Electronic Cigarette Refill Liquids: Nicotine Content, Presence of Child-Resistant Packaging, and in-Shop Compounding.

Introduction:
This article discusses a study on the accuracy of nicotine content labeling and child-resistant packaging of electronic cigarette (e-cigarette) refill liquids (e-liquids). The study also examines compounding-in-shop (CIS) practices and compares the results to those from a similar study conducted in 2015.

Key Points:

* The study analyzed 35 shops and 285 e-liquid samples, with 238 samples containing a specific non-zero nicotine content.
* The actual nicotine content was significantly lower than the identified content, with an average percent deviation of -34.0%.
* Only 3.8% of samples were within 10% of the identified nicotine content, and 4.2% of samples had more than 10% above the identified nicotine content, with a maximum deviation of 213.2%.
* Eight shops compounded e-liquids in-store, resulting in 25 CIS samples with a median identified nicotine concentration of -39.1%.
* The study found that the majority of e-liquid samples, 64.5%, were child-resistant, but 35.5% were not, and 78.6% of those not child-resistant had rubber droppers on the top.
* The study also found that nicotine salt samples were more likely to be child-resistant compared to free-base samples (86.3% vs. 55.1%).
* CIS samples had a significantly higher percentage of samples with actual nicotine content more than 10% above the identified concentration (16.0% vs. 2.8%).

Main Message:
The study highlights the continued issue of inaccurate nicotine content labeling and inconsistent child-resistant packaging of e-liquids. The CIS practices further complicate the issue as they result in a higher percentage of samples with a significant deviation from the identified nicotine content. It is essential to regulate e-liquid manufacturing and packaging to ensure the safety and well-being of consumers.

Buettner-Schmidt K, Miller DR, Orr M, et al. Electronic Cigarette Refill Liquids: Nicotine Content, Presence of Child-Resistant Packaging, and in-Shop Compounding. Journal of pediatric nursing. 2021;59:45-54. doi:10.1016/j.pedn.2020.12.016