E-cigarettes are an emerging threat to children

There is a new emerging health threat to our children: nicotine poisoning.

The number of nicotine exposures in children reported to the National Poison Data System has more than tripled in the last year.

Here’s the fact every parent should know: 1 tablespoon of nicotine oil can be lethal to a 60-pound child!

When doctors were campaigning against tobacco companies through public health legislation, we did not foresee a resultant new market for smokeless nicotine products. Electronic or e-cigarettes apply a heat source to liquid nicotine, causing it to vaporize, known as “vapes.” Because e-cigarettes burn nothing, they release no smoke. These devices were meant to be used as a bridge to smoking and nicotine cessation. However, many have traded one addiction for another. According to the Centers for Disease Control and Prevention, to date, at least 1 in 5 smokers has tried e-cigarettes, as have 10% of U.S. high school students.

The market for e-cigarettes is unregulated, ushering in a new generation of products to those who might not have otherwise tried tobacco. As of the spring of 2014, the U.S. Food and Drug Administration only regulates therapeutic nicotine products. Unfortunately, there’s no regulation of the recreational nicotine market, such as Nicorette® gum or Nicotrol® inhalers.

Electronic cigarettes deliver a cocktail of toxic chemicals including carcinogens into the lungs. The use of e-cigarettes can make bacterial infections resistant to antibiotics. In a recent study in Circulation, vapers caused significantly higher risk than scientists initially speculated. E-cigarettes deliver high levels of nanoparticles, which trigger inflammation and have been linked to asthma, stroke, heart disease, and diabetes.

Worse yet, there’s no child-protective packaging on any of these products. To the contrary, manufacturers are placing child friendly, attractive, cartoon-like labels on products. They add sweet smelling oils or seductive colors together with fruit-like flavors. There is no quality control, no guarantee the consumer is getting what is stated. Because the highly concentrated nicotine solutions used are orders of magnitude higher than traditional, a 15mL vial, or 1 tablespoon can be lethal to a 60-pound child.

Nicotine is a plant based parasympathomimetic alkaloid, an agonist of the nicotinic acetylcholine receptor. At low doses, it stimulates the reticular activating system as well as dopamine release, giving the sensation of excitement and happiness. At higher doses, it causes high blood pressure, higher heart rate and can induce a heart attack. In toxic ranges, nicotine causes seizures, central nervous system and cardiovascular collapse, and death.

Please share this information with all educators, parents, nurses, and doctors alike. We need legislation to protect our children. We need responsible reconsideration of commercial sales of these substances.

Liquid concentrated nicotine can easily be the most deadly substance in your house.

Afshine Ash Emrani is a cardiologist and can be reached at Los Angeles Heart Specialists.

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  • Nathan Johnson

    Rather then focusing on the overly dramatic relative risk, we should talk about absolute risk which is significant but still quite small.
    “Nationwide, the number of poison cases linked to e-liquids jumped to 1,351 in 2013, a 300 percent increase from 2012, and the number is on pace to double this year, according to information from the National Poison Data System. Of the cases in 2013, 365 were referred to hospitals – triple the previous year’s number.”
    I didn’t see anything in the article about any significant injury. Does anyone have that data?
    http://www.nytimes.com/2014/03/24/business/selling-a-poison-by-the-barrel-liquid-nicotine-for-e-cigarettes.html

  • James O’Brien

    Ah yes, legislation and regulation will save us all from dangerous things or bogeymen (where are the dead bodies from e-cigs?) that we don’t like. Because, after all that has worked so well in the past. The same geniuses that greenlighted Zohydro and shut down 23andme.com can obviously be trusted to do the right thing, free from any monetary influence and political arm-twisting and campaigns of hysteria.

    We’re all too stupid to use e-cigarettes responsibly but somehow bright enough to elect archangels who will appoint brilliant impartial scientists as regulators. That’s the thesis of this article.

    If you follow the logic of this article, not only e-cigarettes should be banned, but we should go back to the good old days of alcohol prohibition and the safety police should remove all cleansers from our cabinets.

    I’d also like to point out that the author is from California, where it was decreed that marijuana is good and nicotine bad. In the case of the former, I can actually show the dead bodies:

    http://www.ibtimes.com/driving-while-high-dangerous-fatal-car-accidents-involving-marijuana-triple-over-10-years-1553319

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