Nicotine, now available as a potent liquid, has stepped up the speed with which it kills: From overtime to instantly. Squeezed out of tobacco, liquid nicotine is imbued with a wild variety of colorings, flavorings and chemicals before it hits the galloping e-cigarette industry. As with all other things, it too can be bought online. This new e-killer, entering homes in vials, gallon cans and even barrels, is targeting unsuspecting children.
Labelled the alternative to cigarettes and competing with gums or patches that help quit smoking, e-cigarettes using liquid nicotine are finding more and more takers each year. They are battery-operated devices that heat up the liquid in them to convert it into vapor. While originally e-cigarettes, which also looked like a real cigarette, were use-and-throw-away, newer, reusable versions are now taking over the market, hence the growing market for flavored liquid nicotine, dubbed “e-liquids”.
According to the United States Centers for Disease Control and Prevention, e-cigarettes were used by one in five smokers in 2011 – that is twice the number of people who tried it in 2010. This burgeoning population of e-cigarette users or “vapers,” as they are also known, seems largely unaware of the powerful neurotoxin they are dealing with. In case of ingestion or absorption through the skin, even a tiny amount can cause seizures, vomiting and even death. Even when highly diluted, a teaspoon of these e-liquids can lead to the death of small child.
Neither e-cigarettes nor the liquids that fill them come under any federal regulation. Manufactured on factory floors and in rooms behind shops, flavored liquid nicotine is legally sold in shops as well as on the internet in various quantities. Growing alongside its popularity is the compelling evidence that e-liquids are a threat to public health.
The risk is intensified in the case of children, who are often intrigued by the colorful liquid that smells like bubble gum, cherry or chocolate. For Lee Cantrell, Director at the California Poison Control System (San Diego division), it is not a question of whether a child could be grievously poisoned or killed by this toxin – but a matter of when. Cantrell is also a professor of pharmacy at the University of California in San Francisco.
Poison control centers in the U.S., particularly in Minnesota and Oklahoma, are recording rapid increases in the number of cases involving liquid-nicotine poisoning. Notably, the number of children being accidentally poisoned by the substance is going through the roof. In the past three years, there seems to have been one related death in the U.S where an adult committed suicide by injecting the substance.
Overall, in 2013 the country saw a 300 percent jump in the number of cases connected to e-liquids. Pegged at 1,351, that number is expected to double in 2014 according to the National Poison Data System. Also, 365 cases of the 1,351 recorded in 2013 had to be referred to hospitals – that is three times the number of cases referred in 2012.
With such grim predictions looming over the coming years, it is important to create greater awareness about the toxicity of the e-liquids. Liquid nicotine in a cocktail of flavors and colorings can cause dire symptoms, making it the new e-killer. Signs of early toxicity include nausea, vomiting, agitation, diarrhea and confusion. An overdose of the substance can manifest in elevated blood pressure, pronounced palpitations along with nausea, vomiting, dizziness, diarrhea, and confusion. In some cases, it can even lead to seizures that may result in coma or death. Low heart-rate and blood pressure can result from severe exposure to this substance.
Most of the cases of liquid-nicotine poisoning involving both children and adults seem to have come from carelessness. In one incident in Kentucky, where adults account for over 40 percent of the cases, a woman suffered cardiac arrest and had to be hospitalized after her skin absorbed the liquid that spilled onto her bed when her e-cigarette broke. Ashley Webb, director at the Kentucky Regional Poison Control Center said that in a number of cases involving children, the parents were oblivious to the toxicity of e-liquids – until their kids started throwing up.
Vapers who have children at home must take extreme precautions with the storage of liquid nicotine. While a typical e-liquid solution varies in concentration between two to three percent, there are other versions where the concentration can go up to seven to 10 percent. The severity of exposure to even small amounts ranging from one teaspoon to one tablespoon is dependent on the weight of the person and the morphology of their skin.
There is some anecdotal proof that e-cigarettes are helping people quit traditional smoking, but there aren’t any long-term studies to suggest that e-cigarettes may be more effective than nicotine gum or patches. The effects of prolonged inhalation of nicotine vapor has also not been studied so far. In fact, e-cigarettes are yet to be brought under any kind of regulation like nicotine gum and patches.
While the Food and Drug Administration (FDA) has hinted at plans to bring new regulations covering e-cigarettes, there has been no concrete explanation of how. Even if the FDA did regulate how e-cigarettes are marketed, distributed and advertised, it may not reflect on the number of children getting accidentally poisoned. Child-proof and tamper resistant containers need to be developed, along with increased awareness among vapers about liquid nicotine, the new e-killer.
Opinion by Aruna Iyer