Study reveals how salt-based nicotine and menthol flavors influence e-cigarette use in young adults

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Study reveals how salt-based nicotine and menthol flavors influence e-cigarette use in young adults
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Study found that salt-based nicotine and menthol flavoring in e-cigarettes significantly increase nicotine levels and positive experiences among young adults, potentially heightening addiction risks.

By Dr. Liji Thomas, MDReviewed by Benedette Cuffari, M.Sc.Aug 14 2024 A recent study published in JAMA Network Open examines how salt-based nicotine formulations and menthol flavorings impact nicotine levels and the subjective experience of using e-cigarettes in young adults.

Although the concentration of freebase nicotine in e-cigarettes is up to 90% lower than that in traditional cigarettes, the incorporation of various additives leads to the formation of nicotine salts and non-tobacco flavors that facilitate nicotine dependence. As a result, nicotine inhalation through e-cigarettes is smoother and easier, which increases their palatability for continuous use.

In the first session, all study participants used their usual e-cigarette brand. In the following eight sessions, study participants were provided with any of the laboratory-formulated e-cigarette formulations. A five-minute 10-puff inhalation period was followed by 30 minutes of unrestricted vaping.

Nicotine uptake Salt-based nicotine e-cigarettes were associated with the highest nicotine uptake, especially with the 5% concentration. This led to mean plasma levels of 11.2 ng/mL and 17.2 ng/mL at five and 35 minutes, respectively. Tobacco-flavored 5% freebase nicotine had the least positive subjective outcomes, whereas menthol-flavored 5% nicotine salts had the highest subjective experiences for almost all positive measures.

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