DOI
https://doi.org/10.25772/13JY-VN06
Author ORCID Identifier
0000-0002-0474-6622
Defense Date
2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Integrative Life Sciences
First Advisor
Dr. Michelle Peace
Second Advisor
Dr. Alison Breland
Third Advisor
Dr. Les Edinboro
Fourth Advisor
Dr. Matthew Halquis
Fifth Advisor
Dr. Frederick Moeller
Sixth Advisor
Mr. Justin Poklis
Abstract
The modern electronic cigarette (e-cig) was designed as an alternative nicotine delivery system, and its adoption was widespread and rapid. Advertising claims have led users to believe the liquid formulations (e-liquids) used in e-cigs are relatively simple and safe based on labeling practices. Anecdotal reports found online and direct correspondence from e-cig users indicate that consumers are experiencing alarming and serious adverse events following e-cig use, including delusions, hallucinations, and failed drug tests. The following work documents the surveillance of e-liquids over a six-year period to elucidate chemical compositions of commercially available products. Analytical methods were developed to support characterization, which identified numerous pharmacologically active ingredients, flavoring chemicals, and chemicals which served unknown purposes. Results demonstrated that labeled concentrations of active ingredients were often incorrect, and many pharmacologically active ingredients were not listed. The identification of ethanol as a common ingredient, along with reports of users reporting disciplinary or legal action due to the failed ethanol drug testing following e-cig use, dictated the need for further studies. A clinical study was designed to investigate the impact of vaping ethanol-containing e-liquids on standard impairment testing practices used by law enforcement, and impacts on subjective feelings of impairment. Results demonstrate ethanol could be detected in breath following use of a 20% ethanol e-liquid, but that a wait period of 5 minutes was sufficient to clear residual ethanol. A stability study determined ethanol in e-liquids is stable at various temperatures over six-plus months, suggesting ethanol concentrations in an e-liquid kept at similar conditions will not decrease over a typical e-liquid lifespan. A product submitted as part of a case involving an e-cig user who tested positive for ethanol by preliminary breath testing after submitting for random workplace drug testing was determined to contain ethyl acetate. Ethyl acetate converts to ethanol in vivo, further demonstrating impairment testing complications arising from e-cig use. Continued surveillance of e-liquids and clinical studies assessing ingredient health and safety, impacts of vaping on understood pharmacokinetics, and challenges to interpretation are vital to inform and educate e-cig users, law enforcement, physicians, clinicians, and other stakeholders of the possible negative outcomes from e-cig use.
Rights
© Alaina K Holt
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
12-8-2023