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Reducing the dangers of e‐cigarettes for children: opportunities for regulation and consumer education

Ryan D Kennedy and Vanya C Jones
Med J Aust 2019; 210 (3): . || doi: 10.5694/mja2.50007
Published online: 18 February 2019

The importance of packaging, storage, and product design must be reflected by legislation

Electronic nicotine delivery systems (ENDS), including e‐cigarettes, are devices that heat a liquid (e‐liquid) that usually includes propylene glycol or vegetable glycerine, nicotine, and other constituents, such as colourants and flavourings. Nicotine is a naturally occurring toxin in tobacco plants that affects mammalian nervous and cardiovascular systems.1 E‐liquids containing nicotine are a poisoning risk because small amounts of nicotine can induce vomiting, cause seizures, and be lethal, particularly if ingested by young children.2 As Chivers and colleagues3 report in this issue of the MJA, e‐liquids may also contain a range of other toxic and dangerous constituents, including insecticides. In Australia and overseas, ENDS products are subject to regulations similar to those for tobacco products, including minimum age of purchase and restrictions on advertising.4 However, mitigating the risk of poisoning by ENDS products and their e‐liquids has not been the primary object of legislation.


  • Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States


Correspondence: rdkennedy@jhu.edu

Competing interests:

No relevant disclosures.

  • 1. National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention (USA). Nicotine: systemic agent. Updated 12 May 2011. https://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750028.html (viewed Dec 2018).
  • 2. Richtel M. Selling a poison by the barrel: liquid nicotine for e‐cigarettes. New York Times, 23 March 2014. https://www.nytimes.com/2014/03/24/business/selling-a-poison-by-the-barrel-liquid-nicotine-for-e-cigarettes.html (viewed Dec 2018).
  • 3. Chivers E, Janka M, Franklin P, et al. Nicotine and other potentially harmful compounds in “nicotine‐free” e‐cigarette liquids in Australia. Med J Aust 2019; 2019(210): 000–000.
  • 4. Kennedy RD, Awopegba A, De León E, Cohen JE. Global approaches to regulating electronic cigarettes. Tob Control 2017; 26: 440–445.
  • 5. Brown CJ, Cheng JM. Electronic cigarettes: product characterisation and design considerations. Tob Control 2014; 23 (Suppl 2): ii4–ii10.
  • 6. Food and Drug Administration (USA). FDA warns company for selling e‐liquids that resemble kid‐friendly foods as part of the agency's ongoing Youth Tobacco Prevention Plan [media release]. 29 Nov 2018. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm627123.htm (viewed Dec 2018).
  • 7. Buettner‐Schmidt K, Miller DR, Balasubramanian N. Electronic cigarette refill liquids: child‐resistant packaging, nicotine content, and sales to minors. J Pediatr Nurs 2016; 31: 373–379.
  • 8. Herzog B, Kanada P. Our evening with blu: takeaways from Imperial Brands’ e‐cig event [report]. Wells Fargo Securities, equity research: tobacco. 28 Mar 2018. https://www.wellsfargoresearch.com/Reports/ViewReport/6dd7ce28-1708-4b56-9c05-cd59ca71fb40?source=WFR.COM&ght=bc605b8a-3f2e-4903‐ (viewed Dec 2018).
  • 9. Euromonitor International. Smokeless tobacco and vapour products in Australia [report]. Aug 2018. https://www.euromonitor.com/smokeless-tobacco-and-vapour-products-in-australia/report (viewed Dec 2018).
  • 10. Kong AY, Derrick JC, Abrantes AS, Williams RS. What is included with your online e‐cigarette order? An analysis of e‐cigarette shipping, product and packaging features. Tob Control 2018; 27: 699–702.
  • 11. Hua M, Talbot P. Potential health effects of electronic cigarettes: a systematic review of case reports. Prev Med Rep 2016; 4: 169–178.
  • 12. Wylie C, Heffernan A, Brown JA, et al. Exposures to e‐cigarettes and their refills: calls to Australian Poisons Information Centres, 2009–2016. Med J Aust 2019; 210: 000–000.
  • 13. Hughes A, Hendrickson RG. An epidemiologic and clinical description of e‐cigarette toxicity. Clin Toxicol 2018; 9: 1–7.

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