8 Facts Parents Need to Know About E-Cigarettes and E-Liquids

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You might have seen someone using this device at a restaurant, baseball game, or even on an airplane.  E-cigarettes, or electronic cigarettes, simulate tobacco smoking but do not contain tobacco.  E-cigarettes work by vaporizing a liquid solution.  This solution is referred to as ‘e-liquid’, which usually contains various concentrations of nicotine.

E-cigarettes have been available in the United States since 2007 as a smoking cessation aid, but have gained popularity in the last few years.  Most recently, e-cigarettes and e-liquids have received a lot of coverage in the national media due to their potential for poisoning in young children, lack of federal regulation, and availability for purchase online in large containers, such as gallon size.

As a pharmacist in the Drug and Poison Information Center, I stay up-to-date on trends related to potentially dangerous substances, and like to share what I learn so parents can be armed with information to talk to their kids. From my perspective, here are eight facts parents should know about e-cigarettes and e-liquids:

FACT #1: Accidental poisonings are on the rise, especially in young children. The National Poison Data System reported 4,152 poisoning exposures nationwide from electronic cigarette devices, cartridges or refill liquids in 2014. 2,376 of those poisonings involved children younger than 5 years old. In 2014, Ohio’s Poison Centers managed 161 calls related to e-liquids and 38 of those were in 2 year olds.

FACT #2: More adolescents and teens are using e-cigarettes. What might be surprising for some parents to hear is that use of e-cigarettes among middle and high school students has tripled:  from 4.5% in 2013 to 13.4% in 2014 with high school students and from 1.1% in 2013 to 3.9% in 2014 with middle school students, according to a Centers for Disease Control report.  On a related note, JAMA Pediatrics released a study which reported a high association between adolescents who use e-cigarettes who also use traditional tobacco products.  This report suggests you might want to talk to your child about refraining from using e-cigarettes as well as traditional cigarettes, if it’s your goal to prevent your child from becoming a smoker.

FACT #3: E-liquid is a neurotoxin. E-liquids come in a variety of concentrations. Ingestion of even small amounts in some versions have the potential to be fatal to a young child. Initial symptoms of nicotine poisoning may include vomiting, sweating and dizziness which can progress to affecting the heart rate and blood pressure, lethargy, seizures and respiratory muscle weakness.

FACT #4: It can be absorbed through the skin. Some of the e-cigarettes require a refill of the liquid nicotine. These refills now come in gallon sizes and have desirable flavorings from peppermint to pumpkin and everything in between. The concentration of nicotine can vary widely and given the large refill sizes now available, a spill and subsequent skin absorption with prolonged exposure has the potential to be deadly.

FACT #5: It’s readily available. Both e-cigarettes and e-liquids are not FDA regulated. This means they can be sold to anyone of any age, anywhere and can be readily purchased online.

FACT #6: It comes in bright colors and candy-like flavors. A quick internet search shows liquid nicotine is available in 40-145 different flavors.  Like any other hazardous substance, it is a good idea to keep this potentially toxic substance away from children who might be drawn to the bright colors and scent of candy and flavorings. Many of the e-liquid containers lack child resistant mechanisms, which has the potential for a child to ingest larger amounts.

FACT #7: Nicotine is highly addictive.  Regardless of the form, whether in a traditional cigarette, chewing tobacco or peppermint flavored e-liquid, nicotine is an addicting and abusable substance. The adolescent brain is highly susceptible to the adverse effects of nicotine. Nicotine dependence hinges on various factors such as age, family or peer influence, genetics, medical history and more.  The long term effects of e-liquids are unclear. The best way to prevent nicotine addiction is through education and open communication with your children.

FACT #8: It is difficult to tell when someone is using e-cigarettes.  The user won’t smell like tobacco as with traditional cigarette smoking. The only potential warning signs are dry cough, mouth, and throat irritation which can be easily missed.

I have added e-cigarettes and e-liquids to the list of potential dangerous substances I talk to my kids about. While they’re still young, I personally think it’s important to talk to children before they’re tempted with such substances.

As always, if you have any questions please call the experts at your Cincinnati Drug and Poison Information Center at (800) 222-1222.  We are available to help 24/7.

Editor’s note: the cover image was provided by freedigitalphotos.net

Sheila Goertemoeller, PharmD, D.ABAT

About the Author: Sheila Goertemoeller, PharmD, D.ABAT

Sheila Goertemoeller, PharmD, CSPI, ICPS Certified, is a pharmacist with over 18 years of experience on the Drug and Poison Information Center Hotline at Cincinnati Children's, and is an Internationally Certified (Drug Abuse) Prevention Specialist by examination (Ohio Chemical Dependency Board). In addition, she is a research study coordinator and authors the DPICtions quarterly newsletter.

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  1. Travis whitehead April 12, 11:00
    I own a store in McMinnville Tennessee and refused to sell this product because we do not know all of the health related risk Plus is very dangerous for small children just the comments and thoughts of concerned retailer