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E-liquid,<ref name=Weaver2014>{{cite journal|last1=Weaver|first1=Michael|last2=Breland|first2=Alison|last3=Spindle|first3=Tory|last4=Eissenberg|first4=Thomas|title=atomizers/vaporizers|journal=Journal of Addiction Medicine|volume=8|issue=4|year=2014|pages=234–240|issn=1932-0620|doi=10.1097/ADM.0000000000000043|pmid=25089953}}</ref> e-fluid, or e-juice is the solution used in e-cigarettes.<ref name=Kacker2014/> There is a vast array of e-liquids available.<ref name=Bekki2014>{{cite journal|last1=Bekki|first1=Kanae|last2=Uchiyama|first2=Shigehisa|last3=Ohta|first3=Kazushi|last4=Inaba|first4=Yohei|last5=Nakagome|first5=Hideki|last6=Kunugita|first6=Naoki|title=Carbonyl Compounds Generated from Electronic Cigarettes|journal=International Journal of Environmental Research and Public Health|volume=11|issue=11|year=2014|pages=11192–11200|issn=1660-4601|doi=10.3390/ijerph111111192|pmid=25353061}}</ref> The main ingredients are ], ], water, ], and ]; and optionally, tobacco-derived nicotine.<ref name=Caponnetto2013>{{cite journal|title=Electronic cigarette: a possible substitute for cigarette dependence.|journal=Monaldi archives for chest disease|date=Mar 2013|author1=Caponnetto P|author2=Russo C|author3=Bruno CM|author4=Alamo A|author5=Amaradio MD|author6=Polosa R.|volume=79|issue=1|pages=12–19|pmid=23741941}}</ref> The liquid typically contains 95% propylene glycol and glycerin.<ref name=Ruiz2014>{{cite journal|last1=Jimenez Ruiz|first1=CA|last2=Solano Reina|first2=S|last3=de Granda Orive|first3=JI|last4=Signes-Costa Minaya|first4=J|last5=de Higes Martinez|first5=E|last6=Riesco Miranda|first6=JA|last7=Altet Gómez|first7=N|last8=Lorza Blasco|first8=JJ|last9=Barrueco Ferrero|first9=M|last10=de Lucas Ramos|first10=P|title=The electronic cigarette. Official statement of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) on the efficacy, safety and regulation of electronic cigarettes.|journal=Archivos de bronconeumologia|date=August 2014|volume=50|issue=8|pages=362–7|pmid=24684764|doi=10.1016/j.arbr.2014.06.007}}</ref> The most regularly used base carrier chemical is propylene glycol with or without glycerin. E-liquid containing glycerin and water made without propylene glycol is also sold.<ref name=Kacker2014>{{cite journal|last1=Oh|first1=Anne Y.|last2=Kacker|first2=Ashutosh|title=Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes?: Review on e-cigarette vapor versus tobacco smoke|journal=The Laryngoscope|date=December 2014|volume=124|issue=12|pages=2702–2706|doi=10.1002/lary.24750|pmid=25302452}}</ref> The nicotine in e-liquid may be prepared using a ]-grade nicotine, a tobacco plant extract, tobacco dust or a synthetic nicotine.<ref name=Chang2014>{{cite journal|last1=Chang|first1=H.|title=Research gaps related to the environmental impacts of electronic cigarettes|journal=Tobacco Control|volume=23|issue=Supplement 2|year=2014|pages=ii54–ii58|issn=0964-4563|doi=10.1136/tobaccocontrol-2013-051480|pmc=3995274|pmid=24732165}}</ref> Most e-cigarette liquids contain nicotine, but the level of nicotine varies depending on user-preference and manufacturers.<ref name=Bur2014/> E-liquid without nicotine is also available.<ref name=Bur2014>{{cite journal|last1=Burstyn|first1=I|title=Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks.|journal=BMC Public Health|date=9 January 2014|volume=14|pages=18|doi=10.1186/1471-2458-14-18|pmc=3937158|pmid=24406205}}</ref> Although some e-juice is nicotine-free, surveys demonstrate that 97% of e-cigarette users use products that contain nicotine. A 2015 review suggests that 1% of users use liquid without nicotine.<ref name=Born2015>{{cite journal|last1=Born|first1=H.|last2=Persky|first2=M.|last3=Kraus|first3=D. H.|last4=Peng|first4=R.|last5=Amin|first5=M. R.|last6=Branski|first6=R. C.|title=Electronic Cigarettes: A Primer for Clinicians|journal=Otolaryngology -- Head and Neck Surgery|year=2015|issn=0194-5998|doi=10.1177/0194599815585752|pmid=26002957}}</ref> | |||
The solution is often sold in bottles or pre-filled disposable cartridges, or as a kit for consumers to make their own e-juices.{{CN|date=September 2015}} E-liquids made at home are common. Components are also available to modify or boost their flavor or nicotine strength.<ref name=DiyLiquid>{{cite web|url=http://www.ecigarettemag.com/e-liquid-mixing/|publisher=Ecigarette Mag|title=E-liquid Mixing Guide – a Guide to DIY Mixing|accessdate=10 November 2014}}</ref> Pre-made e-liquids are made with various tobacco, fruit, and other flavors, as well as variable nicotine concentrations (including nicotine-free versions).<ref name=Caponnetto2013/> The standard notation "mg/ml" is often used on labels to denote nicotine concentration, and is sometimes shortened to "mg".<ref name=Laugesen2007>{{cite web|url=http://www.healthnz.co.nz/Ruyan_ecigarette.htm |author=Murray Laugesen|title=The Ruyan e-cigarette; Technical Information Sheet|publisher=Health New Zealand|date=17 October 2007|accessdate=31 March 2008}}</ref> In surveys of regular e-cigarette users, the most popular e-liquids have a nicotine content of 18 mg/ml, and the preferred flavors were largely tobacco, mint and fruit.<ref name=Hajek2014>{{cite journal|last1=Hajek|first1=P|last2=Etter|first2=JF|last3=Benowitz|first3=N|last4=Eissenberg|first4=T|last5=McRobbie|first5=H|title=Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit.|url=http://tobonline.com/Media/Default/Article/Addiction-%20Hajek%2014.pdf|journal=Addiction (Abingdon, England)|date=31 July 2014|volume=109|issue=11|pages=1801–10|doi=10.1111/add.12659|pmid=25078252}}</ref> A cartridge may contain 0 to 20 mg of nicotine.<ref name=Cervellin2013/> EU regulations cap the concentration of nicotine in e-liquid at a maximum of 20mg/mL. A refill bottle can contain up to 1 g of nicotine.<ref name=Cervellin2013>{{cite journal|last1=Cervellin|first1=Gianfranco|last2=Borghi|first2=Loris|last3=Mattiuzzi|first3=Camilla|last4=Meschi|first4=Tiziana|last5=Favaloro|first5=Emmanuel|last6=Lippi|first6=Giuseppe|title=E-Cigarettes and Cardiovascular Risk: Beyond Science and Mysticism|journal=Seminars in Thrombosis and Hemostasis|volume=40|issue=01|year=2013|pages=060–065|issn=0094-6176|doi=10.1055/s-0033-1363468|pmid=24343348}}</ref> Refill liquids are often sold in the size range from 15 to 30 mL.<ref name=Hildick-SmithPesko2015/> One cartridge may typically last as long as one pack of cigarettes.<ref name=Odum2012>{{cite journal|last1=Odum|first1=L. E.|last2=O'Dell|first2=K. A.|last3=Schepers|first3=J. S.|title=Electronic Cigarettes: Do They Have a Role in Smoking Cessation?|journal=Journal of Pharmacy Practice|volume=25|issue=6|year=2012|pages=611–614|issn=0897-1900|doi=10.1177/0897190012451909|pmid=22797832}}</ref> Some liquids without flavoring is also sold.<ref name=Cochrane2014>{{cite journal|last1=McRobbie|first1=Hayden|last2=Bullen|first2=Chris|last3=Hartmann-Boyce|first3=Jamie|last4=Hajek|first4=Peter|last5=McRobbie|first5=Hayden|title=Electronic cigarettes for smoking cessation and reduction|journal=The Cochrane Library|year=2014|volume=12|pages=CD010216|doi=10.1002/14651858.CD010216.pub2|pmid=25515689}}</ref> The flavorings may be natural or artificial.<ref name=Bertholon2013>{{cite journal|last1=Bertholon|first1=J.F.|last2=Becquemin|first2=M.H.|last3=Annesi-Maesano|first3=I.|last4=Dautzenberg|first4=B.|title=Electronic Cigarettes: A Short Review|journal=Respiration|year=2013|issn=1423-0356|volume=86|pages=433–8|doi=10.1159/000353253|pmid=24080743}}</ref> About 8,000 flavors exist as of 2014.<ref name=WHO2014>{{cite web|title=Backgrounder on WHO report on regulation of e-cigarettes and similar products|url=http://www.who.int/nmh/events/2014/backgrounder-e-cigarettes/en/|accessdate=2 June 2015|date=26 August 2014}}</ref> A user does not normally consume a whole cartridge in a single session. Most e-liquids are produced by a few manufacturers in China, the US and Europe.<ref name=Hajek2014/> A user will usually obtain 300 to 500 puffs per mL of liquid.<ref name=Hildick-SmithPesko2015>{{cite journal|last1=Hildick-Smith|first1=Gordon J.|last2=Pesko|first2=Michael F.|last3=Shearer|first3=Lee|last4=Hughes|first4=Jenna M.|last5=Chang|first5=Jane|last6=Loughlin|first6=Gerald M.|last7=Ipp|first7=Lisa S.|title=A Practitioner's Guide to Electronic Cigarettes in the Adolescent Population|journal=Journal of Adolescent Health|year=2015|issn=1054139X|doi=10.1016/j.jadohealth.2015.07.020|pmid=26422289}}</ref> | |||
== Manufacturing == | |||
E-Liquids are manufactured by many producers, both in the United States and across the world. First tier manufacturers use lab suits, gloves, hair covers, inside of certified clean rooms with air filtration similar to pharmaceutical-grade production areas <ref>{{Cite web|title = Avail Vapor offers glimpse into the 'art and science' of e-liquids|url = http://www.richmond.com/business/local/article_9f65201a-94c0-51b1-9663-f9fbb5c522af.html|website = Richmond Times-Dispatch|accessdate = 2015-11-23}}</ref> | |||
==References== | |||
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