a systematic review of refillable e-liquid nicotine content accuracy.

Introduction:
This systematic review examines the accuracy of nicotine content labeling in refillable e-liquids used in electronic cigarettes. The review aims to determine the variation in nicotine content accuracy in e-liquids purchased in different settings and countries. This information is crucial for healthcare professionals, policymakers, and consumers to make informed decisions about the use of e-cigarettes.

Key Points:

* The review included 20 studies with a total of 574 nicotine-containing e-liquid samples.
* The percentage of samples with an analyzed nicotine concentration of more than 10% above or below the labeled nicotine concentration ranged from 0% to 100%.
* The median percentage of samples with a deviation of more than 10% from the labeled nicotine concentration was 46.85%.
* a large percentage of samples deviated by 10% or more from the labeled nicotine concentrations in both U.S. and non-U.S. samples, with U.S. samples having a higher percentage.
* Samples purchased in retail stores and online had high frequencies of mislabeling.
* The majority of the studies found that a large proportion of the samples were mislabeled.
* Most studies reported that some liquids varied from the label by more than 50%, and in some cases, more than 100%.

Main Message:
The study highlights the significant variation in nicotine content accuracy in refillable e-liquids used in electronic cigarettes. The findings emphasize the need for more stringent regulations and quality control measures to ensure accurate labeling of nicotine content in e-liquids. healthcare professionals, policymakers, and consumers should be aware of the potential inaccuracies in nicotine content labeling and their potential health implications. It is crucial to educate users about the potential risks associated with e-cigarette use, and to advocate for stricter regulations to ensure the safety and accuracy of e-liquid products.

Miller DR, Buettner-Schmidt K, Orr M, Rykal K, Niewojna E. a systematic review of refillable e-liquid nicotine content accuracy. Journal of the american Pharmacists association : JaPha. 2021;61(1):20-26. doi:10.1016/j.japh.2020.09.006