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E-cigarettes: an evidence update <br /> <br />75 <br /> <br />Duration and frequency of puffs and mechanical characteristics of EC play a major role <br />in determining nicotine content in vapour. Across the middle range of nicotine levels, in <br />machine tests using a standard puffing schedule, n icotine content of e-liquid is related <br />to nicotine content in vapour only weakly. EC use releases negligible levels of nicotine <br />into ambient air with no identified health risks to bystanders. Use of a cigalike E C can <br />increase blood nicotine levels by around 5ng/ml within five minutes of use. This is <br />comparable to delivery from oral NRT. Experienced EC users using the tank EC can <br />achieve much higher blood nicotine levels over a longer duration, similar to those <br />associated with smoking. The speed of nicotine absorption is generally slower than from <br />cigarettes but faster than from NRT. <br /> <br />Policy implications <br />o General labelling of the strength of e-liquids, along the lines used for example <br />indicating coffee strength, provides sufficient guidance to consumers. <br /> <br />o Regulatory interventions should ensure optimal product safety but make sure EC <br />are not regulated more strictly than cigarettes and can continue to evolve and <br />improve their competitiveness against cigarettes. <br />Sfety of electronic cigarettes in the light of new evidence <br />