TY - JOUR
T1 - Electronic cigarette refill liquids
T2 - Nicotine content, presence of child-resistant packaging, and in-shop compounding
AU - Buettner-Schmidt, Kelly
AU - Miller, Donald R.
AU - Orr, Megan
AU - Balasubramanian, Narayanaganesh
AU - Rykal, Katelyn
AU - Steward, Katherine F.
AU - Swanson, Kathleen
AU - Berry, Missy
N1 - Publisher Copyright:
© 2020 The Authors
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Purpose: To expand on our 2015 study of the nicotine content accuracy of e-liquids, including salts, and the presence of child-resistant packaging. We also describe compounding in shop (CIS). Design and methods: We analyzed samples from 35 shops. CIS processing was observed. Descriptive statistics summarized the data, and inference was performed. Results: Actual nicotine content was significantly less than the identified content, on average, with a mean percent deviation 34.0% below the identified content. Only 3.8% of the samples' actual nicotine content was within 10% of the identified content; the maximum deviation was 213.2%. Of eight uniquely packaged samples, including designs resembling pop cans, ice cream cones, etc., the mean percent deviation was −39.6%; none were within 10% of the identified content. Eight shops compounded samples. After removing outlier values, significant differences were found in the percent deviations between the CIS and non-CIS free-base samples. A significantly higher percentage of CIS samples had nicotine content > 10% above the identified content, and none were within 10%. One shop visually estimated the nicotine quantities to add, e-liquids were not always relabeled to reflect new nicotine levels, and protective materials were not always worn during compounding. Child-resistant packaging was not present for one third of the samples. Conclusions: Labeling of nicotine content in e-liquids remains inaccurate, child-resistant packaging is inconsistent, and CIS is problematic. Effective e-liquid regulation is needed to protect public health. Practice implications: Nurses should educate families about the serious health risks of e-liquids and advocate for increased e-liquid regulations.
AB - Purpose: To expand on our 2015 study of the nicotine content accuracy of e-liquids, including salts, and the presence of child-resistant packaging. We also describe compounding in shop (CIS). Design and methods: We analyzed samples from 35 shops. CIS processing was observed. Descriptive statistics summarized the data, and inference was performed. Results: Actual nicotine content was significantly less than the identified content, on average, with a mean percent deviation 34.0% below the identified content. Only 3.8% of the samples' actual nicotine content was within 10% of the identified content; the maximum deviation was 213.2%. Of eight uniquely packaged samples, including designs resembling pop cans, ice cream cones, etc., the mean percent deviation was −39.6%; none were within 10% of the identified content. Eight shops compounded samples. After removing outlier values, significant differences were found in the percent deviations between the CIS and non-CIS free-base samples. A significantly higher percentage of CIS samples had nicotine content > 10% above the identified content, and none were within 10%. One shop visually estimated the nicotine quantities to add, e-liquids were not always relabeled to reflect new nicotine levels, and protective materials were not always worn during compounding. Child-resistant packaging was not present for one third of the samples. Conclusions: Labeling of nicotine content in e-liquids remains inaccurate, child-resistant packaging is inconsistent, and CIS is problematic. Effective e-liquid regulation is needed to protect public health. Practice implications: Nurses should educate families about the serious health risks of e-liquids and advocate for increased e-liquid regulations.
KW - Child safety
KW - E-liquids
KW - Electronic nicotine delivery systems
KW - Nicotine content
KW - Product packaging
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U2 - 10.1016/j.pedn.2020.12.016
DO - 10.1016/j.pedn.2020.12.016
M3 - Article
C2 - 33460879
AN - SCOPUS:85099476998
SN - 0882-5963
VL - 59
SP - 45
EP - 54
JO - Journal of pediatric nursing
JF - Journal of pediatric nursing
ER -