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

PurposeTo expand on our 2015 study of the nicotine content accuracy e-liquids, including salts, and presence child-resistant packaging. We also describe compounding in shop (CIS).Design methodsWe analyzed samples from 35 shops. CIS processing was observed. Descriptive statistics summarized data, inference performed.ResultsActual significantly less than identified content, average, with a mean percent deviation 34.0% below content. Only 3.8% samples' actual within 10% content; maximum 213.2%. Of eight uniquely packaged samples, designs resembling pop cans, ice cream cones, etc., −39.6%; none were Eight shops compounded samples. After removing outlier values, significant differences found deviations between non-CIS free-base A higher percentage had > above 10%. One visually estimated quantities to add, e-liquids not always relabeled reflect new levels, protective materials worn during compounding. Child-resistant packaging present for one third samples.ConclusionsLabeling remains inaccurate, is inconsistent, problematic. Effective e-liquid regulation needed protect public health.Practice implicationsNurses should educate families about serious health risks advocate increased regulations.