E-liquids often contain alcohol as an unlisted ingredient. What are the health and safety implications?

E-liquids, the nicotine solutions that are flavored and used in electronic cigarettes, often contain ingredients not listed as alcohol or ethanol, according to research conducted by the laboratory by Virginia Commonwealth University professor Michelle Peace, Ph.D.

Of the 56 available commercially-available vape juice samples that Peace’s lab evaluated, all except three contained ethanol, and 11 had more than 10 percent of ethanol. This study was published in 2017 in the Journal of Drug Testing and Analysis, warning that the consequences of vaporizing ethanol as an ingredient in e-liquids are not fully understood.

Today, Peace, an associate professor in the Department of Forensic Science within the College of Humanities and Sciences, examines the implications of two grants granted by the National Institute of Justice in the U.S. Department of Justice with a total of $1.8 million.

“We were shocked to find the amount of ethanol present in e-liquids. A small amount of ethanol is not unusual since the solvent used for many chemical flavoring agents is ethanol.” Peace said. “For instance, if planning to use pure vanilla extracts, you’re likely end up with tiny quantities of ethanol in your liquid. However, to discover ethanol in large amounts, that’s certainly awe-inspiring. Then we asked what were the implications?”

Peace is looking into questions such as: Do vapers who use alcohol feel an itch? Does vaping ethanol result in impairment? What are the effects on the blood alcohol level? Can vaping ethanol cause false-positive results in breath or field sobriety tests by police officers? Alcohol tests? Can vaping ethanol cause people being drunk without knowing it?

There aren’t many studies published regarding the adverse effects of inhaling ethanol. However, Peace hopes that her lab does not discover that vaping ethanol causes a high level of impairment. However, she said that some users have stated on vaping forums online that they experienced the effects of alcohol.

“Do people experience some immediate repercussions or not? In most cases, we thought that probably not,” Peace said. “But another of our reasons is that, when you inhale ethanol, it’s inhaling it through your gut, which adds a layer of protection if you drink alcohol. If you’re inhaling alcohol and inhaling an excessive amount of ethanol, you’ll find enough on the forums for online vaping to ask, “Are individuals experiencing a brief impairment or some other similar thing?”

For both grants, the Peace lab has partnered in collaboration with the Center for the Study of Tobacco Products within the Department of Psychology, the Department of Statistical Sciences and Operations Research as well as in the VCU Police Department, the Department of Pharmacology and Toxicology within the School of Medicine, the Department of Pharmaceutics in the School of Pharmacy, and the Virginia Department of Forensic Science.

In the first funding, “Through the Looking Glass: Abuse of the Evolving Electronic Cigarette and the Impact of Vaping Ethanol in the Evaluation of Impairment,” Peace’s lab is studying the vaping of ethanol as well as field sobriety tests.

“Ethanol is in e-liquids and e-liquids are sticky,” Peace declared. “It is able to stick to the gums as well as inside the mouth. Therefore, can ethanol that remains be present in your mouth to be tested for an initial breath test or a breath test that is evidentiary?”

If e-liquids with ethanol in them can result in a positive outcome in a sobriety exam and could result in severe consequences for the safety of the public and criminal justice.

For instance, Peace said, a lawyer representing a client accused of DUI might argue that the person had been smoking marijuana but not drinking and driving.

“Some of our concern is that vaping ethanol could be used as some kind of tactic to confuse the court system as to why [a defendant] was positive for ethanol,” she explained. “For legitimate cases of driving under the influence, we certainly don’t want there to be a defense that casts so much doubt [of a Breathalyzer result] that a legitimate case gets thrown out.”

This grant, “Through the Looking Glass Part II: Abuse of the Evolving Electronic Cigarette and the Impact of Vaping Ethanol in the Evaluation of Impairment,” extends the studies of the initial grant and also involves the collection of oral fluid blood, urine, and saliva from people who smoke different concentrations of ethanol.

Through the collection of bodily fluids, scientists can determine the amount of absorption in the body, the distribution of metabolism, and the elimination of ethanol after an individual vapes it.

It is essential to know the possibility of vaping ethanol being found in bodily fluids, Peace stated, since it could result in false-positive violations of probation or alcohol treatment facility regulations. Because of this, the people may violate the conditions of their probation. This could result in severe consequences like a longer jail sentence, losing custody of a child, or even being removed from an alcohol treatment program.

“Our concern is that, for people who are vaping ethanol who are on probation or who have to report to drug courts, or they are in a clinic for substance use and abuse, they [get tested] to show that they are not consuming ethanol,” Peace stated. “If somebody is legitimately not drinking alcohol, but they happen to vape and they happen to unknowingly be vaping high ethanol concentration, then they could have the metabolites for ethanol in their urine and then it’d be a violation of the requirements of their program.”

Peace’s work on e-cigarettes goes beyond the use of ethanol in vapes. In the past year, her lab released a research study that described how they tested nine commercially-available CBD e-liquids and discovered that a number of them contained ingredients not listed, like a synthetic cannabinoid known to cause fatal overdoses and the chemical that is found inside cough syrup.

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