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Commentary: E-cigarettes dangerous, addictive

By: Dr. Jessica Neely

The introduction of the e-cigarette has precipitated the resurgence of the tobacco industry and threatens to undo 50 years of progress made by tobacco prevention campaigns.

These products, first introduced in 2007 from China, are rapidly gaining popularity in the United States, particularly among teens. E-cig use in middle school and high school students rose by 61 percent between 2012 and 2013 and tripled between 2013 and 2014 now surpassing traditional cigarette use in teens.

Products are marketed as “alternative” methods of smoking and are appealing to teens as they come in a variety of fruity or candy flavors.

Due to advertising campaigns, the general public is under the false impression that these products are safer than cigarettes. In fact, preliminary studies have shown that there are significant levels of formaldehyde, a carcinogen, inhaled when using e-cigarettes in addition to many heavy metals and aerosols. Furthermore, there is no evidence the use of e-cigarettes as a smoking cessation is effective.

What is most alarming is the rapid rise in accidental exposures, either through oral ingestion or skin contact, to liquid nicotine in young children.

Liquid nicotine is sold in high volumes, up to one gallon, in stores and online, at varying concentrations as high as 100 mg/ml. The toxicity of this substance is such that an average 2-year-old child would only need to ingest approximately 0.5 ml to experience lethal effects.

In 2014, there were 3,783 exposures reported to the national Poison Control Center, an eight-fold increase from 2012. Over half of these exposures were in children less than 6 years of age.

Oral ingestion most often results in stomach upset, including nausea or vomiting, but can also cause respiratory depression, cardiac arrhythmias and death. Tragically, on December 9, 2014, the first reported pediatric death due to ingestion of liquid nicotine occurred in an 18-month-old child in upstate New York, secondary to a fatal cardiac arrhythmia.

There is currently no federal legislation in place to help regulate e-cigarettes and while the FDA has attempted to take over regulation, efforts have been significantly stalled by the strong tobacco muscle behind Congress.

As political efforts move along at snail’s pace, we must begin to act locally. To protect our adolescents, who are the targets of e-cig marketing campaigns, and our vulnerable young children, who are being harmed through accidental ingestion of these toxic products, we must expose e-cigarettes for what they are: another dangerous and addicting method of smoking.

We must counsel our friends and loved that these products are dangerous to use and to have present in households where young children live. And we must advocate at the legislative level for laws that will define e-cigarettes as tobacco products and require them to be sold in childproof packages.

It is critical to intervene now before history is repeated and another generation suffers from the ill effects of tobacco products.

Jessica Neely, a former Henderson resident, is now a pediatrician at the University of California-San Francisco

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