Electronic Cigarette Refill Liquids: Child-Resistant Packaging, Nicotine Content, and Sales to Minors

J Pediatr Nurs. Jul-Aug 2016;31(4):373-9. doi: 10.1016/j.pedn.2016.03.019. Epub 2016 Apr 12.


To determine the accuracy of the labeled quantity of the nicotine content of the e-liquids sold in unlicensed vape stores, whether the packaging of e-liquids sold within the vape stores was child-resistant, whether minors were present within vape stores, and whether sales to minors occurred. This study was conducted across North Dakota prior to implementation of a new e-cigarette state law and provided a baseline assessment before enactment of the new legal requirements.

Design and methods: We tested samples of e-liquids and performed observations in 16 stores that were selling e-cigarettes but were not legally required to be licensed for tobacco retail. The e-liquids were analyzed for nicotine content using a validated high-performance liquid chromatography method for nicotine analysis.

Results: Of the 70 collected e-liquid samples that claimed to contain nicotine, 17% contained more than the labeled quantity and 34% contained less than the labeled quantity by 10% or more, with one sample containing 172% more than the labeled quantity. Of the 94 e-liquid containers sampled, only 35% were determined to be child-resistant. Minors were present in stores, although no sales to minors occurred.

Conclusions: Mislabeling of nicotine in e-liquids is common and exposes the user to the harmful effects of nicotine. The lack of child-resistant packaging for this potentially toxic substance is a serious public health problem. E-cigarettes should be included in the legal definition of tobacco products, child-resistant packaging and nicotine labeling laws should be enacted and strictly enforced, and vape stores should be licensed by states.

Keywords: Child safety; E-cigarette; Nicotine; Product packaging; Public policy; Regulation.

MeSH terms

  • Adolescent
  • Child
  • Commerce / legislation & jurisprudence*
  • Cross-Sectional Studies
  • Electronic Nicotine Delivery Systems / adverse effects
  • Electronic Nicotine Delivery Systems / legislation & jurisprudence*
  • Electronic Nicotine Delivery Systems / statistics & numerical data*
  • Female
  • Flavoring Agents
  • Government Regulation
  • Humans
  • Male
  • Minors
  • Nicotine / administration & dosage
  • Nicotine / adverse effects*
  • Policy Making
  • Product Labeling / standards*
  • Product Packaging
  • Safety Management
  • United States


  • Flavoring Agents
  • Nicotine