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== Contents == == Contents ==
E-liquid,<ref name=Weaver2014>{{cite journal|last1=Weaver|first1=Michael|last2=Breland|first2=Alison|last3=Spindle|first3=Tory|last4=Eissenberg|first4=Thomas|title=Electronic cigarettes: a review of safety and clinical issues|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<ref name=EbbertAgunwamba2015>{{cite journal|last1=Ebbert|first1=Jon O.|last2=Agunwamba|first2=Amenah A.|last3=Rutten|first3=Lila J.|title=Counseling Patients on the Use of Electronic Cigarettes|journal=Mayo Clinic Proceedings|volume=90|issue=1|year=2015|pages=128–134|issn=00256196|doi=10.1016/j.mayocp.2014.11.004|pmid=25572196}}</ref> is the mixture used in vapor products including e-cigarettes.<ref name=Kacker2014/> E-Liquids come in many variations, including different nicotine strengths and many different flavors.<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 ], ], and ]; and most often, ] in liquid form.<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, and the remaining 5% being flavorings and nicotine.<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> E-liquid can be made with or without nicotine, with >90% of e-liquids containing some level of nicotine.<ref>{{Cite web|url = http://roar.uel.ac.uk/1875/1/2013_Dawkins_e-cig_survey.pdf|title = Vaping’ profiles and preferences: an online survey of electronic cigarette users|date = |accessdate = |website = |publisher = School of Psychology-University of East London|last = Lynne Dawkins, John Turner, Amanda Roberts and Kirstie Soar|first = }}</ref> The liquid typically contains 60% propylene glycol and glycerin.<ref name=nicquid/> The ratio balance has an effect on taste and vapor production, and is commonly referred to as PG/VG ratio.<ref name=nicquid>{{Cite web|url = https://www.nicquid.com/faq.html|title = NicQuid® Frequently Asked Questions |date = |accessdate = |website =NicQuid |publisher = |last = |first = }}</ref> The most regularly used base carrier chemical is propylene glycol with or without glycerin.<ref name=Grana2014>{{cite journal|last=Grana|first=R|author2=Benowitz, N |author3=Glantz, SA |title=E-cigarettes: a scientific review.|journal=Circulation|date=13 May 2014|volume=129|issue=19|pages=1972–86|doi=10.1161/circulationaha.114.007667|pmc=4018182|pmid=24821826}}</ref> E-liquid containing glycerin and water made without propylene glycol are 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> It is uncertain whether the nicotine used in e-liquid is manufactured using a ] (USP) 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">{{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.<ref name=Brandon2015>{{cite journal|last1=Brandon|first1=T. H.|last2=Goniewicz|first2=M. L.|last3=Hanna|first3=N. H.|last4=Hatsukami|first4=D. K.|last5=Herbst|first5=R. S.|last6=Hobin|first6=J. A.|last7=Ostroff|first7=J. S.|last8=Shields|first8=P. G.|last9=Toll|first9=B. A.|last10=Tyne|first10=C. A.|last11=Viswanath|first11=K.|last12=Warren|first12=G. W.|title=Electronic Nicotine Delivery Systems: A Policy Statement from the American Association for Cancer Research and the American Society of Clinical Oncology|journal=Clinical Cancer Research|url=http://clincancerres.aacrjournals.org/content/early/2015/01/08/1078-0432.CCR-14-2544.full.pdf+html|year=2015|volume=21|pages=514–525|issn=1078-0432|doi=10.1158/1078-0432.CCR-14-2544|pmid=25557889}}</ref> 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> E-liquid,<ref name=Weaver2014>{{cite journal|last1=Weaver|first1=Michael|last2=Breland|first2=Alison|last3=Spindle|first3=Tory|last4=Eissenberg|first4=Thomas|title=Electronic cigarettes: a review of safety and clinical issues|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<ref name=EbbertAgunwamba2015>{{cite journal|last1=Ebbert|first1=Jon O.|last2=Agunwamba|first2=Amenah A.|last3=Rutten|first3=Lila J.|title=Counseling Patients on the Use of Electronic Cigarettes|journal=Mayo Clinic Proceedings|volume=90|issue=1|year=2015|pages=128–134|issn=00256196|doi=10.1016/j.mayocp.2014.11.004|pmid=25572196}}</ref> is the mixture used in vapor products including e-cigarettes.<ref name=Kacker2014/> E-Liquids come in many variations, including different nicotine strengths and many different flavors.<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 ], ], and ]; and most often, ] in liquid form.<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, and the remaining 5% being flavorings and nicotine.<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> E-liquid can be made with or without nicotine, with >90% of e-liquids containing some level of nicotine.<ref>{{Cite web|url = http://roar.uel.ac.uk/1875/1/2013_Dawkins_e-cig_survey.pdf|title = Vaping’ profiles and preferences: an online survey of electronic cigarette users|date = |accessdate = |website = |publisher = School of Psychology-University of East London|last = Lynne Dawkins, John Turner, Amanda Roberts and Kirstie Soar|first = }}</ref> The liquid typically contains 60% propylene glycol and glycerin.<ref name=nicquid2012/> The ratio balance has an effect on taste and vapor production, and is commonly referred to as PG/VG ratio.<ref name=nicquid2012>{{Cite web|url = https://www.nicquid.com/faq.html|title = NicQuid® Frequently Asked Questions |date = 2012 |accessdate = |website = Nicquid |publisher = Nicquid}}</ref> The most regularly used base carrier chemical is propylene glycol with or without glycerin.<ref name=Grana2014>{{cite journal|last=Grana|first=R|author2=Benowitz, N |author3=Glantz, SA |title=E-cigarettes: a scientific review.|journal=Circulation|date=13 May 2014|volume=129|issue=19|pages=1972–86|doi=10.1161/circulationaha.114.007667|pmc=4018182|pmid=24821826}}</ref> E-liquid containing glycerin and water made without propylene glycol are 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> It is uncertain whether the nicotine used in e-liquid is manufactured using a ] (USP) 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">{{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.<ref name=Brandon2015>{{cite journal|last1=Brandon|first1=T. H.|last2=Goniewicz|first2=M. L.|last3=Hanna|first3=N. H.|last4=Hatsukami|first4=D. K.|last5=Herbst|first5=R. S.|last6=Hobin|first6=J. A.|last7=Ostroff|first7=J. S.|last8=Shields|first8=P. G.|last9=Toll|first9=B. A.|last10=Tyne|first10=C. A.|last11=Viswanath|first11=K.|last12=Warren|first12=G. W.|title=Electronic Nicotine Delivery Systems: A Policy Statement from the American Association for Cancer Research and the American Society of Clinical Oncology|journal=Clinical Cancer Research|url=http://clincancerres.aacrjournals.org/content/early/2015/01/08/1078-0432.CCR-14-2544.full.pdf+html|year=2015|volume=21|pages=514–525|issn=1078-0432|doi=10.1158/1078-0432.CCR-14-2544|pmid=25557889}}</ref> 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 e-liquid is sold in bottles or pre-filled disposable cartridges, or as a kit for consumers to make their own e-juices.<ref name=DiyLiquid2>{{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> Some vendors of e-liquids, offer options to change the amounts of flavorings or nicotine strengths, and build each bottle customized for the purchaser.<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> E-liquids are made with various tobacco, fruit, and other flavors,<ref name=Grana2014/> 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&nbsp;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&nbsp;mg of nicotine.<ref name=Cervellin2013/> EU regulations cap the concentration of nicotine in e-liquid at a maximum of 20&nbsp;mg/mL.<ref name=EbbertAgunwamba2015/> 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>{{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> 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.<ref name=Pepper2013>{{cite journal|last1=Pepper|first1=J. K.|last2=Brewer|first2=N. T.|title=Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review|journal=Tobacco Control|volume=23|issue=5|year=2013|pages=375–384|issn=0964-4563|doi=10.1136/tobaccocontrol-2013-051122|pmid=24259045}}</ref> Most e-liquids are produced by a few manufacturers in China, the US and Europe.<ref name=Hajek2014/> An e-cigarette user will usually obtain 300 to 500 puffs per mL of liquid.<ref name=Hildick-SmithPesko2015/> The e-liquid is sold in bottles or pre-filled disposable cartridges, or as a kit for consumers to make their own e-juices.<ref name=DiyLiquid2>{{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> Some vendors of e-liquids, offer options to change the amounts of flavorings or nicotine strengths, and build each bottle customized for the purchaser.<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> E-liquids are made with various tobacco, fruit, and other flavors,<ref name=Grana2014/> 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&nbsp;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&nbsp;mg of nicotine.<ref name=Cervellin2013/> EU regulations cap the concentration of nicotine in e-liquid at a maximum of 20&nbsp;mg/mL.<ref name=EbbertAgunwamba2015/> 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>{{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> 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.<ref name=Pepper2013>{{cite journal|last1=Pepper|first1=J. K.|last2=Brewer|first2=N. T.|title=Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review|journal=Tobacco Control|volume=23|issue=5|year=2013|pages=375–384|issn=0964-4563|doi=10.1136/tobaccocontrol-2013-051122|pmid=24259045}}</ref> Most e-liquids are produced by a few manufacturers in China, the US and Europe.<ref name=Hajek2014/> An e-cigarette user will usually obtain 300 to 500 puffs per mL of liquid.<ref name=Hildick-SmithPesko2015/>

Revision as of 19:33, 28 November 2015

Various bottles of e-liquid.

E-liquid is the mixture used in vapor products such as electronic cigarettes. The main ingredients in the e-liquid usually are propylene glycol, glycerin, nicotine, and flavorings. However, there are e-liquids sold without propylene glycol, nicotine, or flavors. The liquid typically contains 95% propylene glycol and glycerin. The flavorings may be natural or artificial. About 8,000 flavors exist as of 2014. There are many e-liquids manufacturers in the USA and worldwide. While there are currently no Food and Drug Administration (FDA) manufacturing standards for e-liquid, the FDA has proposed regulations that are expected to be finalized in late 2015. Industry standards have been created and published by the American E-liquid Manufacturing Standards Association (AEMSA).

Contents

E-liquid, e-fluid, or e-juice is the mixture used in vapor products including e-cigarettes. E-Liquids come in many variations, including different nicotine strengths and many different flavors. The main ingredients are propylene glycol, glycerin, and flavorings; and most often, nicotine in liquid form. The liquid typically contains 95% propylene glycol and glycerin, and the remaining 5% being flavorings and nicotine. E-liquid can be made with or without nicotine, with >90% of e-liquids containing some level of nicotine. The liquid typically contains 60% propylene glycol and glycerin. The ratio balance has an effect on taste and vapor production, and is commonly referred to as PG/VG ratio. The most regularly used base carrier chemical is propylene glycol with or without glycerin. E-liquid containing glycerin and water made without propylene glycol are also sold. It is uncertain whether the nicotine used in e-liquid is manufactured using a United States Pharmacopeia (USP) grade nicotine, a tobacco plant extract, tobacco dust or a synthetic nicotine. Most e-cigarette liquids contain nicotine, but the level of nicotine varies depending on user-preference and manufacturers. 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.

The e-liquid is sold in bottles or pre-filled disposable cartridges, or as a kit for consumers to make their own e-juices. Some vendors of e-liquids, offer options to change the amounts of flavorings or nicotine strengths, and build each bottle customized for the purchaser. E-liquids are made with various tobacco, fruit, and other flavors, as well as variable nicotine concentrations (including nicotine-free versions). The standard notation "mg/ml" is often used on labels to denote nicotine concentration, and is sometimes shortened to "mg". 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. A cartridge may contain 0 to 20 mg of nicotine. EU regulations cap the concentration of nicotine in e-liquid at a maximum of 20 mg/mL. A refill bottle can contain up to 1 g of nicotine. Refill liquids are often sold in the size range from 15 to 30 mL. One cartridge may typically last as long as one pack of cigarettes. Some liquids without flavoring is also sold. The flavorings may be natural or artificial. About 8,000 flavors exist as of 2014. 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. An e-cigarette user will usually obtain 300 to 500 puffs per mL of liquid.

Manufacturing

E-liquids are manufactured by many producers, both in the US 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.

Standards

Standards for e-liquid manufacturing have been created by American E-liquid Manufacturing Standards Association (AEMSA), which is trade association dedicated to creating responsible and sustainable standards for the safe manufacturing of e-liquids used in vapor products. AEMSA has published a comprehensive list standards and best known methods, which are openly available for use by any manufacturer of e-Liquids. The AEMSA standards cover nicotine, ingredients, sanitary manufacturing rooms, safety packaging, age restrictions, and labeling.

Regulation

There are no current governmental or US Food and Drug Administration (FDA) manufacturing standards for e-liquid. The FDA has sought to regulate e-liquid through use of the Tobacco Control Act, passed into law in 2009. In April of 2014, the FDA issued it's "Deeming" proposals for public comment, which would cover e-liquids manufacturing. The Final Rule, (in final form) giving the FDA authority to regulate e-liquids is anticipated to be released in late 2015, or early 2016.

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