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Pediatrics. 2018 May;141(5). pii: e20173361. doi: 10.1542/peds.2017-3361.

E-Cigarette and Liquid Nicotine Exposures Among Young Children.

Author information

Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
Rutgers New Jersey Medical School, Newark, New Jersey.
Central Ohio Poison Center, Columbus, Ohio.
Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio; and.
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio;
Child Injury Prevention Alliance, Columbus, Ohio.



To investigate exposures to liquid nicotine (including electronic cigarette devices and liquids) among children <6 years old in the United States and evaluate the impact of legislation requiring child-resistant packaging for liquid nicotine containers.


Liquid nicotine exposure data from the National Poison Data System for January 2012 through April 2017 were analyzed.


There were 8269 liquid nicotine exposures among children <6 years old reported to US poison control centers during the study period. Most (92.5%) children were exposed through ingestion and 83.9% were children <3 years old. Among children exposed to liquid nicotine, 35.1% were treated and released from a health care facility, and 1.4% were admitted. The annual exposure rate per 100 000 children increased by 1398.2% from 0.7 in 2012 to 10.4 in 2015, and subsequently decreased by 19.8% from 2015 to 8.3 in 2016. Among states without a preexisting law requiring child-resistant packaging for liquid nicotine containers, there was a significant decrease in the mean number of exposures during the 9 months before compared with the 9 months after the federal child-resistant packaging law went into effect, averaging 4.4 (95% confidence interval: -7.1 to -1.7) fewer exposures per state after implementation of the law.


Pediatric exposures to liquid nicotine have decreased since January 2015, which may, in part, be attributable to legislation requiring child-resistant packaging and greater public awareness of risks associated with electronic cigarette products. Liquid nicotine continues to pose a serious risk for young children. Additional regulation of these products is warranted.


Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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