Regulatory authorities should consider banning electronic cigarettes until safety concerns have been addressed, concludes research published online in Tobacco Control.
The researchers base their conclusions on an evaluation of six different brands of electronic nicotine delivery systems or ENDS. These are not tobacco products, but are designed to look and feel like regular cigarettes.
They are aimed at smokers for use in places where cigarette smoking is not permitted as they don't produce smoke. They usually consist of a battery, an atomiser, and a replaceable cartridge containing nicotine suspended in propylene glycol and water.
The e-cigarettes analysed in the study were bought from online vendors and assessed on design features; the accuracy and clarity of labelling; and the quality of instruction leaflets and associated printed material either supplied with the product or available on the manufacturer's website.
The basic design of all the products was similar, but the design features varied considerably, the evaluation showed.
Fluid containing nicotine readily leaked out of most cartridges, and it was difficult to put together or take apart the devices without getting nicotine over the user's hands.
Cartridge labelling was very poor, with most replacement packs lacking any indication of cartridge content, expiry date, or health warnings.
Cartridges claiming to have no nicotine content looked identical to those claiming to have high nicotine content and they were indistinguishable once removed from their packs and wrappers.
All brands were sold with "ambiguous amounts of nicotine," with levels varying from 6 mg to 24 mg, and it was not clear if this referred to the cartridge itself or the fluid suspension.
Internet orders were often filled incorrectly, with the wrong strength of nicotine or kits or cartridges supplied.
Disposal of used cartridges containing nicotine was not adequately covered in any of the websites or accompanying instruction leaflets.
Safety features did not always work correctly and print and internet material often contained information or made claims for which there is currently no scientific evidence, say the authors.
Examples of this included: "Be careful to avoid inhaling any significant quantity of fluid. Although it gives you a slight tingling sensation, it is not harmful." And: "Within two weeks your lung capacity will increase by 30%...Wrinkles in your skin will become less noticeable."
Their findings prompt the authors to conclude: "Our observations provide evidence that regulators should consider removing ENDS from the market until design features, quality control, labelling, disposal and safety issues have been adequately addressed."