Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects

Area of Science:

• Tobacco Control Research
• Nicotine Addiction Studies
• Vaping Behavior Analysis

Background:

• Self-titration, adjusting intake to maintain desired nicotine levels, is known in traditional tobacco use.
• The degree to which electronic cigarette users (vapers) self-titrate nicotine remains largely uninvestigated.

Purpose of the Study:

• To investigate the impact of varying nicotine strengths in e-liquids on vapers' puffing patterns.
• To assess nicotine delivery, subjective effects, and self-titration behaviors in experienced vapers using different nicotine concentrations.

Main Methods:

• Eleven experienced male vapers participated in two 60-minute ad libitum vaping sessions.
• Sessions involved low (6 mg/mL) and high (24 mg/mL) nicotine strength e-liquids.
• Measurements included puff topography, plasma nicotine levels, craving, withdrawal, satisfaction, and adverse effects.

Main Results:

• Vapers consumed more liquid and took more puffs with lower nicotine strength (6 mg/mL) e-liquid.
• Plasma nicotine levels were significantly higher in the high nicotine strength (24 mg/mL) condition.
• No significant differences were observed in craving, withdrawal, satisfaction, or adverse effects between conditions.

Conclusions:

• Vapers exhibit compensatory puffing behavior, increasing consumption with lower nicotine e-liquids.
• While compensatory vaping reduces craving and withdrawal, it does not fully compensate for lower nicotine concentrations.
• Self-titration is incomplete, as evidenced by higher plasma nicotine levels when using higher nicotine strength e-liquids.