number of people vaping, size of enclosed/unenclosed space, proximity to non-vaping people, how you define ‘harmful level of nicotine’, etc). I suspect that as more and more research on this topic is published, the evidence for secondhand e-cigarette vapor being a health risk to non-vapers will grow substantially.


Is a harmful level of nicotine exhaled when vaping?

Lynne Dawkins has answered Extremely Unlikely

An expert from London South Bank University in Addiction, Psychology, Public Health

Nicotine actually carries minimal health risks – it’s the thousands of other chemicals in tobacco smoke that are responsible for almost all the harms. There is clear evidence that second hand smoke is harmful but this is not because of the nicotine. In relation to e-cigarette vapour, in a recent evidence review of e-cigarettes commissioned by Public Health England (1) it was concluded that there is no evidence that e-cigarette vapour is harmful to bystanders. Detectable levels of nicotine have been found in e-cigarette vapour generated in the laboratory but these were 10 times lower than levels measured in tobacco smoke (3.32 μg /m3 compared with 31.6 μg /m3) (2). Moreover, under normal usage conditions, the user would inhale most of this vapour, so exhaled levels would be even lower. So, using an e-cigarette in an indoor environment may expose others to low levels of nicotine but this is unlikely to be harmful.




Is a harmful level of nicotine exhaled when vaping?

Thanh-Huyen T Vu has answered Likely

An expert from Northwestern University School of Medicine in Cardiovascular Disease, Epidemiology

Although scientific evidence isn’t yet available on the health effects of the aerosol from e-cigarettes, we cannot say that the nicotine exhaled when vaping is not harmful.

The exhaled aerosol contains nicotine, and nicotine is a known health risk. Also, the exhaled aerosol contains many other chemicals that can cause health problems. Therefore there may be a negative health effect from inhaling the nicotine exhaled by vapers. We are working to develop scientific evidence on this question.

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