Mint and mint-flavored e-cigarettes are popular for their "cooling" effect. E-cigarette suppliers have recently started selling synthetic coolants as additives with cooling effects, but they lack the "mint" smell. However, the general public has very limited knowledge about the content of synthetic coolants in e-cigarettes sold in the United States and their health risks.

"In a previous study, we found that a synthetic cooling agent, WS-3, was added to Juul e-cigarettes sold in Europe," said the paper's author, associate professor of anesthesiology at Duke University School of Medicine in Durham, North Carolina. said Dr. Sven Jordt, associate professor of pharmacology and cancer biology. "Juul was the most popular e-cigarette brand at the time. This prompted us to explore whether synthetic cooling agents were also added to e-cigarettes sold in the United States."

Dr. Jordt and colleagues started their research by looking at e-liquid supplier websites and searching for certain terms such as "cool" and "ice." They looked to see if the companies sold the cooling agents W-3 and WS-23. Their research focused on the "ice" and "non-ice" varieties of Puffbar -- the most popular e-cigarette brand currently designed as a single-use e-cigarette to evade the Food and Drug Administration's possible use of Juul and others. Supervision of equipment for replacing pods.

The researchers characterized the e-liquids and synthetic cooling agents using gas chromatography/mass spectrometry, which can identify different substances in the samples. They then calculated the magnitude of exposure (MOE) to determine the risk associated with exposure to synthetic cooling agents from e-cigarette use. An MOE of 100 means that the user's exposure is 100 times lower than levels proven to cause toxic effects in animal organs. Scientists who study potentially harmful substances know that an MOE below 100 indicates an increased risk.

"When the MOE falls below 100, regulatory agencies such as the FDA or the World Health Organization should review the safety of the product and recommend that manufacturers take steps to make the product safe to use," Dr. Jordt said, noting that he and the research team simulated a Routine vaping usage scenarios with occasional to heavy usage.

The scientists detected WS-3 in 24 of the 25 filled e-liquids they found. Almost all (13 of 14) one-off Puff bar flavor varieties contain WS-23, and 5 of 14 also contain WS-3, including "ice" and "non-ice" flavors.

Shockingly, modeling the consumption of vaped e-liquids found that MOEs were below the safe range (<100) for most daily vaping levels. In all use cases, 11 of the 13 Puff bar products had MOEs of WS-23 below 100.

Synthetic cooling agents are found not only in mint or mint-flavored products, but also in fruit- and candy-flavored products, including Puff bars and other single-use e-cigarettes. Flavors sold at Puff bar include mango, vanilla, berry and many other sweets popular with young people.

"Our measurements and calculations show that e-cigarette users are inhaling levels of WS-3 and WS-23 above levels considered safe by the World Health Organization, with the potential to cause organ poisoning," Dr. Jordt said. "Regulators such as the FDA should consider reviewing the product safety of the Puff bar vaping device and the vaping refills we tested."

Although they are found in the most popular vaping devices, "WS-3 and WS-23 are regulated by the FDA as food additives, but not for inhalation. E-cigarette manufacturers are 'flying blind' by adding these chemicals." .

In April 2021, the Biden administration announced its decision to ban menthol cigarettes and flavored cigars. In a press release, the American Pulmonary Society (ATS) noted that "flavored tobacco products have been a key strategy in Big Tobacco's marketing arsenal to activate early smokers."

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