Study links youth vaping to increased metal exposure, raising public health concerns

Study links youth vaping to increased metal exposure, raising public health concerns

In a recent study published inBMJ Tob ControlResearchers examined factors associated with urinary biomarkers of metal exposure from e-cigarettes in adolescents in the United States (US).

background

E-cigarettes have become the predominant form of nicotine use among U.S. teenagers, and their use is increasing dramatically.

These e-cigarettes are sold in a variety of flavors and contain potentially dangerous chemicals, including metals. Metal concentrations in e-cigarette aerosol formulations and liquids are common, making youth vaping a serious public health risk.

Metals ingested through the consumption of tobacco and e-cigarettes can cause systemic damage, particularly in childhood and adolescence.

Chronic exposure to lead at low concentrations has significant effects on cardiovascular and cognitive outcomes. Exposure to cadmium increases the incidence of osteoporosis and acts as a significant carcinogen through various biochemical processes.

Chronic exposure to lead in low concentrations impairs the cardiovascular and renal systems, cognitive and intellectual development, and fertility of both sexes. Exposure to uranium can cause local cytotoxic effects, and renal tubule toxicity is particularly harmful.

About the study

In the present study, researchers analyzed metal exposure in adolescent e-cigarette users and examined associations between metal concentrations and vaping frequency and taste.

Researchers analyzed data from the fifth wave of the Population Assessment of Tobacco and Health (PATH) study, conducted between December 2018 and November 2019 and involving 200 U.S. adolescents between the ages of 13 and 17.

Using mass spectrometry, they analyzed urine contamination with uranium, cadmium and lead based on the frequency and taste of vaping. The detection limits for uranium, lead and cadmium were 0.0024 µg/L, 0.022 µg/L and 0.055 µg/L, respectively.

The team classified participants who reported using e-cigarettes ≥ 1.0 days in the previous month as current e-cigarette users. They divided e-cigarette frequency into frequent (>20 days), intermittent (six to <20 days), and occasional (one to five days) within the previous month, as well as flavors such as mint/menthol, sweet (such as candy, chocolate, and desserts), and fruit.

They collected urine samples from participants in the fourth wave of PATH, excluding those who received nicotine replacement treatment in the last three days and those with creatinine levels ≤ 10.0 mg/dL or above 370 mg/dL.

Researchers also excluded people who used other forms of tobacco (e.g., cigars, cigarettes, hookahs, pipes, bidi, smokeless tobacco, or kretek), e-cigarette non-users, and users of e-cigarettes that did not contain nicotine.

For the analysis, they used multivariate linear regressions and geometric mean ratios (GMR) adjusted for exposure to used tobacco, e-cigarette device type, age, gender, race, ethnicity and household income.

Results

Among the participants (mean age 16 years, 63% female), 65 used occasionally, 45 used some of the time, and 81 used frequently.

The average number of daily puffs showed an exponential increase in vaping frequencies (0.90 puffs, 7.90 puffs, and 27 puffs for occasional use, intermittent use, and frequent use, respectively). The researchers found that 33% preferred mint/menthol, 50% preferred fruity and 15% preferred sweet flavors.

Intermittent (0.2 ng/mg creatinine) and frequent e-cigarette users (0.2 ng/mg creatinine) had higher urinary lead concentrations than those who used e-cigarettes occasionally (0.2 ng/mg creatinine).

Intermittent users had higher urine lead concentrations compared to occasional e-cigarette users (GMR, 1.4). Similarly, frequent e-cigarette users also showed higher urine lead levels than occasional users (GMR, 1.3).

Adolescents who frequently used e-cigarettes also showed higher urinary uranium concentrations than adolescents who occasionally used e-cigarettes (0.0090 ng versus 0.0050 ng per mg creatinine, GMR 2.3).

Those who preferred sweet flavors showed higher uranium concentrations than those who preferred mint/menthol flavors (0.0090 ng versus 0.0050 ng per mg creatinine, GMR 1.9).

Conclusions

The study results showed that vaping at a young age increases the risk of metal exposure, which can damage organ development and alter brain function. Frequent and intermittent users reported higher levels of lead and uranium in urine compared to occasional users.

Sweet-flavored vapers had almost twice as much uranium as menthol or mint users. The findings are concerning because a significant number of teen vapers use candy-flavored e-cigarettes, which could reduce the unpleasant effects of nicotine while enhancing its rewarding effects, leading to increased responsiveness to brain signals.

The study highlights the importance of passing e-cigarette laws and developing targeted prevention measures for youth.

Future research with larger samples could consider regional differences and metal concentrations in e-cigarette aerosol forms or e-liquids as contaminants or byproducts.

Further studies could reveal the specific sources and mechanisms of uranium exposure. E-cigarette regulations are intended to protect young people from addiction and exposure to metals.

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