Discrepancies in Nicotine Content of E-Cigarette Liquids: A Systematic Review of High Performance Liquid Chromatography-Based Analyses
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Abstract
Introduction: E-cigarettes have emerged as a popular alternative to traditional tobacco products, largely driven by perceptions of reduced harm and customizable nicotine delivery. Accurately determining nicotine concentrations using high performance liquid chromatography is crucial for guiding public health policies and ensuring consumer safety. This assessment method is preferred due to its high sensitivity, precision and ability to reliably quantify nicotine in complex matrices especially the liquid in e-cigarettes. Methods: A systematic search using electronic databases was performed using PubMed, Science Direct, and Google Scholar with specific keywords to identify relevant studies to determine the findings. The articles that met the inclusion criteria were retrieved following the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: The findings of this systematic review revealed that the nicotine concentration in e-liquid samples varies across multiple studies. The deviation of nicotine content in e-liquid samples found to be high as +451% and as low as −90.6%. The analyzed e-liquid samples with concentrations ranging from 0 to 50 mg/ml indicated that nicotine levels were more than 20% and at least 10% below the labelled concentrations in packaging. The analysis also exposed the existence of nicotine in e-liquid samples labelled as nicotine-free. Conclusion: This systematic review employing high performance liquid chromatography as primary analytical method to uncover inconsistencies between measured nicotine content of e-liquids and their labelled values. These findings underscore the urgent need for stricter regulatory oversight and standardized quality control measures for consumer safety and compliance with regulatory standards.
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Berry KM, Fetterman JL, Benjamin EJ, Bhatnagar A, Barrington-Trimis JL, Leventhal AM, Stokes A. Association of electronic cigarette use with subsequent initiation of tobacco cigarettes in US youths. JAMA Netw Open. 2019 Feb 1;2(2): e187794-. doi: 10.1001/jamanetworkopen.2018.7794
Stallings-Smith S, Ballantyne T. Ever use of e-cigarettes among adults in the United States: a cross-sectional study of sociodemographic factors. Inquiry: J Health Care Organ Provis Financ. 2019 Jul; 56:0046958019864479. doi: 10.1177/0046958019864479
Cao DJ, Aldy K, Hsu S, McGetrick M, Verbeck G, De Silva I, Feng SY. Review of health consequences of electronic cigarettes and the outbreak of electronic cigarette, or vaping, product use-associated lung injury. J Med Toxicol. 2020 Jul; 16:295-310. doi: 10.1007/s13181-020-00772-w
Jackson R, Huskey M, Brown S. Labelling accuracy in low nicotine e-cigarette liquids from a sampling of US manufacturers. Int J Pharm Pract. 2020 Jun;28(3):290-4. doi: 10.1111/ijpp.12596
Eaton DL, Kwan LY, Stratton K, National Academies of Sciences, Engineering, and Medicine. Toxicology of E-cigarette constituents. InPublic Health Consequences of E-Cigarettes 2018 Jan 23. Natl Acad Press (US). doi: 10.17226/24952
Sreeramareddy CT, Shroff SM, Gunjal S. Nicotine dependence and associated factors among persons who use electronic e-cigarettes in Malaysia: an online survey. Subst Abuse Treat Prev Policy. 2023;18(1):51. doi:10.1186/s13011-023-00558-7
Etter JF, Bullen C. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction. 2011;106(11):2017–28. doi:10.1111/j.1360-0443.2011.03505.x
Zhu SH, Gamst A, Lee M, Cummins S, Yin L, Zoref L. The use and perception of electronic cigarettes and snus among the U.S. population. PLOS ONE. 2013;8(10):e79332. doi:10.1371/journal.pone.0079332
Farsalinos KE, Polosa R. Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Ther Adv Drug Saf. 2014;5(2):67-86. doi:10.1177/2042098614524430
Levett JY, Filion KB, Reynier P, Prell C, Eisenberg MJ. Efficacy and safety of E-cigarette use for smoking cessation: a systematic review and meta-analysis of randomized controlled trials. Am J Med. 2023 Aug 1;136(8):804-13. doi: 10.1016/j.amjmed.2023.04.014
Grana R, Benowitz N, Glantz SA. E-cigarettes: a scientific review. Circulation. 2014 May 13;129(19):1972-86. doi: 10.1161/circulationaha.114.007667
Zhu SH, Sun JY, Bonnevie E, Cummins SE, Gamst A, Yin L, Lee M. Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob Control. 2014 Jul 1;23(suppl 3): iii3-9. doi: 10.1136/tobaccocontrol-2014-051670
Huang J, Duan Z, Kwok J, Binns S, Vera LE, Kim Y, Szczypka G, Emery SL. Vaping versus JUULing: how the extraordinary growth and marketing of JUUL transformed the US retail e-cigarette market. Tob Control. 2019 Mar 1;28(2):146-51. doi: 10.1136/tobaccocontrol-2018-054382
Goniewicz ML, Lee L. Electronic cigarettes are a source of thirdhand exposure to nicotine. Nicotine Tob Res. 2015 Feb 1;17(2):256-8. doi: 10.1093/ntr/ntu152
Kim S, Goniewicz ML, Yu S, Kim B, Gupta R. Variations in label information and nicotine levels in electronic cigarette refill liquids in South Korea: regulation challenges. Int J Environ Res Public Health. 2015;12(5):4859-4868. doi:10.3390/ijerph120504859.
Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, Walker N. Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet. 2013 Nov 16;382(9905):1629-37. doi: 10.1016/S0140-6736(13)61842-5
Dill M, Deconinck E, Barhdadi S. Method Development and Validation of an Aerosol Sampling Technique for the Analysis of Nicotine in Electronic Cigarette Aerosols. Molecules. 2024 Jul 25;29(15):3487. doi: 10.3390/molecules29153487
Sahu R, Shah K, Malviya R, Paliwal D, Sagar S, Singh S, Prajapati BG, Bhattacharya S. E-cigarettes and associated health risks: an update on cancer potential. Adv Respir Med. 2023 Nov 14;91(6):516-31. doi: 10.3390/arm91060038
Bold KW, Krishnan-Sarin S. E-cigarettes: tobacco policy and regulation. Curr Addict Rep. 2019 Jun 15; 6:75-85. doi: 10.1007/s40429-019-00243-5
Pisinger C, Døssing M. A systematic review of health effects of electronic cigarettes. Prev Med. 2014 Dec 1; 69:248-60. doi: 10.1016/j.ypmed.2014.10.009
Seiler-Ramadas R, Sandner I, Haider S, Grabovac I, Dorner TE. Health effects of electronic cigarette (e cigarette) use on organ systems and its implications for public health. Wien Klin Wochenschr. 2021 Oct; 133:1020-7. doi: 10.1007/s00508-020-01711-z
Trucco EM, Fallah-Sohy N, Hartmann SA, Cristello JV. Electronic cigarette use among youth: understanding unique risks in a vulnerable population. Curr Addict Rep. 2020 Dec; 7:497-508. doi: 10.1007/s40429-020-00340-w
Grabovac I, Oberndorfer M, Fischer J, Wiesinger W, Haider S, Dorner TE. Effectiveness of electronic cigarettes in smoking cessation: a systematic review and meta-analysis. Nicotine Tob Res. 2021 Apr 1;23(4):625-34. doi: 10.1093/ntr/ntaa181
Kapan A, Stefanac S, Sandner I, Haider S, Grabovac I, Dorner TE. Use of electronic cigarettes in European populations: a narrative review. Int J Environ Res Public Health. 2020 Mar;17(6):1971. doi: 10.3390/ijerph17061971
Svirsky L, Howard D, Berman ML. E-cigarettes and the multiple responsibilities of the FDA. Am J Bioeth. 2022 Oct 3;22(10):5-14. doi: 10.1080/15265161.2021.1907478.
Zhang YY, Bu FL, Dong F, Wang JH, Zhu SJ, Zhang XW, Robinson N, Liu JP. The effect of e-cigarettes on smoking cessation and cigarette smoking initiation: an evidence-based rapid review and meta-analysis. Tob Induc Dis. 2021;19. doi: 10.18332/tid/131624
Eden VR, Mustapha MS, Jaganathan S, Jaafar H. Factors of e-cigarette use among Malaysian adolescents: A systematic review. J Health Sci Res. 2024 Jan 25;9(1):7-12. doi:10.25259/jhsr_43_2023
Hajizadeh A, Lotfi T, Falzon D, Mertz D, Nieuwlaat R, Gebreselassie N, Jaramillo E, Korobitsyn A, Zignol M, Mirzayev F, Ismail N. Recommendation mapping of the World Health Organization's guidelines on tuberculosis: A new approach to digitizing and presenting recommendations. J Clin Epidemiol. 2021 Jun 1; 134:138-49. doi: 10.1016/j.jclinepi.2021.02.009
Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008. doi:10.1136/bmj.j4008
Althakfi SH, Hameed AM. Investigating the efficiency of mechanical agitation on the quantification of nicotine in e-cigarettes, using a novel method. J Umm Al-Qura Univ Appl Sci. 2024 Mar;10(1):73-82. https://doi.org/10.1007/s43994-023-00079-w
Davis B, Dang M, Kim J, Talbot P. Nicotine concentrations in electronic cigarette refill and do-it-yourself fluids. Nicotine Tob Res. 2015;17(2):134-141. doi:10.1093/ntr/ntu080.
Etter JF, Zäther E, Svensson S. Analysis of refill liquids for electronic cigarettes. Addiction. 2013;108(9):1671-1679. doi:10.1111/add.12235.
Taylor A, Turfus S. A review of nicotine-containing electronic cigarettes—trends in use, effects, contents, labelling accuracy and detection methods. Drug Test Anal. 2021;13(3):479-497. doi:10.1002/dta.2998.
Zain SMSM, Khair SKJ, Mohamad N, Noh MFM, Radhakrishnan DA. Nicotine content in electronic cigarette refill solutions and its release in aerosols. J Environ Prot. 2019;10(10):1317-1332. doi:10.4236/jep.2019.1010078.
Bahl V, Lin S, Xu N, et al. Comparison of nicotine levels in e-cigarette refill solutions and aerosol. Tob Control. 2012;21(2):127-133. doi:10.1136/tobaccocontrol-2011-050043.
Yamin C, Bitton A, Walley S. E-cigarettes: A rapidly growing internet-based phenomenon. JAMA Intern Med. 2013;173(3):219-223. doi:10.1001/jamainternmed.2013.1628.
Althakfi SH, Hameed AM. Nicotine in electronic cigarettes. J Umm Al-Qura Univ Appl Sci. 2024 Feb 19:1-4. Doi: 10.1007/s43994-024-00123-3
Alhusban AA, Ata SA. Simple HPLC method for rapid quantification of nicotine content in e-cigarettes liquids. Acta Chromatogr. 2021 Apr 28;33(3):302-7. Doi: 10.1556/1326.2020.00832
Bennani I, Alami Chentoufi M, El Karbane M, Cheikh A, Bouatia M. E‐cigarette quality control: Impurity and nicotine level analysis in electronic cigarette refill liquids. Sci World J. 2020;2020(1):3050189. doi: 10.1155/2020/3050189.
Alotaybi M, Alzahrani SS, Algethmi AM, Alamri NS, Natto YS, Hashim ST, Altammar A, Alzubaidi AS, Alzahrani IB, Alghamdi AA. E-cigarettes and Vaping: A Smoking Cessation Method or Another Smoking Innovation? Cureus. 2022 Dec;14(12). doi: 10.7759/cureus.32435
Farsalinos K. Electronic cigarettes: an aid in smoking cessation, or a new health hazard?. Ther Adv Respir Dis. 2018 Jan 10; 12:1753465817744960. doi: 10.1177/1753465817744960
Ali N, Xavier J, Engur M, Mohanan PV, de la Serna JB. The impact of e-cigarette exposure on different organ systems: A review of recent evidence and future perspectives. J Hazard Mater. 2023 Sep 5; 457:131828. Doi: 10.1016/j.jhazmat.2023.131828
Kopel J, Dennis JA, Nugent K. Electronic cigarette survey characteristics. J Community Hosp Intern Med Perspect. 2020 May 3;10(3):216-23. doi: 10.1080/20009666.2020.1766841
Snoderly HT, Nurkiewicz TR, Bowdridge EC, Bennewitz MF. E-cigarette use: device market, study design, and emerging evidence of biological consequences. Int J Mol Sci. 2021 Nov 18;22(22):12452. doi: 10.3390/ijms222212452
Ronald Eden V, Hamid H, Das S, Dioso III R. Trend and Awareness of E-Cigarettes Among Students in a Private College in Sabah Malaysia. AUIQ Complement Biol Syst. 2024;1(2):86-95. doi:10.70176/3007-973X.1018