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Beware the Dangers of “Safer” E-Cigarettes

Ann P. Slattery  DrPH, RN, RPh, CSPI, DABAT is the Managing Director and Clinical Toxicologist of the Regional Poison Control Center at Children’s of Alabama. She is a registered nurse, registered pharmacist and holds both a Master’s degree and Doctorate in Public Health. Ann is a member of member of the American Association of Poison Control Centers, the American Academy of Clinical Toxicology and the American Board of Applied Toxicology. 

VapingThe dangers and side effects of smoking cigarettes are well documented, but electronic cigarettes that are promoted as a “safer” alternative can be just as harmful.
Electronic cigarettes, or e-cigarettes, are battery-powered smoking devices. They use cartridges filled with a liquid that contains nicotine, flavorings and other chemicals. A heating element in the e-cigarette converts the e-liquid into a vapor that can be inhaled. Using e-cigarettes is sometimes called “vaping.”

“Even without the tobacco, there are several dangers associated with vaping,” said Ann Slattery, managing director of the Regional Poison Control Center at Children’s of Alabama. “When you are vaping, you are inhaling substances that your lungs aren’t equipped to handle.”

One such ingredient in the e-liquid is propylene glycol. This is a substance that has many applications, including aircraft de-icing fluid. When propylene glycol is heated, as in the e-cigarette, it produces known carcinogens. Because the liquid used in e-cigarettes isn’t regulated by the U.S. Food and Drug Administration, there could be other harmful substances lurking there in addition to the listed ingredients.

There are also concerns similar to the secondhand smoke associated with traditional tobacco cigarettes. “If you are using e-cigarettes near children, some of the vapor will escape into the air. Therefore, there is potential that the child is being exposed to the same chemicals that you are inhaling,” Slattery said.

One of the primary dangers associated with the e-liquid is the high concentration of nicotine. One 30 milliliter (ml) bottle of e-liquid with a concentration of 3.6 percent (36 milligrams of nicotine per milliliter) is equivalent to smoking 600 traditional tobacco cigarettes. With the variety of familiar flavorings and bright colors that are added, these e-liquids could easily attract the interest of a curious child. And just a small amount – as little as 1/8 teaspoon – of this e-liquid can be potentially fatal for a child who ingests it. Even touching liquid nicotine is dangerous because it can be easily absorbed through the skin.

“The number of accidental exposures to liquid nicotine reported to poison centers has increased,” Slattery said. Data from across the country between 2011 and 2014 show an alarming 2810 percent increase in the number of calls about children ages 5 and under who had been exposed to liquid nicotine.

Those using e-cigarettes are susceptible to overexposure to liquid nicotine as well. “The devices can leak, and the user could ingest a dangerous amount of the liquid,” Slattery said.

Direct contact with liquid nicotine can cause:

  • eye irritation
  • skin irritation
  • severe stomach pain
  • vomiting
  • seizures
  • difficulty breathing
  • fast heart rate
  • high blood pressure

If you suspect a child has come in contact with liquid nicotine, call 1-800-222-1222 immediately. The hotline to the Regional Poison Control Center at Children’s of Alabama is available 24 hours a day, 7 days a week.

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