Advocates, doctors, and lawmakers, have been sounding the alarm bells about about the risks of increasingly popular e-cigarettes, and worst fears were confirmed when a 1-year-old child died last year after ingesting a related product called liquid nicotine. But as a relatively new product, understanding what e-cigarettes are, how they are difference from traditional, combustible cigarettes, and why they are particularly dangerous can be confusing for parents, educators, and the media.

We break down exactly what an e-cigarette is, why they’re a serious threat to the health of our children, and what we should be doing about it.

What is an e-cigarette?

Disposable e-cigarette
Rechargeable e-cigarette

E-cigarettes are battery powered devices with a heating element that turns liquid nicotine into a smoke-like vapor that the user inhales. E-cigarettes can be single use or rechargeable. Many of the devices are designed to look like and mimic the feel of smoking combustible cigarettes.

Liquid nicotine

Instead of dried tobacco leaves, e-cigarettes contain liquid nicotine. Some e-cigarettes contain liquid nicotine when they are sold, others require smokers to pour or inject liquid nicotine into cartridges or atomizers. The nicotine found in e-cigarettes is derived from tobacco and carries with it the same risks as the nicotine in combustible cigarettes.

It is possible for e-cigarette vapor to not contain any nicotine, and the consumer often has the option of selecting the nicotine concentration in liquid nicotine.

In addition to nicotine, liquid nicotine often contains a cocktail of water, vegetable glycerin, propylene glycol, and flavoring. Some retailers offer additional liquid nicotine additives, like caffeine.

E-cigarette users, particularly younger users, will often refer to them by names such as “vapes,” “vape pens,” “e-hookahs,” or “hookah pens” without necessarily understanding that they are e-cigarettes.

How popular are e-cigarettes?

E-cigarette use among older children and teenagers is skyrocketing. The U.S. Centers for Disease Control and Prevention (CDC) reported that middle and high school student usage tripled from 2013 to 2014, the first time that youth use of e-cigarettes surpassed their use of all other tobacco products. Over 13 percent of all high school students reported using an e-cigarette in the past 30 days, an especially concerning trend when considering that it was less than 2 percent in 2011.

In less than a decade since their introduction to the United States, the e-cigarette business has grown into a $3.5 billion industry, based on annual sales. With very low entry costs and fewer regulatory barriers, many liquid nicotine retailers are small businesses with little regard to safe production, transparency, and child safety.

Why are e-cigarettes dangerous?

E-cigarettes are dangerous devices because they contain poisonous liquid nicotine. Liquid nicotine is harmful to young children who can be accidentally exposed, as well as older children who can become addicted the drug.

Often sold in flavors attractive to kids like bubblegum and cotton candy, just one teaspoon of concentrated liquid nicotine can be a deadly dose for children. Accidental ingestion and skin exposure more commonly mean symptoms like vomiting and seizures. Flavored liquid nicotine is attractive to young children who recognize the fluid by its label, smell, and taste, not as the poison that it is.

Starburst flavored liquid nicotine

To make matters worse, a recent First Focus investigation uncovered over 500 cases of liquid nicotine being sold not only only as attractive flavors, but as exact copies of, if not confusingly similar to, brands kids already know and love like Cap’n Crunch and Skittles.

It’s no surprise that poison control centers reported an astounding 1,296 percent increase in exposures from 2011 to 2014. More than half of the exposures were to children under age 6. In 2014, 18-month-old Eli James Hotaling became the tragic first case of a child to die from accidental exposure to liquid nicotine when an open bottle was left within his reach.

The tobacco industry acknowledges that its use of “fun flavors” make teenagers particularly vulnerable” to trying e-cigarettes, so the same flavors that lure curious toddlers also appeal to young smokers who could end up addicted for a lifetime.

Most tobacco use begins in childhood or young adulthood. E-cigarettes were the most common tobacco product used by high school students in 2014, with 13.4 percent reporting use within the 30 days prior to being surveyed. Teens who use e-cigarettes by the time they begin ninth grade are more likely than their peers to smoke combustible cigarettes.

While one of the most serious consequences of nicotine use is addiction, other side effects are far from benign. Adolescent exposure to nicotine can have permanent effects on the developing brain, including a negative impact on memory, attention, and behavior control.

Aside from nicotine, the additional chemicals in liquid nicotine can be harmful. Despite being considering safe when ingested, reports have found flavoring chemicals to be used at unsafe levels when used to flavor liquid nicotine. Additionally, the flavoring can cause irritation when inhaled rather than swallowed. Harvard researchers have found that the flavorings causes a respiratory disease known as “popcorn lung.” And when nicotine becomes vapor, chemicals such as formaldehyde can form.

There is simply no safe level of e-cigarette and nicotine exposure for children.

What exactly is an e-cigarette? Liquid nicotine? @First_Focus explains >> #InvestInKids
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