Assessing Nicotine Exposure in Users and Non-Users of Electronic Cigarettes Through Silicone Wristbands

Although the use of electronic nicotine delivery systems (ENDS) among youth has declined since its peak in 2018, it remains popular among young adults. Despite its popularity, research on the health effects of secondhand exposure to ENDS remains limited. Silicone wristbands offer a simple, cost-effective method for measuring nicotine exposure. The study employed a quasi-experimental design and recruited six dyads consisting of ENDS users and non-users. Over three consecutive months, all participants wore silicone wristbands for one week at a time to assess nicotine exposure. ENDS users had a higher overall median nicotine concentration in their silicone wristbands (423.2 ng/g, IQR: 199.2-669.1) compared to non-users (17.2 ng/g, IQR: 6.5-128.0). This trend was consistent across all time points. Statistically significant differences between ENDS users and non-users were observed during months 1 and 2 (<i>p</i>-values = 0.0303 and 0.0411, respectively), but not during month 3 (<i>p</i>-value = 0.2468). Similar trends were observed in urinary cotinine levels, with higher medians among ENDS users (1013.0 ng/mL, IQL: 442.0-1490.0) compared to non-users (1.3 ng/mL, IQL: 1.0-1.4). A significant correlation was found between urinary cotinine and wristband nicotine levels only in non-users (r = 0.69, <i>p</i>-value = 0.0017). Silicone wristbands worn by non-users can detect secondhand nicotine exposure and are significantly correlated with urinary cotinine.