The e-cigarette market, which broadly encompasses the delivery of nicotine via an electronic apparatus such as a Juul, is a billion-dollar industry. Public health experts warm that these devices with their nicotine pods, cartridges, or the like have to be treated like any potentially hazardous chemical when it comes to children.

There was a dramatic increase in the number of calls to the poison control center over the first 4 years that e-cigarettes were are the market. That trend continues, with nearly 2,100 cases reported from January 1st through July 1st in 2019.

At issue is the liquid nicotine used in these devices to create the flavored vapor inhaled by users. Nicotine, which is naturally present in tobacco leaves in small amounts, is a highly potent neurotoxin at higher levels. Symptoms of nicotine poisoning include abdominal cramping, agitation, rapid breathing, confusion, and in extreme cases, coma and death. As little as a tablespoon of a 10 percent liquid nicotine formulation can be lethal.

Many parents are unaware of just how dangerous liquid nicotine can be—or how appealing it can be to curious children. E-cigarette nicotine is sold in child-friendly flavors, including bubble gum and gummy bear. It’s vital to keep all liquid nicotine products in a childproof place. Nicotine can be ingested through the mouth or absorbed by the skin and can make a child ill within minutes.

E-cigarettes are not regulated by the FDA or any other federal organization, meaning there is no quality control for the nicotine, nor are there published guidelines for safety. They are not required to have child-resistant caps or warning labels. While many researchers feel this is a better option than a traditional cigarette, long-term studies are still ongoing to determine the effects of inhaling nicotine alone. They are not an FDA-approved method of smoking cessation.

E-cigarettes have the potential to positively impact the health of traditional smokers as they quit. Unfortunately, their popularity is increasing among non-smokers including children, making public health officials concerned that Americans may be trading one addiction for another. In addition, not all states limit the sale of e-cigarettes to adults, making them available to middle and high school children.


  • E-cigarettes are electronic cigarettes that contain nicotine but not the tar and other carcinogens of a traditional cigarette.
  • The nicotine fillers come in a variety of flavors, some of which are very appealing to children.
  • E-cigarettes are not an FDA-regulated product.
  • Accidental ingestion is becoming more common, according to the CDC.
  • Parents are encouraged to keep e-cigarettes away from children, just as they would a traditional cigarette.

Last reviewed by Sara Connolly, MD, FAAP. Review Date: August 2019


  1. Centers for Disease Control and Prevention. New CDC study finds dramatic increase in e-cigarette related calls to poison centers.
  2. Medline Plus. Nicotine poisoning.
  3. The New York Times. Selling a Poison by the Barrel: Liquid Nicotine for E-Cigarettes.


  1. From the sound of it, none of you vape. I use nicotine free from Atomic Dog(TM) and the have child proof caps, it toke me a few minutes to open the cap and I’m 18.
    You’re almost misleading in this article especially about vape pens. They are very different from Ecigs and also another misleading point, most manufacturers on their website include ingredients the most common are Glycerin, Propylene Glycol-free, and water and natural and artificial flavoring and citric acid. That’s all!
    And in all state you have to be 21 in order to get a vape pen, and there is no real second hand smoke, and when they say nicotine free they mean nicotine free (I’m allergic) and as a marijuana smoker it’s not good to put oil in your pen and no you can’t smoke bud out of a vape pen, I’ve tried and it failed. But it’s the parents fault that their child died, or got sick.
    vape pens ARE NOT the same as e cigs. Get your facts first

  2. New research has shown that the idea of trading one habit for another to be false. This new research has shown that nicotine is nowhere as addictive as one would expect (when used in e-cigs vs analog cigs). Granted the research was after this article published, so I can’t fault there.

    The next issue is the claim the use of the CDC info that claims “e-cigs on the rise with kids” when the evidence when actually analyzed (not just reading the CDC’s “take always”) demonstrates that their rise is directly linked to youth smoking being at an all time low.

    But the one part that bothers me the most is how this article talks about how toxic and dangerous e-liquid is (which I agree it can be) but never once does it put the blame where it belongs….. on the parents. The tragedy of the child that died is an issue of a failure of the parents to secure their stuff. The e-liquid ranks incredibly low on the list of things that parents call poison control about. There are way many more worse things that patents let their children get into.
    This article does a great job of saying ” Look, e-cigs are bad! ” when what it really needs to be saying is “Parents, add e-liquid to the list of all things toxic and poisonous to keep out of the reach of your children!”

    Just shows where the authors intent was. Demonizing and fear mongering of e-cigs instead of focusing on child safety.

  3. very interesting, but unfortunate article. maybe now all of these stubborn parents using these dang e-cigarettes will finally listen and realize that they are also terrible, and not a proper substitute for their unhealthy habit.

  4. I feel like this is replacing one bad habit for another. They are everywhere and people are not just using them for nicotine. They are incredibly popular for the occasional to everyday pot smoker. The various flavors of nicotine that can be purchased appeal to young teens/children. Therefore, I can totally see how accidental ingestion in children is becoming more common.


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