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 - Funding Information:
Funding was provided by North Dakota Department of Health (NDDOH) Contract # PF17.225 and Grants # G19.276 and # G19.276A to conduct the study and to prepare the article. The NDDOH had no other involvement in the conduction of the study or preparation of the article. Funding for the Proteomics, Metabolomics and Mass Spectrometry Facility used in this study was made possible in part by the M. J. Murdock Charitable Trust and the National Institute of General Medical Sciences of the National Institutes of Health (NIH) under Award # P20GM103474 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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 -