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Comparison of nicotine emissions rate, ‘nicotine flux’, from heated, electronic and combustible tobacco products: data, trends and recommendations for regulation
  1. Mario El Hourani1,2,
  2. Alan Shihadeh1,2,
  3. Soha Talih1,2,
  4. Thomas Eissenberg2,3
  5. CSTP Nicotine Flux Work Group
  1. 1Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
  2. 2Virginia Commonwealth University Center for the Study of Tobacco Products, Richmond, Virginia, USA
  3. 3Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
  1. Correspondence to Professor Alan Shihadeh, Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon; as20{at}


Introduction Tobacco smoking is a major cause of disease and premature death worldwide. While nicotine is recognised as the main addictive component in tobacco smoke, the total nicotine amount emitted (nicotine yield) and the rate of nicotine emission per second (‘nicotine flux’) contribute to the abuse liability of a given product. These variables can be regulated for public health ends and conveniently so for electronic cigarettes or electronic nicotine delivery systems (ENDS).

Methods In this study we computed nicotine flux from previously reported values of yield and puff topography for a wide range of tobacco products.

Results We found that nicotine flux varied widely across tobacco products, from less than 0.1 µg/s to more than 100 µg/s, and that since 2015 the upper limit of the ENDS nicotine flux range has risen significantly and is now approaching that of combustible cigarettes. We also found that products that differ in nicotine flux may exhibit similar nicotine yields due to differences in user puffing behavior. Nicotine flux is a tool that can be used to regulate nicotine emissions of tobacco products, including ENDS.

  • nicotine
  • electronic nicotine delivery devices
  • toxicology

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors The idea for this report was developed at a meeting of the Center for the Study of Tobacco Products (CSTP) Nicotine Flux Work Group in Lisbon, Portugal, 25–27 October 2019, thus all CSTP Nicotine Flux Work Group members are listed as collaborators and the work group name is included in the author list. MH and AS prepared the first draft of the manuscript and performed data analysis and figure preparation. The manuscript was finalised with input from ST and TE. Study guarantor: AS.

  • Funding This research is supported by grant number U54DA036105 from the National Institute on Drug Abuse of the National Institutes of Health and the Center for Tobacco Products of the US Food and Drug Administration.

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the views of the NIH or the FDA.

  • Competing interests TE and AS are paid consultants in litigation against the tobacco industry and also the electronic cigarette industry and are named on one patent for a device that measures the puffing behaviour of electronic cigarette users. TE is also named on a patent for a smartphone app that determines electronic cigarette device and liquid characteristics.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.