Reinskje Talhout's research while affiliated with National Institute for Public Health and the Environment (RIVM) and other places

Publications (74)

Article
The most direct effects of inhaled harmful constituents are the effects on the airways. However, inhaled compounds can be rapidly absorbed and subsequently result in systemic effects. For example, e-cigarette vapor has been shown to evoke local effects in the lung, although little is known about subsequent effects in secondary target organs such as...
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Health risk assessment of tobacco and related products (TRPs) is highly challenging due to the variety in products, even within the product class, the complex mixture of components in the emission and the variety of user behaviour. In this paper, we summarize methods that can be used to assess the health risks associated with the use of TRPs. The c...
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Many novel tobacco products have been developed in recent years. Although many may emit lower levels of several toxicants, their risk in the long term remains unclear. We previously published a method for the exposure assessment of mixtures that can be used to compare the changes in cumulative exposure to carcinogens among tobacco products. While f...
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The popularity of heated tobacco products (HTPs) is of concern, as most users are dual users exposed to emissions of both HTPs and conventional cigarettes. Furthermore, HTPs may appeal to young people and non-smokers. This study aims to build intelligence on user experiences in order to inform policy development. We conducted five semi-structured f...
Article
Objectives Flavoured products are especially appealing to youth and contribute to the onset of waterpipe smoking and continued use of waterpipe tobacco. The goal of database and chemical analysis was to provide a clear overview of commonly used flavours and flavourings in tobacco and related waterpipe products, that is, herbal molasses and steam st...
Article
Declines in cigarette smoking prevalence in many countries and the consolidation of the tobacco industry have prompted the introduction of other forms of nicotine delivery. These include electronic nicotine delivery systems (ENDS), heated tobacco products (HTPs) and oral nicotine products (ONPs). Evolving over time, some of these products now deliv...
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Objectives Recent years have seen an increase in e-liquids containing nicotine salts. Nicotine salts are less harsh and bitter than free-base nicotine and therefore can facilitate inhalation. Because inhalation-facilitating ingredients are banned in the European Union, we assessed the occurrence and characteristics of nicotine salt-containing e-liq...
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Introduction: E-cigarettes are popular among youth. There are concerns that e-cigarettes attract youth that would otherwise not use addictive substances. While e-cigarettes are thought to be less harmful than tobacco, there is reason for caution. We examined to what extent adolescent e-cigarette users have characteristics associated with increased...
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Objectives Sensory experience is an important determinant of smoking initiation, brand choice and harm perception, but little is known about how cigarette design shapes sensory experience. This study reports which variations in tobacco blend and design characteristics available on the market are likely to be perceived as different by consumers. Me...
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Introduction: E-cigarette product regulation requires accurate analyses of emissions. User behavior, including device power setting selection, should be mimicked closely when generating e-cigarette emissions in a laboratory. Excessively high power settings result in an adverse burnt off-taste, called "dry puff flavor". This should be avoided becau...
Article
Many new tobacco and related products (nTRP) have emerged on the market, with unknown health risks. Here, we present a conceptual model containing the factors and relations between them that contribute to the nTRP's health effects. Factors that determine attractiveness, addictiveness and toxicity of nTRP were defined based on previous assessments,...
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Tobacco use is the leading cause of preventable death worldwide and is highly addictive. Nicotine is the main addictive compound in tobacco, but less is known about other components and additives that may contribute to tobacco addiction. The zebrafish embryo (ZFE) has been shown to be a good model to study the toxic effects of chemicals on the neur...
Article
Objectives: Sensory methods use human senses to evaluate product attributes. This review provides an overview of the types of sensory methods used to evaluate the perception of flavour in tobacco and other nicotine-containing (ToNic) products and to discuss how sensory data could inform flavoured ToNic product policy. Data sources: PubMed, Embas...
Article
Objectives Many tobacco and related products (TRPs) are less strictly regulated and marketed as less harmful than cigarettes. Little is known about their awareness, use, user profile, use behavior, reasons for use and risk perception, especially for the newest products. In an exploratory survey study among Dutch adolescents and adults, we have inve...
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Background Studies demonstrated that adolescent e-cigarette use is associated with subsequent tobacco smoking, commonly referred to as the gateway effect . However, most studies only investigated gateways from e-cigarettes to tobacco smoking. This study replicates a cornerstone study revealing a positive association between both adolescent e-cigare...
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Background Risk assessment of individual tobacco smoke components is important for the purpose of prioritization or selecting chemicals for monitoring products. Smoking is characterized by a highly varying, intermittent exposure and the challenge is to choose the most appropriate dose metric. Methods Generally, average daily exposure estimates are...
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Smokers may reduce their health risk by switching to electronic cigarette (e-cigarette) use. As e-cigarettes are not harmless, concerns exist about e-cigarette use by non-smokers and youth. E-liquids are available in many different flavors that increase sensory appeal. Flavor preferences may differ between user groups, which could open doors for pr...
Article
Many people understand chemicals as entities that do not occur naturally, and which are also invariably toxic. Tobacco control messages liberally use the term 'chemicals' to evoke these meanings and create concern among smokers. This may reinforce misunderstandings, potentially leading to smokers making harmful choices. To investigate smokers' unde...
Preprint
BACKGROUND There is an ongoing debate whether or not electronic cigarettes (e-cigarettes) should be advocated for smoking cessation. Because of this uncertainty, information about the use of e-cigarettes for smoking cessation is usually not provided in governmental smoking cessation communications. However, there is an information need among smoker...
Article
Background There is an ongoing debate whether electronic cigarettes (e-cigarettes) should be advocated for smoking cessation. Because of this uncertainty, information about the use of e-cigarettes for smoking cessation is usually not provided in governmental smoking cessation communications. However, there is an information need among smokers becau...
Article
Objective: In this paper, we evaluate the effectiveness of agricultural approaches and manufacturing techniques that can be applied to reduce nicotine content of tobacco to minimally addictive levels (< 0.4 mg/g). Methods: Using a semi-structured approach, we searched scientific and grey literature including patents and internal industry documents,...
Article
Smokers are exposed to more than 6000 (toxic) smoke components including volatile organic compounds (VOCs). In this study VOCs levels in headspace of blood and exhaled breath, in the mainstream smoke of three types of cigarettes of one brand varying in declared tar, nicotine and carbon monoxide (TNCO) yields are investigated. The objective was to i...
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Introduction Despite its known adverse effects on human health, waterpipe smoking is increasing in popularity worldwide. However, compared to cigarettes, regulation of waterpipe product smoking lags behind and presents unique challenges. In search for regulatory options, this systematic review analyzes 36 studies on the differential effects on huma...
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Introduction Tobacco smoking may increase susceptibility to and severity of coronavirus disease 2019 (COVID-19). This information may influence smoking cessation related beliefs in smokers. Methods Online questionnaires were answered from 26 March to 3 April 2020 in the Netherlands by 340 smokers willing to quit smoking. Beliefs regarding (quittin...
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Human smoking behavior influences exposure to smoke toxicants and is important for risk assessment. In a prospective observational study, the smoking behavior of Marlboro smokers was measured for 36 h. Puff volume, duration, frequency, flow and inter-puff interval were recorded with the portable CReSSmicro™ device, as has often been done by other s...
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Comparing the harmful health effects related to two different tobacco products by applying common risk assessment methods to each individual compound is problematic. We developed a method that circumvents some of these problems by focusing on the change in cumulative exposure (CCE) of the compounds emitted by the two products considered. The method...
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Objectives Electronic cigarette refill solutions (e-liquids) are available in various flavor descriptions that can be categorized as fruit, tobacco, and more. Flavors increase sensory appeal, thereby stimulating e-cigarette use, and flavoring ingredients can contribute to e-cigarette toxicity. We aim to inform toxicologists, sensory scientists, and...
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Objectives Flavours increase e-cigarette attractiveness and use and thereby exposure to potentially toxic ingredients. An overview of e-liquid ingredients is needed to select target ingredients for chemical analytical and toxicological research and for regulatory approaches aimed at reducing e-cigarette attractiveness. Using information from e-ciga...
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Introduction: The WHO Framework Convention on Tobacco control recognises the need for tobacco product regulation. In line with that, the WHO Study Group on Tobacco Product Regulation proposed to regulate nine toxicants in mainstream cigarette smoke, including aldehydes, volatile organic compounds (VOCs) and carbon monoxide (CO). We analysed their...
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Objectives Flavours increase attractiveness of electronic cigarettes and stimulate use among vulnerable groups such as non-smoking adolescents. It is important for regulators to monitor the market to gain insight in, and regulate the range of e-liquid flavours that is available to consumers. E-liquid manufacturers are required to report key product...
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Although total cessation of nicotine and tobacco products would be most beneficial to improve public health, exclusive e-cigarette use has potential health benefits for smokers compared to cigarette smoking. This study investigated differences between dual users and exclusive e-cigarette users provide information to optimize health communication ab...
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Introduction: Sensory research on e-liquid flavors can be performed by means of smelling and vaping. However, data comparing smelling versus vaping e-liquid flavors is lacking. This study aims to investigate if smelling could be an alternative to vaping experiments by determining the correlation for hedonic flavor assessment between orthonasal sme...
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This works aimed to assess the health risks of e-cigarette use to bystanders. The exhaled breath of 17 volunteers was collected while they were vaping, and the levels of nicotine, propylene glycol, glycerol, formaldehyde, acetaldehyde, acrolein, tobacco-specific nitrosamines (TSNAs), and heavy metals were analyzed. Increased levels of nicotine, pro...
Article
The European Commission has established a priority list of 15 additives contained in cigarettes and roll-your-own tobacco subject to enhanced reporting obligations. The European Union (EU) Tobacco Products Directive (TPD) prescribes that Member States shall require manufacturers and importers of tobacco products to carry out comprehensive studies o...
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E-cigarettes are increasingly popular among both cigarette smokers and non-users. Although smoking cessation yields the most individual and population health benefits, switching to exclusive e-cigarette use offers some individual health benefits for cigarette smokers. However, e-cigarette use is not harmless, and its use among non-cigarette smokers...
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This paper aims to provide an in-depth understanding of the attractiveness of e-cigarettes for several different groups. For this purpose, perceptions of and reasons for e-cigarette use were systematically reviewed as reported by e-cigarette users, cigarette smokers, dual users, and non-users, among both adults and youth. MEDLINE® and Scopus were u...
Article
Background: A wide variety of new tobacco and tobacco-related products have emerged on the market in recent years. Objective: To understand their potential implications for public health and to guide tobacco control efforts, we have used an infoveillance approach to identify new tobacco and tobacco-related products. Methods: Our search for tob...
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Objectives Tobacco flavours are an important regulatory concept in several jurisdictions, for example in the USA, Canada and Europe. The European Tobacco Products Directive 2014/40/EU prohibits cigarettes and roll-your-own tobacco having a characterising flavour. This directive defines characterising flavour as ‘a clearly noticeable smell or taste...
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Introduction: E-liquids are available in a high variety of flavors. A systematic classification of e-liquid flavors is necessary to increase comparability of research results. In the food, alcohol and fragrance industry, flavors are classified using flavor wheels. We systematically reviewed literature on flavors related to e-cigarette use, to inve...
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The WHO Study Group on Tobacco Product Regulation (TobReg) advised regulating and lowering toxicant levels in cigarette smoke. Aldehydes are one of the chemical classes on the TobReg smoke toxicants priority list. To provide insight in factors determining aldehyde yields, the levels of 12 aldehydes in mainstream cigarette smoke of 11 Dutch brands w...
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Background The European Tobacco Product Directive 2014/40/EU prohibited cigarettes and roll-your-own tobacco having a characterizing flavor, which is defined as "a clearly noticeable smell or taste other than one of tobacco […]". To practically distinguish between products with and without a characterizing flavor, some questions need to be answered...
Article
Background E-cigarettes are available in a wide variety of flavors, which increases sensory appeal and stimulates smoking initiation, especially among youth. To determine regulatory measures on flavors in e-cigarettes, e.g. restriction or prohibition, more insight should be obtained in the role of flavors in e-cigarette addiction. Core components o...
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Background: As a legal obligation, the Dutch government publishes online information about tobacco additives to make sure that it is publicly available. Little is known about the influence this website (”tabakinfo”) has on visitors and how the website is evaluated by them. Objective: This study assesses how visitors use the website and its effect...
Presentation
Background It is important to know why individuals use electronic cigarettes (e-cigarettes) compared to tobacco cigarettes. This comparison provides policy makers with opportunities to target different types of users. This study examined behavioral determinants associated with both tobacco and e-cigarette use. Differences between non-users (neither...
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Objectives: This study combines chemical analysis and flavour descriptions of flavour additives used in tobacco products, and provides a starting point to build an extensive library of flavour components, useful for product surveillance. Methods: Headspace gas chromatography-mass spectrometry (GC-MS) was used to compare 22 commercially available...
Article
Humectants, especially glycerol and propylene glycol, are tobacco additives that are used to facilitate several processes in the production of tobacco products and to maintain the moisture content. Humectants in tobacco are usually detected by gas chromatography with flame ionization detection after a pre-analytical conditioning procedure. During t...
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Cigarettes are an often-used consumer product, and flavor is an important determinant of their product appeal. Cigarettes with strong nontobacco flavors are popular among young people, and may facilitate smoking initiation. Discriminating flavors in tobacco is important for regulation purposes, for instance to set upper limits to the levels of impo...
Technical Report
The Commission has established a priority list of 15 additives contained in cigarettes and roll-your-own tobacco subject to enhanced reporting obligations, based on a scientific Opinion (Tobacco Additives I) of the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR). The EU Tobacco Product Directive (TPD) prescribes that Me...
Article
The new EU Tobacco Product Directive (TPD) prohibits tobacco products containing additives that are toxic in unburnt form or that increase overall toxicity of the product. This paper proposes a strategy to assess additive attributed toxicity in the context of the TPD. Literature was searched on toxicity testing strategies for regulatory purposes fr...
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Background: Cigarettes and other forms of tobacco contain the addictive drug nicotine. Other components, either naturally occurring in tobacco or additives that are intentionally added during the manufacturing process, may add to the addictiveness of tobacco products. As such, these components can make cigarette smokers more easily and heavily depe...
Technical Report
The main purpose of this scientific Opinion is to assist the Commission in identifying the additives that should be put on the priority list as foreseen by Article 6 of the TobaccoProducts Directive 2014/40/EU (TPD). The SCENIHR was asked to identify those additives, amongst the most commonly used additives by weight or number, that have one or mor...
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A shisha-pen is an electronic cigarette variant that is advertised to mimic the taste of a water pipe, or shisha. The aim of this study was to assess the potential harmful health effects caused by inhaling the vapor of a nicotine-free shisha-pen. Gas chromatography analysis was performed to determine the major components in shisha-pen vapor. Risk a...
Article
Background: Products with strong non-tobacco flavours are popular among young people, and facilitate smoking initiation. Similar to the U.S. Food and Drug Administration Tobacco Control Act, the new European Tobacco Product Directive (TPD) prohibits cigarettes and roll-your-own tobacco with a characterising flavour other than tobacco. However, no...
Article
Objectives: To discuss product-wide implementation of WHO FCTC Article 9 by applying lessons learned from routine measurement of cigarettes to roll-your-own tobacco, cigars, water pipes, and snus. Methods: A qualitative review of existing peer-reviewed and grey literature from science, industry, and government was performed. Results: We recommend:...
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shows that smoking rates among men and women aged 15 years and over fell from 33.1% in 1989 to 17.2% in 2008. This fall in smoking prevalence has led to substantial improvements in public health in Brazil due to the strong as-sociation between smoking and morbid condi-tions, such as chronic obstructive pulmonary disease (COPD), cancer (lung, larynx...
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1,3-butadiene (BD) is a smoke component selected by the World Health Organization (WHO) study group on Tobacco Product Regulation (TobReg) for mandated lowering. We examined the tobacco-smoke related health effects induced by BD and possible health impacts of risk reduction strategies. BD levels in mainstream smoke (MSS) from international and Cana...
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Tobacco smoke is a toxic and carcinogenic mixture of more than 5,000 chemicals. The present article provides a list of 98 hazardous smoke components, based on an extensive literature search for known smoke components and their human health inhalation risks. An electronic database of smoke components containing more than 2,200 entries was generated....