Liquid nicotine used in e-cigarettes still a danger to children despite recent decline in exposures

April 23, 2018, Nationwide Children's Hospital
The growing popularity of e-cigarettes has led to an alarming number of children who are dangerously exposed to liquid nicotine, according to a new study from Nationwide Children's Hospital. Credit: Nationwide Children's Hospital

A new study published online today by Pediatrics and conducted by the Center for Injury Research and Policy and the Central Ohio Poison Center at Nationwide Children's Hospital found that there were more than 8,200 calls to US poison centers regarding exposures to liquid nicotine and e-cigarettes among children younger than 6 years of age from January 2012 through April 2017, averaging 129 calls each month or more than 4 a day.

Children younger than 3 years accounted for most (84%) exposures, and ingestion was the most common (93%) way children were exposed to liquid . More than one-third of exposed children were treated/evaluated and released, while 1.4% were admitted to the hospital. A quarter of children exposed to liquid nicotine experienced one or more related clinical effects. Severe clinical effects were rare, and included coma, seizure, respiratory arrest, and cardiac arrest.

"These exposures are concerning because a very small amount of concentrated nicotine solution could easily deliver a lethal dose to a young child," said Henry Spiller, MS, D.ABAT, study author, and director of the Central Ohio Poison Center. Increased concern about the risks of liquid nicotine exposures led to state and federal legislation requiring child-resistant packaging for liquid nicotine containers in recent years.

The annual rate of exposure to liquid nicotine and e-cigarettes increased by almost 1400% from 2012 to 2015 and then decreased by about 20% from 2015 to 2016. The observed decline in exposures since January 2015 may, in part, be attributable to legislation requiring child-resistant packaging and greater public awareness of the dangers of products to .

While e-cigarettes remain popular with consumers, a new study shows they are still extremely dangerous to children. Researchers found that from January 2012 through April 2017, there were more than 8,200 calls to US poison centers regarding liquid nicotine exposures among children younger than six years of age. Credit: Nationwide Children's Hospital

"Although the observed decrease in exposures is encouraging, the number of young children still being exposed to liquid nicotine is unacceptably high," said Gary Smith, MD, DrPH, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children's Hospital. "Additional regulation is needed."

The authors recommend adding flow restrictors to liquid nicotine refill bottles, similar to those used for children's fever medications, to limit young children's ability to empty the contents of the bottles, and child-resistant chambers on e-cigarette devices to help prevent liquid nicotine exposure to young children. Additionally, the volume and concentration of liquid nicotine in refill bottles should be limited to a sub-lethal dose for an average young child. This approach has been used for decades for products like children's aspirin. To decrease exposure among young children, the authors also call on the US Food and Drug Administration to prohibit the use of flavors and attractive labeling for liquid nicotine as was done for cigarettes.

Parents and child caregivers can help children stay safer by following these tips:

While e-cigarettes remain popular with consumers, a new study shows they are still extremely dangerous to children. Researchers found that from January 2012 through April 2017, there were more than 8,200 calls to US poison centers regarding liquid nicotine exposures among children younger than six years of age. Credit: Nationwide Children's Hospital

  • Store e-cigarettes and refill products where children cannot see or reach them like you would for other poisons - 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 want to imitate adults, using e-cigarettes and refilling them with children nearby could lead to a dangerous exposure. The images, smells, and colors may attract children.
  • Refill, clean, and dispose of products safely. Wear rubber or latex gloves when handling liquid nicotine. Clean up spills right away with paper towels. Get rid of leftover liquid by pouring it into a bag of kitty litter or coffee grounds. Put empty liquid nicotine containers, papers towels, and any other waste into the bag, and throw it away in a trash can kids can't open. Once everything is in the trash, wash your hands.
  • Adults in households with children younger than 6 years old should be counseled on vaping cessation. If adults with young continue to use e-cigarettes, they are strongly encouraged not to use or store e-cigarettes, liquid nicotine, and related products in the home.

Save the national Poison Help Line number (1-800-222-1222) in your cellphone and post it near your home phones.

Data for this study were obtained from the National Poison Data System, which is maintained by the American Association of Poison Control Centers (AAPCC). The AAPCC receives data on calls to participating poison centers that serve the US and its territories. Poison centers receive phone calls through the Poison Help Line and document information about the product, route of exposure, individual exposed, scenario, and other data.

Explore further: Liquid nicotine from e-cigs poses poison danger to children

Related Stories

Liquid nicotine from e-cigs poses poison danger to children

August 4, 2015
(HealthDay)—The increasing popularity of electronic cigarettes has led to a number of cases of nicotine poisoning in recent years, the U.S. Centers for Disease Control and Prevention warns.

E-cigarette poisonings surge in young children, study says

May 9, 2016
Electronic cigarettes have sickened rising numbers of young children, a study of U.S. poison center calls has found. Most cases involve swallowing liquid nicotine.

Spike in US poison calls over e-cigarettes (Update)

April 3, 2014
The number of calls to US poison control centers about accidents with bottles of liquid nicotine for refilling e-cigarettes—many involving children—has spiked in recent years, health authorities said Thursday.

Kids landing in ERs after drinking parents' e-cig nicotine liquid

December 27, 2016
(HealthDay)—A case study highlights the danger liquid nicotine for electronic cigarettes poses to children.

Even toddlers endangered by opioids, other addictive drugs

April 10, 2018
(HealthDay)—The youngest victims of America's addiction crisis are not the teenagers tempted by tobacco, pot and pills.

E-cigarette nicotine refill cartridges pose danger for toddlers

September 8, 2014
The safety of nicotine refill cartridges used in electronic cigarettes needs to be improved to prevent toddlers accidentally swallowing the contents and potentially coming to serious harm, warn doctors in Archives of Disease ...

Recommended for you

App helps hearing-impaired parents know when and why their baby is crying

May 23, 2018
For parents Delbert and Sanaz Whetter a crying baby is a particularly difficult challenge. The Whetters are deaf, so when they're in another room they rely on cameras and remote noise-monitors to help keep an eye on their ...

Pregnancy drug DES might have triggered ADHD in the grandchildren of women who used it

May 21, 2018
A study conducted by researchers at Columbia University's Mailman School of Public Health and Harvard T.H. Chan School of Public Health reported elevated odds for attention deficit hyperactivity disorder (ADHD) in the grandchildren ...

Age-related racial disparity in suicide rates among US youth

May 21, 2018
New research suggests the suicide rate is roughly two times higher for black children ages 5-12 compared with white children of the same age group. The study, funded by the National Institute of Mental Health (NIMH), appears ...

One in 10 parents say their child has gotten sick from spoiled or contaminated food

May 21, 2018
No parent wants to come home from a picnic or restaurant with a little one whose stomachache turns into much worse.

Infant growth patterns affected by type of protein consumed

May 14, 2018
A new study by CU School of Medicine researchers has determined that choices of protein intake from solid foods has a significant impact on infant growth during the first year of life.

Parents say intense gun violence in PG-13 movies appropriate for teens 15 and older

May 14, 2018
Parents are more willing to let their children see PG-13 movies with intense gun violence when the violence appears to be "justified," used in defense of a loved one or for self-protection, than when it has no socially redeeming ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.