Response to: Electronic cigarette vapour enhances pneumococcal adherence to airway epithelial cells under abnormal conditions of exposure

Extract

M. Caruso and co-workers raise several points related to our electronic cigarette (EC) study [1]. First, they suggest that we generated EC vapour (ECV) under “extreme” experimental conditions, which could lead to overheating and thermal decomposition of E-liquids around a heated coil [2]. However, we minimised the potential effect of coil overheating by ensuring that the EC reservoir was always more than three quarters full, and by using a low power second generation EC device (3.7 V), instead of a later generation 8 V device, which would have an increased potential for substantially higher coil temperatures and under-dry conditions [2]. In addition, our use of a 4-s puff duration and 8-s interpuff interval cannot be regarded as extreme, since a recent long-term study of young vaping adults found that one inhalation pattern is multiple rapid puffs taken over very short time periods [3]. Furthermore, the production of toxins under extreme conditions in vitro does not explain why we found that a “normal” vaping session increased nasal platelet-activating factor receptor (PAFR) expression in adult volunteers.