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Comment & Response
March 2020

Estimating Fluid Consumption Volumes in Electronic Cigarette Use—Reply

Author Affiliations
  • 1Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
JAMA Intern Med. 2020;180(3):468-469. doi:10.1001/jamainternmed.2019.6630

In Reply In response to Morgan and Jones, consumption of e-liquids in volumes of more than 10 mL/d is not uncommon, especially for users tapering nicotine strength. Users of low nicotine strength (3-6 mg/mL) electronic cigarette (e-cigarette) liquids often vape more frequently to compensate for low nicotine concentrations, with some consuming large e-liquid volumes in the range of 15 to 30 mL/d.1 Surveys of vape shop customers found that users vaping low nicotine e-liquids (average, 3.3 mg/mL) consumed an average of 9 mL/d (range, 1.7-17.7 mL/d), and a substantial portion (13%) of these low-nicotine users frequently used mint or menthol e-cigarette liquids.2 Other surveys corroborate high volume consumption (>10 mL/d) in large proportions of users of low nicotine strength.2,3 These high-volume consumers predominantly use sub-ohm devices.

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