J Am Pharm Assoc (2003). 2021 Jan-Feb;61(1):20-26. doi: 10.1016/j.japh.2020.09.006. Epub 2020 Oct 2.
The use of e-cigarettes is becoming more common in the United States. E-cigarettes are often refilled with nicotine-containing solutions of various concentrations purchased in local shops or on the Internet. There is evidence that the nicotine content in these solutions is often mislabeled; thus, we reviewed the available literature on this topic.
We conducted a systematic review of peer-reviewed articles published worldwide on e-liquid nicotine content accuracy using the databases CAB Direct, Cochrane Central Register of Controlled Trials, PubMed, and SPORTDiscus (EBSCO).
Initial screening of titles and abstracts was conducted to determine relevancy for inclusion. Full-article reviews of studies involving the purchase and chemical analysis of nicotine content in refillable e-liquids were conducted for final inclusion.
Data extraction included e-liquid sample size, whether the samples were labeled to contain nicotine, whether the samples were purchased in retail shops or online, and the number and percentage of samples where the analyzed nicotine content fell outside 10% of the labeled nicotine content.
Twenty articles described cross-sectional studies of purchased samples containing nicotine. The number of nicotine-containing e-liquid samples obtained in each study varied from 2 to 71. 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% (277/574 or 48.3%; median 46.85%). A large percentage of the samples deviated by 10% from the labeled nicotine concentrations in both U.S. and non-U.S. samples, with U.S. samples having a higher percentage.
Our review shows that actual nicotine concentrations in e-liquids may vary considerably from labeled concentrations. Pharmacists should warn patients to be wary of the contents of e-cigarettes, and explain the dangers of using these products.
在美国，电子烟的使用越来越普遍。电子烟通常用从当地商店或互联网购买的各种浓度的含尼古丁溶液进行再填充。有证据表明，这些溶液中的尼古丁含量经常被错误标记；因此，我们回顾了这一主题的现有文献。
我们在全球范围内使用 CAB Direct、Cochrane 对照试验中心注册、PubMed 和 SPORTDiscus（EBSCO）数据库，对发表的关于电子烟液尼古丁含量准确性的同行评审文章进行了系统回顾。
对标题和摘要进行初步筛选，以确定纳入的相关性。对涉及可再填充电子烟液中尼古丁含量购买和化学分析的研究进行全文审查，以进行最终纳入。
数据提取包括电子烟液样本量、样本是否标记含有尼古丁、样本是否在零售店或网上购买，以及分析尼古丁含量超出标签尼古丁含量 10%的样本数量和百分比。
20 篇文章描述了购买的含有尼古丁的样本的横断面研究。每项研究中含有尼古丁的电子烟液样本数量从 2 到 71 不等。分析尼古丁浓度高于或低于标签尼古丁浓度 10%的样本比例从 0%到 100%（277/574 或 48.3%；中位数 46.85%）。在美国和非美国样本中，很大比例的样本偏离标签尼古丁浓度 10%，美国样本的比例更高。
我们的综述表明，电子烟液中的实际尼古丁浓度可能与标签浓度有很大差异。药剂师应警告患者警惕电子烟的内容，并解释使用这些产品的危险。
