Health and Medicine

E-cigs’ Toxicity Increased by Flavorings and Higher Voltage


Maciej Goniewicz, PhD, PharmD, Assistant Professor of Oncology in the Department of Health Behavior at Roswell Park recently led a research team looking into the effects of adding flavors to and increasing the voltage of electronic cigarettes. An earlier finding that increasing the output voltage of these devices increases toxicity significantly was confirmed in the study. Testing several flavorings in electronic cigarettes also revealed that it increases the toxicity of the devices, with strawberry being the most toxic.

Goniewicz explains that little is known about the effects of flavorings when they are heated and inhaled in e-cigarettes, although many of these have been certified as safe for eating. He advises that caution should be used with electronic cigarettes until studies that are more comprehensive are performed, as the study shows that a number of features of e-cigarettes, including flavorings, may result in inhalation toxicity.

Bronchial cells were exposed to aerosol generated from several variable-voltage e-cigarettes in the study. The team then studied the release of inflammatory mediators as well as cell viability and activity. Six types of e-cigarette devices were evaluated. All were filled with liquids of different flavors (coffee, menthol, tobacco, pina colada and strawberry) at different battery output voltages. The researchers’ findings indicate that the addition of any flavorings, as well as the power of the e-cigarette device, considerably affect the toxicity of e-cigarette aerosol. Strawberry flavorings was shown to be the most toxic to users.

Dr. Goniewicz notes that the results show that e-cigarette products differ considerably in the degree of their cellular toxicity to bronchial epithelial cells. As the features of e-cigarette products such as the presence of flavorings and the power of the device can be standardized and regulated, the findings have important regulatory implications. Users are advised to reduce their potential harm by using their devices at a lower power setting and selecting products with a lower toxicity profile.

Research has been published online in the Tobacco Control journal.