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Table 3 Results from the recent biomarker studies identified involving use of modern ENDS products (and data on exclusive ENDS use and exclusive smoking with data collection since 1 January 2017)

From: Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking

Study

Level in exclusive ENDS users [A]

Level in exclusive smokers [B]

% of [A] relative to [B]

ENDS users (N)

Smokers (N)

Additional details* (with further details in the Supplementary Information)

Non-cancer chronic respiratory disease (VOCs)

 Jay et al. 2020 [32]

0.2

1.87

10.7%

60

15

3-HPMA; within group experiment**; mean level in mg over 24 h (urine).

 Hatsukami et al. 2020 [36]

0.34

1.00

34.0%

58

63

CEMA (biomarker for acrylonitrile) showing ratio relative to exclusive smoking; RCT; within group relative change**

 Hatsukami et al. 2020 [36]

0.53

1.00

53.0%

59

63

3-HPMA showing ratio relative to exclusive smoking; RCT; within group relative change**

 Hatsukami et al. 2020 [36]

0.53

1.00

53.0%

58

63

HMPMA showing ratio relative to exclusive smoking; RCT; within group relative change**

 Oliveri et al. 2020 [33]

655.1

1232.4

53.2%

59

54

3-HPMA; cartridge-based product. Least squares mean level in μg/g creatinine (urine).

Weighted mean#

 

40.5%

   

All cancers (TSNAs and PAHs)

 Oliveri et al. 2020 [33]

28.6

230.1

12.4%

59

57

Total NNAL; ng/g creatinine (urine), least squares mean level; cartridge based product

 Boykan et al. 2019 [35]

10

56

17.9%

51

9

Total NNAL (the proportion above threshold of 14.5 pg/mL, %); aged 12 to 21 years old; convenience sample of outpatients.

 Jay et al. 2020 [32]

6.1

15.8

38.6%

60

15

NNN; mean ng over 24 h (urine); within group experiment**; the authors noted some anomalous results for NNN that concerned them.

 Hatsukami et al. 2020 [36]

0.47

1.00

47.0%

56

76

Total NNAL showing ratio relative to exclusive smoking; RCT; within group relative change**. There was little difference between the relative levels at 4 weeks (0.44) and 8 weeks (0.47).

 Hatsukami et al. 2020 [36]

0.79

1.00

79.0%

56

62

PheT (phenanthrene tetraol) a PAH showing ratio relative to exclusive smoking; RCT; within group relative change**

Weighted mean#

 

41.8%

   

Cardiovascular disease (CO and acrolein)

 Jay et al. 2020 [32]

0.2

1.87

10.7%

60

15

3-HPMA; within group experiment**; mean level in mg over 24 h (urine).

 Jay et al. 2020 [32]

1.9

7.0

27.1%

60

15

COHb in blood (percent saturation); within group experiment**

 Nga et al. 2020 [34]

6.40

16.47

38.9%

15

15

eCO as end tidal CO at 45 min; quasi-experimental with no randomisation (participants allowed to select products)

 Hatsukami et al. 2020 [36]

0.43

1.00

43.0%

58

76

eCO showing ratio relative to exclusive smoking; RCT; within group relative change**

 Hatsukami et al. 2020 [36]

0.53

1.00

53.0%

59

63

3-HPMA showing ratio relative to exclusive smoking; RCT; within group relative change**

 Oliveri et al. 2020 [33]

655.1

1232.4

53.2%

59

54

3-HPMA; cartridge based product. Least squares mean level in μg/g creatinine (urine).

 Oliveri et al. 2020 [33]

2.2

4.1

53.7%

61

62

COHb in blood, least squares mean level; cartridge based product

Weighted mean#

 

42.9%

   
  1. *Terms and acronyms:
  2. 3-HPMA 3-hydroxypropylmercapturic acid, a metabolite of acrolein. Half-life: 5–9 h [55].
  3. CEMA 2-cyanoethylmercapturic acid (biomarker for acrylonitrile). Half-life: 8 h [56]
  4. CO carbon monoxide
  5. COHb Carboxyhaemoglobin, carbon monoxide measured from a blood sample, % saturation. Half-life: 5–9 h [55]
  6. eCO Exhaled carbon monoxide
  7. HMPMA: 3-hydroxy-1-methylpropylmercapturic acid (biomarker for crotonaldehyde/methylvinyl ketone). Half-life: 5–9 h [55]
  8. NNN N-nitrosonornicotine. Half-life: 45 min [55]
  9. PAH Polycyclic aromatic hydrocarbons
  10. PheT (phenanthrene tetraol), a PAH. Half-life: 8 h [57]
  11. RCT Randomised controlled trial
  12. Total NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol) and its glucuronides, NNAL-O-glucuronide, and NNAL-N-glucuronide (ng/g creatinine). Half-life: 2–6 h [58]
  13. TSNAs Tobacco-specific N´-nitrosamines
  14. VOCs Volatile organic compounds
  15. **By “within group” we compared the results at the start of the study when participants were all smokers with the results for the same group of individuals when they had all become ENDS users. All other comparisons in this table were between separate groups of exclusive ENDS users and exclusive smokers
  16. # Mean for category, weighted by total number of study participants (ENDS users plus smokers)