Hospital toxicologist Ryan Marino has witnessed the alarming effects of liquid nicotine poisoning in children who have been exposed to electronic cigarettes. One young boy who arrived at his emergency room experienced severe symptoms such as nausea, diarrhea, and vomiting, and required intravenous fluids to rehydrate. Children can also experience dizziness, loss of consciousness, and dangerous drops in blood pressure. In the most severe case, a boy had to be placed on a ventilator in the intensive care unit because he couldn’t breathe. Marino, from Case Western Reserve University School of Medicine, has seen thousands of kids exposed to liquid nicotine from e-cigarettes every year, which can even be fatal for toddlers when just a few drops are consumed. Despite the Child Nicotine Poisoning Prevention Act of 2016, cases of nicotine exposure from vaping reported to poison centers reached an all-time high in 2022. The law mandates child-resistant packaging for bottles of vaping liquid but does not require protective packaging for the devices themselves. Marino explains that refillable vapes pose a danger to kids because they have a central reservoir for liquid nicotine, and even vapes that appear to be more child-resistant because the nicotine is sealed inside a removable cartridge can still be pried open. Disposable e-cigarettes, which are now the top-selling type on the market, can be used for thousands of “puffs” and contain as much nicotine as multiple packs of cigarettes. Many e-cigarettes and liquids are designed to attract children with pastel packaging, names like “Candy King,” and flavors such as bubble gum and blue raspberry. This makes them far more enticing and hazardous than traditional cigarettes, which have lower nicotine doses and a bitter taste that prompts children to spit them out. Senator Richard Blumenthal plans to expand the childproof packaging requirement to disposable and pod-based e-cigarettes. Despite the FDA’s refusal to comment, they did include a feature about nicotine poisoning in children in their “CTP Connect” newsletter. According to an FDA analysis, the number of reports to poison control centers about e-cigarettes has more than doubled since 2018, with over 7,000 vaping-related exposures reported from April 2022 to March 2023. Almost 90% of these exposures involved children under 5. The report suggests that these numbers may be an underestimate since not every case is reported to poison control centers. The vaping industry claims to take safety seriously, but many vaping products are manufactured outside the US, and the country has recently seen a flood of illegal e-cigarettes, mostly from China. The increasing number of nicotine exposures among children reflects the growing sales of e-cigarettes. Natalie Rine, director of the Central Ohio Poison Center, explains that parents do not see it as a significant risk. Banning flavored products has been an effective strategy in reducing e-cigarette sales. Several states, including California, Massachusetts, New Jersey, New York, Rhode Island, and Washington, D.C., have banned all flavored e-cigarettes, resulting in sales dropping by 25% to 31% compared to states without bans. Doctors argue that more needs to be done to protect children, including expanding federal laws to include child safety requirements for e-cigarette devices and limiting the nicotine concentration in vape juices. E-cigarette liquids also contain harmful chemicals such as arsenic, lead, carcinogens, and volatile organic compounds. Fortunately, when children ingest nicotine, their bodies have protective mechanisms, and the risk of serious harm is relatively low. However, they may still require medical attention due to symptoms like nausea and vomiting. The FDA advises parents and guardians to keep e-cigarettes and vaping liquid out of the reach of young children and in their original containers. In case of emergencies, they can call Poison Help at 800-222-1222 or visit poisonhelp.org for support and resources.
Child Nicotine Poisoning Raises Concerns as Vape Usage Surges in the US
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