title: What is included with your online e-cigarette order? An analysis of e-cigarette shipping, product and packaging features.
abstract: The electronic cigarette industry is growing, with youth using e-cigarettes at higher rates than they are using cigarettes, and retail and online sales projected to reach $10 billion in 2017. Minimal regulation of the production and marketing of e-cigarettes exists to date, which has allowed companies to promote unsupported claims. We assessed the shipping, product features and packaging of a wide variety of e-cigarettes purchased online by adults and youth.
  
  
  
  The most popular internet e-cigarette vendors were identified from a larger study of internet tobacco vendors. Between August 2013 and June 2014, adults made 56 purchase attempts from online vendors, and youth made 98 attempts. Packages received were assessed for exterior and internal packaging features, including product information, health warnings and additional materials.
  
  
  
  We analysed a total of 125 orders featuring 86 unique brands of e-cigarettes. The contents were rarely indicated on package exteriors. Product information came with just 60% of orders and just 38.4% included an instruction manual. Only 44.6% of products included a health warning, and some had unsupported claims, such as lack of secondhand smoke exposure. Additionally, some products were leaking e-liquid and battery fluid on arrival.
  
  
  
  A large variety of e-cigarette products are manufactured and marketed to consumers. Many products do not include instructions for use, and unsupported claims are being presented to consumers. Effective federal regulation of the manufacturing, packaging, product information and health claims surrounding e-cigarettes is necessary to ensure consumers are presented with accurate e-cigarette use information.
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.|Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Amanda Y
authors.initials: AY
authors.lastname: Kong
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Derrick
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.|Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Abrantes
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.|Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D003132:Commerce / Q000379:methods*; D054626:Consumer Health Information / Q000706:statistics & numerical data*; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet; D019064:Product Packaging / Q000706:statistics & numerical data*
keywords: Advertising and Promotion; Electronic nicotine delivery devices; Packaging and Labelling; Public policy; Tobacco industry