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Fagan P, Pokhrel P, Herzog TA, Guy MC, Sakuma KLK, Trinidad DR, Cassel KD, Jorgensen D, Lynch T, Felicitas-Perkins JQ, Palafox S, Hamamura FD, Maloney S, Degree K, Sterling K, Moolchan ET, Clanton MS, Eissenberg TE. Warning Statements and Safety Practices Among Manufacturers and Distributors of Electronic Cigarette Liquids in the United States. Nicotine Tob Res 2019; 20:970-976. [PMID: 28520985 DOI: 10.1093/ntr/ntx101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 05/11/2017] [Indexed: 11/13/2022]
Abstract
Introduction Prior to the US Food and Drug Administration's (FDA) regulation of electronic cigarettes and warning statements related to nicotine addiction, there was no critical examination of manufacturer/distributor voluntary practices that could potentially inform FDA actions aimed to protect consumers. This study examined the content of warning statements and safety characteristics of electronic cigarette liquid bottles using a national sample. Methods Research staff randomly selected four electronic cigarette liquid manufacturers/distributors from four US geographic regions. Staff documented the characteristics of product packaging and content of warning statements on 147 electronic cigarette liquids (0-30 mg/ml of nicotine) purchased online from 16 manufacturers/distributors in April of 2016. Results Data showed that 97.9% of the electronic cigarette liquid bottles included a warning statement, most of which focused on nicotine exposure rather than health. Only 22.4% of bottles used a warning statement that indicated the product "contained nicotine." Of bottles that advertised a nicotine-based concentration of 12 mg/ml, 26% had a warning statements stated that the product "contains nicotine." None of the statements that indicated that the product "contained nicotine" stated that nicotine was "addictive." All bottles had a safety cap and 12% were in plastic shrink-wrap. Fifty-six percent of the websites had a minimum age requirement barrier that prevented under-aged persons from entering. Conclusions Most manufacturers/distributors printed a warning statement on electronic cigarette liquid bottles, but avoided warning consumers about the presence and the addictiveness of nicotine. Studies are needed to examine manufacturer/distributor modifications to product packaging and how packaging affects consumer behaviors. Implications These data can inform future FDA requirements related to the packaging and advertising of e-cigarette liquids; regulation related to the content of warning statements, including exposure warning statements, which are not currently mandated; and requirements on websites or language on packaging to help manufacturers adhere to the minimum age of purchase regulation. The data can also be used to help FDA develop additional guidance on the framing of statements on packaging that helps consumers make informed decisions about purchasing the product or protecting young people from use or unintentional exposure to the product.
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Affiliation(s)
- Pebbles Fagan
- Center for the Study of Tobacco, Department Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR.,Center for the Study of Tobacco Products, Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA
| | - Pallav Pokhrel
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Thaddeus A Herzog
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Mignonne C Guy
- Center for the Study of Tobacco Products, Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA.,Department of African American Studies, Virginia Commonwealth University, Richmond, VA
| | - Kari-Lyn K Sakuma
- Department of Health Promotion and Behavior, College of Public Health and Human Sciences, Oregon State University, Waldo Corvallis, OR
| | - Dennis R Trinidad
- Family Medicine and Public Health, University of California, San Diego, La Jolla, CA
| | - Kevin D Cassel
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Dorothy Jorgensen
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Tania Lynch
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | | | - Sherilyn Palafox
- Center for the Study of Tobacco Products, Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA.,Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Faith D Hamamura
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Sarah Maloney
- Center for the Study of Tobacco Products, Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Kaylah Degree
- Center for the Study of Tobacco Products, Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA.,Department of African American Studies, Virginia Commonwealth University, Richmond, VA
| | - Kymberle Sterling
- Department of Health Promotion and Behavior, School of Public Health, Georgia State University, Atlanta, GA
| | | | | | - Thomas E Eissenberg
- Center for the Study of Tobacco Products, Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA
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