Short-term effects of electronic and tobacco cigarettes on exhaled nitric oxide

Toxicol Appl Pharmacol. 2014 Jul 1;278(1):9-15. doi: 10.1016/j.taap.2014.04.004. Epub 2014 Apr 13.


The objective of this study was to compare the short-term respiratory effects due to the inhalation of electronic and conventional tobacco cigarette-generated mainstream aerosols through the measurement of the exhaled nitric oxide (eNO). To this purpose, twenty-five smokers were asked to smoke a conventional cigarette and to vape an electronic cigarette (with and without nicotine), and an electronic cigarette without liquid (control session). Electronic and tobacco cigarette mainstream aerosols were characterized in terms of total particle number concentrations and size distributions. On the basis of the measured total particle number concentrations and size distributions, the average particle doses deposited in alveolar and tracheobronchial regions of the lungs for a single 2-s puff were also estimated considering a subject performing resting (sitting) activity. Total particle number concentrations in the mainstream resulted equal to 3.5±0.4×10(9), 5.1±0.1×10(9), and 3.1±0.6×10(9) part. cm(-3) for electronic cigarettes without nicotine, with nicotine, and for conventional cigarettes, respectively. The corresponding alveolar doses for a resting subject were estimated equal to 3.8×10(10), 5.2×10(10) and 2.3×10(10) particles. The mean eNO variations measured after each smoking/vaping session were equal to 3.2ppb, 2.7ppb and 2.8ppb for electronic cigarettes without nicotine, with nicotine, and for conventional cigarettes, respectively; whereas, negligible eNO changes were measured in the control session. Statistical tests performed on eNO data showed statistically significant differences between smoking/vaping sessions and the control session, thus confirming a similar effect on human airways whatever the cigarette smoked/vaped, the nicotine content, and the particle dose received.

Keywords: Alveolar and tracheobronchial particle dose; Electronic cigarette; Exhaled nitric oxide; Short-term effect; Tobacco cigarette; Ultrafine particles.

Publication types

  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Administration, Inhalation
  • Adult
  • Aerosols
  • Breath Tests
  • Drug Delivery Systems / instrumentation*
  • Electronics
  • Equipment Design
  • Exhalation*
  • Female
  • Humans
  • Lung / drug effects*
  • Lung / metabolism
  • Lung / physiopathology
  • Male
  • Nicotine / administration & dosage
  • Nicotine / adverse effects
  • Nicotinic Agonists / administration & dosage
  • Nicotinic Agonists / adverse effects
  • Nitric Oxide / metabolism*
  • Particle Size
  • Particulate Matter / adverse effects*
  • Smoking / adverse effects*
  • Time Factors
  • Tobacco Products / adverse effects*
  • Volatilization
  • Young Adult


  • Aerosols
  • Nicotinic Agonists
  • Particulate Matter
  • Nitric Oxide
  • Nicotine