Multidisciplinary approaches in electronic nicotine delivery systems pulmonary toxicology: emergence of living and non-living bioinspired engineered systems

Technology-based platforms offer crucial support for regulatory agencies in overseeing tobacco products to enhance public health protection. The use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes, has surged exponentially over the past decade. However, the understanding of the impact of ENDS on lung health remains incomplete due to scarcity of physiologically relevant technologies for evaluating their toxicity. This review examines the societal and public health impacts of ENDS, prevalent preclinical approaches in pulmonary space, and the application of emerging Organ-on-Chip technologies and bioinspired robotics for assessing ENDS respiratory toxicity. It highlights challenges in ENDS inhalation toxicology and the value of multidisciplinary bioengineering approaches for generating reliable, human-relevant regulatory data at an accelerated pace.