Evidence map›Paper›PMID 34987081›Full record

ArticleTobacco control2023

Comprehensive Dutch market data analysis shows that e-liquids with nicotine salts have both higher nicotine and flavour concentrations than those with free-base nicotine.

Jeroen L A Pennings, Anne Havermans, Charlotte G G M Pauwels, Erna J Z Krüsemann, Wouter F Visser, Reinskje Talhout

Open access · hybridAbstract read
In one paragraph

Article in Tobacco control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
3.5field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Article
  4. Review
  5. Acute exposure to electronic cigarette components alters mRNA expression of pre-osteoblasts.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2024
    Article
  6. Vaping: Public Health, Social Media, and Toxicity.Online journal of public health informatics · 2024
    Article
  7. Comparison of brain nicotine accumulation from traditional combustible cigarettes and electronic cigarettes with different formulations.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Jeroen L A PenningsCentre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands jeroen.pennings@rivm.nl.ORCID 0000-0002-9188-6358
Anne HavermansCentre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.ORCID 0000-0003-2874-6560
Charlotte G G M PauwelsCentre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.ORCID 0000-0001-6727-0804
Erna J Z KrüsemannCentre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Wouter F VisserCentre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.ORCID 0000-0003-1129-262X
Reinskje TalhoutCentre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
National Institute for Public Health and the Environment · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesRecent years have seen an increase in e-liquids containing nicotine salts. Nicotine salts are less harsh and bitter than free-base nicotine and therefore can facilitate inhalation. Because inhalation-facilitating ingredients are banned in the European Union, we assessed the occurrence and characteristics of nicotine salt-containing e-liquids notified for the Netherlands.

methodsWe analysed data for 39 030 products, submitted by manufacturers in the European Union Common Entry Gate system, as extracted on 30 June 2020.

resultsNicotine salts were present in 13% of e-liquids, especially in pod-related e-liquids (73%) and e-liquids registered from 2018 onwards (over 25%). We found six nicotine salt ingredients (NSIs): nicotine lactate, salicylate, benzoate, levulinate, ditartrate and malate. Nicotine salts also occurred as nicotine-organic acid ingredient combination (NAIC), like nicotine and benzoic acid. Nicotine concentrations were twofold higher in e-liquids with NSI (median 14 mg/mL) and NAIC (11 mg/mL) than for free-base nicotine (6 mg/mL). E-liquids with NSI contained a fourfold higher number (median n=17) and concentration (median 31.0 mg/mL) of flavour ingredients than e-liquids with free-base nicotine (n=4, 7.4 mg/mL). In NAIC-containing e-liquids, these were threefold higher (n=12, 21.5 mg/mL). E-liquids with nicotine salts were less often tobacco flavoured but more often had fruity or sweet flavours.

conclusionsA substantial and increasing share of e-liquids in the Netherlands contains nicotine salts. Their characteristics can make such e-liquids more addictive and more attractive, especially to young and beginning users. Policymakers are advised to consider regulating products containing nicotine salts.

Indexed as

Electronic Nicotine Delivery SystemsTobacco ProductsFlavoring AgentsHumansNicotineSaltsSmoking DevicesFlavoring AgentsNicotineSaltsaddictionelectronic nicotine delivery devicesnicotine

Identifiers

PMID34987081
PMCPMC10086466
OpenAlexW4206204732

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.