Spurred by a report in the New York Times about the dangers of e-cigarette’s liquid nicotine — a neurotoxin that can cause vomiting, seizures and even death — Sen. David Pryor, armed with information from Arkansas Poison Control, has asked the Food and Drug Administration to immediately require child-proof packaging. Liquid nicotine is not regulated; the FDA is considering regulations now.

Howell Foster, director of the Arkansas Poison Center, said 21 children ages 5 and under have been exposed to the poison; one of those children had to be placed in intensive care. There were “multiple hospitalizations.” Three children ages 6-18 and 28 adults have also been exposed. Two adults attempted to commit suicide by using the liquid nicotine. 

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The liquid is far more potent than leaves and does not have to be taken by mouth to cause serious illness or death. A child who simply spills the nicotine on his skin will be affected, Foster said. Refills of the liquid nicotine for e-cigarette users are not now child-proof; Foster said he’s seen one vial that was barely labeled as nicotine.

Reports started coming in 2010, but the majority of poisonings came in 2013 and this year as e-cigarettes have become more widely used, Foster said. Foster said there have been no fatalities yet, but unless the FDA takes action or manufactures to child-proof the vials, there will be. The American Association of Poison Control has issued a nationwide alert to the danger.

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Is this election year posturing? So what? Doesn’t feel like it either. He’s brought attention to a health threat.

Pryor’s letter to the FDA:

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I am writing in response to recent news coverage regarding the sharp spike in poison cases related to liquid nicotine. I am deeply concerned about the potential dangers liquid nicotine poses to consumers and families, especially young children.

As reported recently in the New York Times, the number of poison cases related to liquid nicotine has jumped to 1,351 in 2013, a 300 percent increase over 2012. Liquid nicotine used to fuel e-cigarettes contains many neurotoxins and even a small amount that is ingested can have serious effects on an adult and could be fatal to a small child. The materials pose a greater risk than regular tobacco because the liquid can be much more concentrated and absorbed more quickly. I am particularly concerned about the risks to children because liquid nicotine is sold in bottles without child-proof lids, and contains colors and flavors such as cherry, chocolate, and bubble gum.

I recognize that the FDA is in the process of issuing regulations related to e-cigarettes. However, I believe that readily available liquid nicotine poses a serious risk and that steps should be taken immediately to protect the public, especially children. Appropriate safeguards must be instituted and the public should be alerted to the dangers associated with these products. I am likewise concerned about high-concentration liquid tobacco that is available over the Internet.

Specifically, I am requesting information about the following:

• What will the FDA do to ensure liquid tobacco sold to American consumers contains nicotine levels that are safe?

• What is FDA doing to ensure American consumers have access to information about the ingredients contained in e-liquids?

• Is FDA considering measures to ensure parents have adequate information about the nicotine concentration level and the potential risks those levels could pose to children who come into contact with the e-liquid?

• How will the FDA work with the Consumer Products Safety Commission and industry to ensure liquid nicotine is packaged in child-resistant containers?

I urge the FDA to work quickly to ensure consumers and the public are protected from risks associated with liquid tobacco. As Lee Cantrell, the director of the San Diego division of the California Poison Control System, said recently of our current trajectory, “it’s not a matter of if a child will be seriously poisoned or killed, it’s a matter of when.”

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