title: Availability, Price, and Packaging of Electronic Cigarettes and E-Liquids in Guatemala City Retailers.
abstract: Electronic cigarettes (e-cigarettes) have the potential to normalize smoking and undermine tobacco control efforts. However, if well regulated, they also have a potential as smoking cessation aids. This study sought to determine the availability and types of e-cigarettes and e-liquids in Guatemala. We also assessed packaging characteristics and price.
  
  
  
  We surveyed a convenient sample of 39 Guatemala City retailers and purchased all e-cigarettes and e-liquids available. Duplicate samples (same brand, e-liquid type, flavor, nicotine content, or packaging) were purchased when prices were different between each other. Country of manufacture, flavor, expiration date, nicotine concentration, and price were recorded. We also documented package marketing strategies and warning labels.
  
  
  
  We purchased 64 e-cigarettes (53 unique and 11 duplicates) and 57 e-liquids (52 unique and 5 duplicates), mostly found on mall retailers. Most e-cigarettes (42, 66%) were first generation, followed by second (18, 28%) and third generations (4, 6%). Price of e-cigarettes differed significantly by generation. Most e-cigarettes (31, 58%) and 24 (46%) e-liquids did not include warning labels. Nicotine content was reported in 21 (39%) e-cigarettes that included e-liquids and 41 (79%) e-liquids' packages.
  
  
  
  E-cigarettes and e-liquids are available among a variety of retailers in Guatemala City and the industry is taking advantage of the fact that they are not regulated (eg, health claims, minimum sales age, and taxation). Our findings support the need for further research on e-cigarettes and e-liquids in Guatemala.
  
  
  
  To the best of our knowledge, this is the first study describing e-cigarettes and e-liquids available in retailers in a low/middle-income country like Guatemala. E-cigarettes and e-liquids were found in a variety of types, flavors, and nicotine concentrations in Guatemalan retailers. Our findings support the need for further research on e-cigarettes and e-liquids in Guatemala.
authors.affiliation: Cardiovascular Surgery Unit of Guatemala, Guatemala City, Guatemala.
authors.forename: Violeta
authors.initials: V
authors.lastname: Chacon
authors.affiliation: Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.
authors.forename: Astrid
authors.initials: A
authors.lastname: Arriaza
authors.affiliation: Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO.
authors.forename: Patricia
authors.initials: P
authors.lastname: Cavazos-Rehg
authors.affiliation: Cardiovascular Surgery Unit of Guatemala, Guatemala City, Guatemala.|Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, MO.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Barnoya
mesh_terms: D002947:Cities; D003132:Commerce / Q000706:statistics & numerical data*; D066300:Electronic Nicotine Delivery Systems / Q000191:economics* / Q000706:statistics & numerical data*; D006166:Guatemala; D006801:Humans; D019064:Product Packaging / Q000379:methods*; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000145:classification*