Nicotine in its potent, liquid form is the key ingredient in electronic cigarettes, and like e-cigarettes, e-liquids are not regulated by federal authorities.
The liquid nicotine, mixed with flavoring, colorings and assorted chemicals, is a powerful neurotoxin, and tiny amounts whether ingested or absorbed through the skin can cause vomiting and seizures and even be lethal.
Toxicologists are warning that e-liquids pose a significant risk to public health, particulary to children, who may be drawn to their bright colors and flavors such as cherry and bubble gum.
Since 2011, there has been one death in the United States, a suicide by an adult who injected nicotine. However, there has been a surge of calls to poison control centers and nationwide, the number of cases linked to e-liquids has jumped to 1,351 in 2013, a 300 percent increase from 2012.
Last month, a 2-year-old girl in Oklahoma City drank a small bottle of a parent's nicotine liquid and was rushed to an emergency room.
One woman was admitted to the hospital with cardiac problems after her e-cigarette broke in her bed, spilling the e-liquid, which was then absorbed through her skin.
In terms of immediate risk, e-liquids are far more dangerous than tobacco, because the liquid is absorbed more quickly.
Unlike nicotine gums and patches, e-cigarettes and their ingredients are not regulated, but rather mixed on factory floors and in the back rooms of shops and sold legally online and in stores. The Food and Drug Administration has said it plans to regulate the industry but has not disclosed how it will approach the issue.
It is estimated that this year in the United States there will be sales of one to two million liters of liquid used to refill e-cigarettes.
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Source: The NY Times, "Selling a Poison by the Barrel: Liquid Nicotine for E-Cigarettes," March 23, 2014.