Electronic Cigarettes and Nicotine

Electronic cigarettes, also known as e-cigarettes, are popular among adults and teens alike. While the devices come in many different shapes and sizes, they all do the same thing: produce a vapor that the user inhales. Some people turn to e-cigarettes to help them quit smoking regular cigarettes. Others feel e-cigarettes are safer than regular cigarettes, but research is ongoing to learn if this is actually true.

The starting liquid used in e-cigarettes — also called e-liquid or smoke juice — often contains nicotine, with only a few brands offering nicotine-free liquid. The liquids may come in prefilled cartridges or in bottles used to refill the e-cigarette device.

But, what many people might find surprising is that many of these liquids come in flavors, such as:

Fruit punch
Strawberry
Chocolate
Mint
Cola

And, although these liquids should only be used by adults, some are even packaged as kid-friendly food products like juice boxes, candies, and cookies. In fact, the bottles of nicotine-containing e-liquid are required to be child-resistant. These liquids are concentrated, so even a small taste can be dangerous for a young child.

Nicotine Toxicity: What You Need to Know

The symptoms of nicotine toxicity depend on the amount of nicotine ingested.

Mild symptoms	Severe symptoms
Nausea	Seizures
Vomiting	Decreased heart rate
Dizziness	Decreased blood pressure
Increased heart rate
Increased blood pressure

Symptoms can develop if nicotine is:

Swallowed
Inhaled too often
Spilled on the skin and not washed off right away

These risks apply to everyone, not just small children.

Tobacco products like cigarettes, cigars, chewing tobacco, and pipe tobacco can also put young children at risk for poisoning. Additionally, products that help people stop smoking, like nicotine patches, gum and lozenges, also contain amounts of nicotine that are dangerous for young children.

Help from poison experts is available any time, day or night, by calling 1-800-222-1222. Call right away if a young child has ingested any of the above products. Wash your hands thoroughly after handling e-liquids and use e-cigarette products responsibly.

Maryland Law and E-Cigarettes

People living in the state of Maryland should be aware of the following laws related to the sale and use of e-cigarettes:

Tobacco products, including e-cigarettes, may ONLY be sold to people age 18 or older.
The sale or use of tobacco in any form (including e-cigarettes) is prohibited in school buildings at all times.
Local governments can issue criminal citations to both a store and person selling e-cigarettes to a minor AND the minor attempting to purchase e-cigarettes (this is a new law passed during the 2018 Maryland Legislative Session).

Quick Facts About E-cigarettes and Tweens/Teens

Image of a Juul-branded device that teens use for vaping and juuling.

Photo Courtesy of the Florida Poison Information Center-Jacksonville.

E-cigarettes are the most commonly used form of tobacco by youth in the U.S.

More than 2 million middle and high school students used e-cigarettes within 30 days prior to being surveyed. This included 4.3% of middle school students and 11.3% of high school students.

The 2015 Maryland High School Youth Risk Behavior Survey showed 38% of students have used an electronic vapor product.

A 2016 report from the Surgeon General stated there is no safe level of nicotine use for youth. It is addictive and causes permanent changes to the brain.

A National Institute for Drug Abuse report from 2016 showed 66% of teens thought their e-cigarette contained flavoring only. But, 99% of e-cigarettes sold in the U.S. contain nicotine.

Some e-cigarettes look like USB drives. They charge by plugging into a computer. They do contain nicotine and students are using them during the school day. Kids refer to this as “juuling.” Examples of brands: Juul, Bo One, Kandypens RUBI, MLV Phix, Cue Vapor System.

Illustration showing the different devices teens use for vaping and juuling.