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E-cigarettes are an emerging threat to children

Afshine Ash Emrani, MD
Medications
June 29, 2014
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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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