Flavoring ingredient exceeds safety levels in e-cigarettes, Duke study shows

In a new study, researchers found a potential carcinogen that has been banned as a food additive is present in very high levels in electronic cigarette liquids and smokeless tobacco products.

The research was conducted by a team from Duke Health.

The chemical — called pulegone (pronounced pju-leh-goan) – is contained in menthol and mint flavored e-cigarettes and smokeless tobacco products.

Because of its carcinogenic properties, the U.S. FDA banned pulegone as a food additive last year in response to petitions from consumer groups.

Yet the agency does not regulate the chemical’s presence in e-cigarettes and smokeless tobacco, which are promoted as safer alternatives to regular cigarettes.

Previous research from the U.S. Centers for Disease Control and Prevention has shown that mint- and menthol-flavored e-cigarette liquids and smokeless tobacco products marketed in the U.S. contain substantial amounts of pulegone.

In the study, the team analyzed whether several top brands of regular menthol cigarettes, three e-cigarette brands, and one smokeless tobacco brand contain enough pulegone to be a cause for concern.

They compared the CDC-reported amounts of pulegone with the FDA’s exposure risk data — the levels at which exposure-related tumors were reported in animal studies.

Their analysis found that the levels in the e-cigarettes and smokeless tobacco exceeded the thresholds of concern. Regular menthol cigarettes contained levels below the thresholds.

The analysis suggests that users of mint- and menthol-flavored e-cigarettes and smokeless tobacco are exposed to pulegone levels higher than the FDA considers acceptable for intake in food, and higher than in smokers of combustible menthol cigarettes

The team says the tobacco industry has long known about the dangers of pulegone and has continuously tried to minimize its levels in menthol cigarette flavorings, so the levels are much lower in menthol cigarettes than in electronic cigarettes.

They suggest that the FDA should implement measures to mitigate pulegone-related health risks before suggesting mint- and menthol-flavored e-cigarettes and smokeless tobacco products as alternatives for people who use combustible tobacco products.

The lead author of the study is Sven-Eric Jordt, Ph.D., a professor of the Department of Anesthesiology at Duke.

The study is published in JAMA Internal Medicine.

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