LOUISVILLE, Ky. — Billed as a safer, cleaner way to get a nicotine fix, electronic cigarettes are surging in popularity. But some doctors and researchers say these smoking substitutes are far from harmless — especially to children.
More teens are trying these products, even as scientists increasingly raise concerns about the effects of e-cigarettes’ “secondhand vapor” on children.
In addition, the liquid nicotine used in the devices, which comes in flavors such as bubblegum and cola, is being blamed for a growing number of poisonings across the nation.
“Accidental exposure by children to e-cigarettes is a public health concern that we need to take seriously,” said LaQuandra Nesbitt, director of the Louisville Metro Department of Public Health and Wellness, which will soon recommend age restrictions on the devices. “Parents need to be aware of the potential dangers to their children.”
The battery-operated units contain cartridges filled with nicotine, flavor and other chemicals, which are heated to create a vapor inhaled by the user. Starter kits can cost $60-$80, five-packs of cartridges can run around $10, and sales of e-cigarettes have doubled to more than $1.5 billion in the past year.
But problems among children also have risen.
Ashley Webb, director of the Kentucky Regional Poison Control Center of Kosair Children’s Hospital, said the center received more than 40 calls involving e-cigarette poisonings in 2013, up from nine in 2012 and one in 2010. Nationally, there were 427 such exposures in 2012, according to the latest annual report from the National Poison Data System. Meanwhile, the 2012 National Youth Tobacco Survey shows that recent e-cigarette use nearly doubled in one year among U.S. high school students, rising from 1.5(PERCENT) in 2011 to 2.8(PERCENT) smoking them in 2012.
While Indiana prohibits sales of e-cigarettes to minors, Kentucky and the federal government do not. But a soon-to-be-released report from the Louisville health department recommends restricting the sale of e-cigarettes to Jefferson County minors.
The U.S. Food and Drug Administration is also considering whether to regulate e-cigarettes. The agency issued a warning in 2009 that the devices were being marketed to youth, but does not regulate the products unless they make therapeutic claims.
“It’s really up to individual store owners not to sell to children,” said Troy LeBlanc, owner of Derb E Cigs in Jeffersontown, who won’t sell to anyone younger than 18. “I wouldn’t be opposed to government age restrictions.”
LeBlanc said e-cigarettes can be beneficial for adults, helping them quit tobacco smoking, which is documented to be more dangerous.
Ray Story, chief executive officer of the Tobacco Vapor Electronic Cigarette Association, agreed they’re an effective smoking substitute, saying the industry designs and markets the devices for adults. He said the vapor is harmless, and it’s up to adults to keep children from the e-liquid, which can sicken them.
“At the end of the day, everything’s attractive to kids,” Story said. “If you’re an adult, it’s a matter of choice. But we have to safeguard those who don’t have the ability to safeguard themselves.”
Webb said parents often don’t think of nicotine as a poison, so they may leave liquid e-cigarette cartridges within reach of children.
Children are getting ahold of e-cigarettes and taking them apart, she said. “They either ingest the liquid or get it onto their skin. Even on the skin, the nicotine is absorbed.”
She said toddlers and preschoolers sometimes lick the containers or drink the liquid, enticed by the flavoring.
“Kids will eat most anything,” said George Rodgers, associate medical director of the poison control center.
Ingesting e-liquid can give children a harmful or even deadly dose of nicotine. Rodgers said many cartridges contain more than 14 milligrams, enough to cause harm.
“And since children are not used to consuming nicotine, their symptoms may be more severe at lower levels,” he said.
Symptoms include hyperactivity, flushing, sweating, headache, dizziness, rapid heart rate, vomiting and diarrhea. Even small amounts on a child’s skin can cause irritation and a burning sensation. In very severe cases, a child’s heart rate and blood pressure may drop dangerously low, resulting in a coma or even death.
Webb said there have been no deaths so far among cases her center has handled, but children have ended up in the emergency room.
Story said his organization has pushed for safety packaging, and e-liquid refills come with tamper-evident caps.
LeBlanc said some of his products now come with child-resistant caps, and “we’re transferring everything to child-resistant.”
“All of our liquids have a warning on them to keep out of the reach of children,” he added.
Jenny Haliski, an FDA spokeswoman, said federal regulations now apply only to conventional cigarettes and other tobacco products, but her agency is considering new rules that may cover e-cigarettes.
Stephen Wright, Kosair hospital’s medical director, said people should be cautious.
“Since the industry is still so new, we don’t yet know all of the long-term health effects of e-cigarettes to the user, in addition to any effects of secondhand vapor,” he said. “We do know that not smoking anything — especially around children — is always the best bet.”