Dangers of E-cigarettes and Liquid Nicotine Among Children

Since e-cigarettes, vape pens, and other similar devices hit the U.S. market several years ago, their popularity has skyrocketed. While we don’t know a lot about the long-term effects of using e-cigarettes or the effects of secondhand vapor, we do know that liquid nicotine is a dangerous poison for children. Liquid nicotine is the fluid used to fill e-cigarettes and is increasingly found in homes with young children across the country.

A new study conducted by the Center for Injury Research and Policy of The Research Institute and the Central Ohio Poison Center, both at Nationwide Children’s Hospital, investigated exposure to e-cigarettes, liquid nicotine, and other tobacco products among U.S. children younger than 6 years of age during a 40-month period from January 2012 to April 2015. Calls to U.S. poison control centers related to e-cigarette and liquid nicotine exposure saw a remarkable 1,500 percent increase during the study period. Data from April 2015 show that on average, every three hours a poison center received a call about a young child exposed to an e-cigarette or liquid nicotine-that’s more than seven children each day. Although liquid nicotine can be absorbed through the skin, more than 90 percent of children were exposed through ingestion (swallowing it).

After even small doses, liquid nicotine can cause serious poisoning, and even death, among young children. In the recent study, children exposed to e-cigarettes and liquid nicotine were more than five times more likely to be admitted to the hospital and two-and-one-half times more likely to have a severe medical outcome than children exposed to traditional cigarettes. There was one child death during the study period associated with exposure to liquid nicotine.

Children younger than three years of age are the most vulnerable age group. Children in this age group are curious, have newfound mobility, explore their environment by putting things in their mouth, and do not recognize danger. It is of great concern that liquid nicotine is sold in bottles with non-child-resistant closures and comes in attractive colors and flavors like chocolate cake, gummy bear, and cotton candy. Flavoring in cigarettes (other than menthol) has been prohibited since 2009; the same should be done for e-cigarettes and liquid nicotine. E-cigarettes and liquid nicotine refill containers should be child-resistant and labeling should not display images attractive to children.

E-cigarettes and their refill bottles often end up in purses and backpacks, which get thrown on a floor or couch. Sometimes people leave e-cigarettes and liquid nicotine bottles in their car or just out on a coffee table. This practice is dangerous because young children are curious and want to check out everything around them. It only takes a sip of liquid nicotine to potentially cause serious medical effects, including coma, seizures, stopped breathing, or even death. E-cigarettes and liquid nicotine need to be regarded like other dangerous poisons. They should be kept out of sight and reach of children, preferably in a locked location.

The observed 1,500 percent increase in the number of cases is an epidemic by any definition. If this were an infectious disease, this would make headlines across the country. A recently passed federal law will become effective in July 2016 that requires child-resistant closures for liquid nicotine containers. This is a good first step, but further swift action is needed by the Food and Drug Administration, industry, and others to adequately protect children from the increasing threat of nicotine poisoning associated with e-cigarette use.

This is not primarily a parenting problem. Rather, this is another example of a highly dangerous product being introduced into the places where young children live and play without adequate regard for child safety. It is unacceptable that children are being rushed to emergency departments in coma, with seizures or breathing failure, and dying. Child safety should be put first.

Here are some tips for parents and child caregivers to help children stay safer around liquid nicotine:
¥ Store e-cigarettes and refill products where children cannot see or reach them-in a locked location is best. Do not store them in a purse, which children can easily access.
¥ Use and refill alone. Do not use e-cigarettes around children. Because children like to imitate adults, using e-cigarettes and refilling them with children nearby could lead to a dangerous exposure. The images, smells, and colors may be attractive to them.
¥ If a child has been exposed to liquid nicotine, call the national Poison Help Line (1-800-222-1222). Save the number in your cell phone and post it near your home phones. Upon calling, you will be connected with an expert who can talk through what to do and whether to seek medical attention.

Learn more about the latest liquid nicotine study from Nationwide Children’s Hospital, here:
¥ The study (Pediatrics, June 2016): http://pediatrics.aappublications.org/content/137/6/e20160041
¥ Press release: http://www.nationwidechildrens.org/news-room-articles/new-study-finds-child-e-cigarette-exposures-up-1500?contentid=153940
¥ Multimedia release: https://www.youtube.com/watch?v=eKO9gUtHCxo

Learn more about e-cigarette and liquid nicotine injury prevention here: http://www.nationwidechildrens.org/liquid-nicotine