Hospital toxicologist Dr. Ryan Marino, from Case Western Reserve University School of Medicine, has witnessed firsthand the devastating effects of liquid nicotine poisoning in children exposed to electronic cigarettes. He recounts the harrowing case of a young boy who suffered from severe nausea, diarrhea, and vomiting, requiring intravenous fluids for dehydration treatment. Another child had to be placed on a ventilator in the intensive care unit because he couldn’t breathe.
The problem of liquid nicotine exposure in e-cigarettes, or vapes, affects thousands of children each year, with even a few drops posing fatal risks to toddlers. Despite the 2016 Child Nicotine Poisoning Prevention Act mandating child-resistant packaging for bottles of vaping liquid, cases of vaping-related nicotine exposure reported to poison centers reached an all-time high in 2022. The law, unfortunately, fails to require protective packaging for the vaping devices themselves.
Marino highlights the danger of refillable vapes that hold liquid nicotine in a central reservoir, making them easily accessible to children. Even seemingly child-resistant vapes with sealed nicotine cartridges can be opened by kids. Moreover, some disposable e-cigarettes, which are currently the top-selling type on the market, contain large amounts of nicotine, making them even more hazardous.
The packaging and flavors of many e-cigarettes are designed to appeal to kids, with pastel colors, catchy names like “Candy King,” and flavors such as bubble gum and blue raspberry. Unlike traditional cigarettes, which have a bitter taste that often deters children, vapes’ enticing flavors and concentrated nicotine content make them far more tempting and dangerous.
To address the growing issue of child exposure to e-cigarettes, Senator Richard Blumenthal (D-Conn.) advocates for expanding the childproof packaging requirement to include disposable and pod-based e-cigarettes. The FDA reports that e-cigarette-related poison control center reports have more than doubled since 2018, with nearly 90% of exposures involving children under five years old.
Several states have taken action to ban flavored e-cigarettes, leading to a drop in overall sales of e-cigarettes in those regions. Nonetheless, some doctors argue that more needs to be done to protect children, such as implementing child safety requirements for e-cigarette devices, limiting nicotine concentrations in vape juices, and banning candy-like flavors and colors on the packaging.
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While the human body can protect itself from some toxic effects of nicotine exposure by causing children to vomit, ingestion still leads to numerous health issues and emergency department visits. The FDA advises parents and guardians to keep e-cigarettes and vaping liquid out of reach and in their original containers, and for immediate assistance, they can call Poison Help at 1-800-222-1222 or visit PoisonHelp.org for support and resources.