Pediatricians, Poison Control Experts Reaffirm Dangers of Liquid Nicotine: Household bleach not nearly as dangerous as liquid nicotine to kids

Despite the support from many vaping shops, the Ohio Chapter, American Academy of Pediatrics (Ohio AAP) and poison control experts, critics of SB 54, a bill to require child-resistant packaging for liquid nicotine, are twisting facts and words to contest the statements that liquid nicotine is a lethal substance when ingested compared to other toxins that can be ingested.

“Senate Bill 54 is yet another demonstration of the tenacious leadership and commitment to the health and safety of Ohio children, which Senator Jones has continually demonstrated during her tenure at the Statehouse,” said Melissa Wervey Arnold, Executive Director of the Ohio AAP. “These attacks are just another example at people trying to twist statements and focus the blame away from a deadly substance if ingested by children, instead of making a substance safer to have in homes around small children.” Wervey Arnold further stated “it’s unfortunate when even many vaping store owners have supported this common sense legislation, that a few are out there taking the focus away from a dangerous substance and trying to turn this legislation into an anti-tobacco piece of legislation. This bill is not anti e-cigarette; this bill is about protecting children.”

The Ohio AAP firmly stands behind comments made by Senator Jones at a press conference last week to announce the legislation to require child resistant packaging.

Senator Jones used an infographic developed by the Ohio AAP to discuss the extreme dangers a small child could face if they ingest liquid nicotine, and makes the comparison that in the pediatric community, we do not see a bottle of bleach as a lethal substance when compared to a few mLs of liquid nicotine.

“Would we be concerned if a child drank an entire bottle of bleach? Concerned yes, corrosive elements yes, but fatal? Highly unlikely. A child would not voluntarily drink even 8 ounces of household bleach because of the smell and taste and large amount they would need to drink to prove lethal. In comparison, a child could easily consume even a teaspoon of liquid nicotine and have it prove fatal,” states Henry Spiller, Director of the Central Ohio Poison Center at Nationwide Children’s Hospital.

The facts and statements stand. When comparing a bottle of bleach vs. a small amount of liquid nicotine, the liquid nicotine is considered the lethal of the two based on the amount needed to prove fatal.

“Twisting around the comments, trying to make Senator Jones sound as if she is not knowledgeable, is a desperate attempt by people to stop common sense regulation of nicotine products. The Senator was merely highlighting that a household substance that most understand to be toxic, a bottle of bleach, is not as dangerous to a child when consumed, and that an entire bottle would need to be consumed to be lethal compared to only the ½ tsp a child consumed in December that proved fatal,” said Wervey Arnold.

“Contents of liquid nicotine are currently unregulated and contain high amounts of nicotine in very small volumes. Concentrations range from 6mg/mL-36mg/ml in stores, and even higher concentrations online. Even a very small volume if consumed could be fatal at these concentrations. Additionally, we are seeing flavors like bubble gum, gummy bears and berry that are attractive to curious children,” said Sarah Denny, MD, Injury Co-Chair with the Ohio AAP.

Nearly 4,000 calls were made to poison control centers around the country in 2014 reporting a child exposed to liquid nicotine. That’s more than twice the reported calls in 2013. In December 2014, a toddler in New York died as a result of ingesting liquid nicotine. The Ohio AAP expects these numbers will continue to rise without interventions by lawmakers.

Spiller recently testified that “drinking a small half ounce bottle could be a fatal amount in a toddler. Nicotine in these concentrations is a nerve poison. At lower doses you would see milder symptoms like nausea, vomiting and an increase in heart rate. As the dose increases you would see increasingly serious symptoms: muscle weakness, bradycardia, hypotension, respiratory weakness, and finally shock, seizures, and death. The dose to produce all these symptoms is available in one small bottle if you are a toddler.”

Child-resistant packaging has proven effective in reducing child fatalities associated with ingestion of medications such as Tylenol, Iron-containing medications, aspirin and Benadryl.

“We look forward to continuing to work closely with Senator Jones and the Ohio General Assembly to continue to fulfill our mission of promoting the health, safety and well-being of children and adolescents so they may reach their full potential,” said Denny.