New publications

Cigarette filter ventilation, product appeal and regulatory options: a review of the influence of ventilation on consumers’ sensory and risk perceptions Rees V.W. et al, Tobacco Control Published Online First: 03 February (2025) Cigarette filter ventilation may enhance product appeal, support initiation and sustained smoking, and increase smoking prevalence. A scoping review showed that cigarettes with filter ventilation are perceived as smoother and less irritating than non-ventilated cigarettes. These modified sensory experiences shape perceptions of reduced health risks. Pack text descriptors and colours convey further information to consumers about smoothness, supporting lowered risk perceptions. Since filter ventilation has no benefits for public health, policy makers could consider banning filter ventilation or even disallowing filters.

Patterns of use of heated tobacco products: a comprehensive systematic review Scala, M. et al, Journal of Epidemiology. Advance online publication, January 11 (2025) A systematic review and meta-analysis was conducted on the usage patterns of heated tobacco products (HTPs) and their impact on conventional tobacco smoking. The study analyzed 76 eligible articles, including cross-sectional and prospective cohort studies. Findings indicate that HTP use is more prevalent among young adults and less common among middle-aged and older adults. Former and current smokers are more likely to use HTPs, with 68.3% of HTP users being dual users of both HTPs and conventional cigarettes. The analysis also reveals that HTP users are more likely to start smoking conventional cigarettes, and current smokers using HTPs are less likely to quit smoking. The study concludes that HTPs are popular among younger generations but are not effective tools for smoking cessation.

The Effects of Filter Ventilation and Expanded Tobacco on the Tar, Nicotine and Carbon Monoxide Yields from Cigarettes Sold in AustraliaWinall, W.R. et al, International Journal of Environmental Research and Public Health, 22, 50 (2025). RIVM assessed Australian cigarettes to determine differences between variants and effects of the characteristics on TNCO emissions. When measured using the HCI protocol, which better emulates human smoking behavior than the industry-favored ISO protocol, TNCO emissions were markedly higher. Also, the emission differences by extent of filter ventilation were minimized, indicating that ISO measurements are misleading. Using the HCI protocol, our measurements show that higher levels of filter ventilation are not associated with reduced TNCO emissions measured. These findings confirm that cigarette color names, and the filter ventilation levels they signify, remain misleading more than a decade after plain packaging eliminated pack colors in Australia.

On the extension of the use of a standard operating procedure for nicotine, glycerol and propylene glycol analysis in e-liquids using mass spectrometry Davoli, E. et al, Tobacco Induced Diseases 22 (2024) A standardised operating procedure (SOP) for the determination of nicotine, glycerol and propylene glycol has been published by the European-Joint Action on Tobacco Control and the WHO Tobacco Laboratories Network (WHO TobLabNet - SOP11) using GC-FID. In this study, the nicotine, glycerol and propylene glycol content in e-liquids was compared using GC-FID and GC-MS. The study shows that results are comparable and both techniques can be used for the analysis of the nicotine, glycerol and propylene glycol content in e-liquids.

Coolants, organic acids, flavourings and other additives that facilitate inhalation of tobacco and nicotine products: implications for regulation Talhout, R., et al, Tobacco Control Published Online First: 10 September (2024) Manufacturers use additives to improve flavour, sensory experience and appeal of tobacco and nicotine products. This paper provides a conceptual model and definition for additives that facilitate inhalation of smoke, and reviews evidence on example additives. Three different mechanisms were found: activating the cooling receptor TRPM-8, lowering pH (nicotine protonation) and enhancing olfactory/orosensory experience. The outcomes  inform regulatory science and policy.

Determination of Nicotine Protonation State in E-Liquids by Low-Resolution Benchtop NMRSpectroscopy Hartendorp, A.P.T. et al, Chem Res Toxicol., 37(8):1283-1289 (2024) E-liquids containing nicotine salts have gained considerable popularity in the last years.  RIVM has developed a method to measure the amount of nicotine that is present in these salt forms using a benchtop NMR spectrometer. 33 e-liquids were analyzed using this technique. 3 e-liquids which were marketed as normal e-liquids, were found to contain nicotine salts.

Urgent health concerns: Clinical issues associated with accidental ingestion of new metal-blade-containing sticks for heated tobacco products Havermans, A. et al, Tob Prev Cessat 10 (2024) In clinical settings, a pattern draw attention to the potential health risks associated with the accidental ingestion of blade-containing HTP sticks, mostly by infants and toddlers. This new type of stick contains a sharp metal blade inside. A study identified 40 such cases in Italy, with most affected children requiring hospitalization and various medical procedures. These incidents prompted immediate corrective measures, including a Ministry of Health alert and enhanced package warnings. Raising awareness among the public and medical practitioners is essential to prevent further cases and ensure prompt emergency responses.

Alterations in the molecular regulation of mitochondrial metabolism in human alveolar epithelial cells in response to cigarette- and heated tobacco product emissions Davigo, M. et al, Toxicology Letters, Volume 401, Pages 89-100 (2024) The heated tobacco product IQOS is commercialized as less harmful alternative to regular cigarettes, although few studies determining the toxicity of IQOS emissions have been performed. Human alveolar epithelial cells were exposed to different concentrations of cigarette or IQOS emissions. This study shows that IQOS emissions may exert the same toxicological effects as cigarette smoke on human alveolar epithelial cells, and suggests re-evaluation and reformulation of the industry claims defining IQOS as less toxic alternative to regular cigarettes. 

Across the world availability of flavour accessories for tobacco products Havermans, A. et al, Tobacco Control Published Online First: 05 April (2024) RIVM investigated the availability and marketing of flavour accessories for combustible tobacco products across eight countries worldwide. On web shops various flavour accessories were found such as capsules, cards, filter tips, drops, sprays, and more, mostly with fruity and sweet flavours. These products often circumvent flavour bans and pose public health concerns by enticing users with attractive flavours. As flavour accessories are not regulated like tobacco products, RIVM recommends policymakers to include them in comprehensive flavour bans to address this regulatory gap and enhance tobacco control measures.

In Vitro Assessment of Translocation and Toxicological Effects of Nicotine and Ethyl Maltol from e-Cigarettes Using Air–Liquid Interface-Cultured Bronchial Epithelial CellsStaal, Y.C.M. et al, Applied In Vitro Toxicology 10:1, 1-14 (2024) The use of e-cigarettes increases rapidly. Still, only little information is available on the effects of flavourants in e-cigarettes. Cell models of the lungs were used to determine the effects of e-cigarette vapour with nicotine and ethyl maltol. Both nicotine and ethyl maltol were found to induce an inflammatory response in lung cells. Also, both compounds are able to cross the lung barrier, meaning that they could enter the blood stream and reach other organs in the human body. Finally, our results show that it is important to measure concentrations at the site of the cells.

Reducing attractiveness of e-liquids: proposal for a restrictive list of tobacco-related flavourings Pennings J.L.A. et al., Tobacco Control 33:e41-e47 (2024). The Dutch government announced in 2020 to only allow tobacco flavours in e-liquids. We propose a restrictive list of flavourings that will only enable the production of e-liquids with a tobacco flavour. We used ingredient data for tobacco flavoured e-liquids notified via the European Common Entry Gate system. We applied selection criteria related to prevalence of use, chemical composition, flavour description and health effects to compile a restrictive list of tobacco flavourings. This resulted in a final list of 16 flavourings.

Menthol and related compounds in waterpipe products Bakker-’t Hart I. et al., Tobacco Prevention and Cessation, 10 (2024). Menthol-like compounds that provide flavoring or cooling effects are found in nearly all investigated products, including waterpipe tobacco, steam stones and herbal molasses. Waterpipe products without menthol or similar indicators in product names were found to frequently contain menthol-like substances. Cooling substances are banned in tobacco products by the tobacco products directive, therefore these findings can support regulation of waterpipe tobacco.

Context matters: Neural processing of food-flavored e-cigarettes and the influence of smoking Hellmich, I.M. et al., Biological Psychology (2024). Measured neural and subjective responses to food odors in a 2 (sweet vs. savory odor) x2 (food vs. e-cigarette context) x2 (smokers vs. non-smokers) design. The authors identified that flavor perception and processing differs between the contexts of eating and vaping. Smoking did not have an influence. Our results indicate that the principles of flavor preference in food cannot directly be applied to e-cigarettes and that it is challenging to design sweet and savory e-cigarettes to appeal to smokers only.

An ingredient co-occurrence network gives insight into e-liquid flavor complexityPennings, J.L.A. et al.,  Tob Induc Dis. 22 (2024). Determined if there are e-cigarette ingredients that are frequently used together. The authors identified frequently co-occurring flavor ingredient pairs and illustrate how these ingredients act together to create (more) attractive flavors. These results show that the flavor of e-liquids is more than just the sum of its parts.