Electronic nicotine delivery systems (ENDS) continue to rapidly evolve. Current products pose unique challenges and opportunities for researchers and regulators. This commentary aims to highlight research gaps, particularly in toxicity research, and provide guidance on priority research questions for the tobacco regulatory community. Disposable flavoured ENDS have become the most popular device class among youth and may contain higher nicotine levels than JUUL devices. They also exhibit enhanced harmful and potentially harmful constituents production, contain elevated levels of synthetic coolants and pose environmental concerns. Synthetic nicotine and flavour capsules are innovations that have recently enabled the circumvention of Food and Drug Administration oversight. Coil-less ENDS offer the promise of delivering fewer toxicants due to the absence of heating coils, but initial studies show that these products exhibit similar toxicological profiles compared with JUULs. Each of these topic areas requires further research to understand and mitigate their impact on human health, especially their risks to young users.
- electronic nicotine delivery devices
- public policy
- tobacco industry
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Deceased Vladimir B Mikheev is deceased
Collaborators Special Interest Group (SIG) on Emerging and Long-Term ENDS Toxicity, Center for Coordination of Analytics, Science, Enhancement and Logistics (CASEL) in Tobacco Regulatory Science: Robert M Strongin, Eva Sharma, Hanno C Erythropel, Ahmad El-Hellani, Nada O F Kassem, Vladimir B Mikheev, Alexandra Noël, David H Peyton, Matthew L Springer.
Contributors RMS and ES contributed to writing the initial draft and the overall organisation of the manuscript. RMS, ES, HCE, AE-H, NOFK, VBM, AN, DHP and MLS each contributed specific written sections and references, along with proofreading and revision. Figure 1 was provided by MLS; the others, Poonam Rao and Jordan Naughton took the photo.
Funding This paper is a collaborative project by the Center for Coordination of Analytics, Science, Enhancement and Logistics (CASEL) in Tobacco Regulatory Science Toxicity Special Interest Group (SIG), which is supported, in part, by the CASEL cooperative agreement U54DA046060-01 (National Institute of Drug Abuse (NIDA) and the Food and Drug Administration’s Center for Tobacco Products (FDA CTP)). Support for authors was also provided by NIDA and FDA CTP awards R01ES025257 (RMS), U54DA036151 (HCE), 1R01HL139335-01A1 (VBM), U54DA036105, R03ES029441-02S1 (AN), U54HL147127 (MLS), T30IR0894 (NOFK) and U54DA046060-01 (ES).
Disclaimer The content and opinions expressed in this paper are solely the responsibility of the authors and do not represent the official views of the authors’ institutions, the NIH or the FDA.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Author note This manuscript is dedicated to the memory of our coauthor and great friend and colleague, Dr Vladimir B Mikheev.