Flavor Preference and Systemic Immunoglobulin Responses in E-Cigarette Users and Waterpipe and Tobacco Smokers: A Pilot Study

Int J Environ Res Public Health. 2020 Jan 19;17(2):640. doi: 10.3390/ijerph17020640.


Electronic cigarette (e-cigarette) use has had an exponential increase in popularity since the product was released to the public. Currently, there is a lack of human studies that assess different biomarker levels. This pilot study attempts to link e-cigarette and other tobacco product usage with clinical respiratory symptoms and immunoglobulin response. Subjects completed surveys in order to collect self-reported data on tobacco product flavor preferences. Along with this, plasma samples were collected to test for immunoglobulin G (IgG) and E (IgE) levels. Our pilot study's cohort had a 47.9% flavor preference towards fruit flavors and a 63.1% preference to more sweet flavors. E-cigarette and traditional cigarette smokers were the two subject groups to report the most clinical symptoms. E-cigarette users also had a significant increase in plasma IgE levels compared to non-tobacco users 1, and dual users had a significant increase in plasma IgG compared to non-tobacco users 2, cigarette smokers, and waterpipe smokers. Our pilot study showed that users have a preference toward fruit and more sweet flavors and that e-cigarette and dual use resulted in an augmented systemic immune response.

Keywords: biomarkers; e-cigarette; flavors; immune response; motivation; respiratory symptoms.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Consumer Behavior
  • Flavoring Agents / chemistry*
  • Immunoglobulin E / blood*
  • Immunoglobulin G / blood*
  • Pilot Projects
  • Smokers / classification
  • Smokers / psychology*
  • Taste*
  • Tobacco Use / psychology
  • Vaping / psychology
  • Water Pipe Smoking / psychology


  • Flavoring Agents
  • Immunoglobulin G
  • Immunoglobulin E