Risk of severe poisoning: Senior physician warns against dangerous substances in puff bars

Senior researcher Brian Schou Rasmussen carefully unpacks illicit, sweet-smelling puff bars in a sterile grey laboratory at the University of Copenhagen’s Institute of Forensic Medicine. Even reading the packaging does not reveal what is inside the small plastic tubes filled with nicotine and fruit or candy flavourings, he says.

“Especially with puff bars, it can be difficult or impossible to know what is inside,” Rasmussen said. “You cannot trust the packaging or the product names. It can be completely unpredictable what a user actually ingests.”

The Danish Broadcasting Corporation reports on the findings as part of an investigation into the health risks of vaping products suspected of containing illegal drugs.

When Rasmussen analyses the liquid inside, he often finds synthetic cannabinoids—substances more potent and dangerous than natural cannabis. These chemicals can cause psychosis, seizures, heart rhythm disorders, signs of heart attacks, heart failure and kidney failure, according to Dorte Fris Palmqvist, a senior physician and drug expert at the Danish Poison Control Centre.

“You can be affected in all your organs,” Fris Palmqvist said. “You can experience psychosis, seizures, heart rhythm disturbances and signs of blood clots in the heart, heart failure, kidney failure.”

The Poison Control Centre receives about one report per week involving suspected illegal substances in vaping products such as puff bars, she said, adding that unreported cases likely exist. Around 113,000 people aged 15 to 29 use e-cigarettes or disposable vapes in Denmark, with four out of five choosing flavoured products that are illegal.

Fris Palmqvist said recent severe poisoning cases linked to synthetic cannabinoids in puff bars have led to hospitalisation and intensive care. In February 2026, a death was associated with synthetic cannabinoids potentially inhaled through a puff bar.

“New psychoactive substances are constantly appearing across Europe,” she said. “It is difficult even for professionals to keep up.” She fears young people underestimate the risks because puff bars, despite being illegal, remain easy to purchase in shops.

“When a product is readily available and you can just pick it up from a shelf, people may mistakenly believe it is also safe to use,” Fris Palmqvist said. “If people knew they risked kidney, heart and organ failure and could end up in intensive care for days, I don’t think anyone would use these products.”

Both experts say packaging often misleads consumers by using coded language or slang to hide the true contents.