Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Pediatric Exposure to E-Cigarettes, Tobacco Products

Pediatrics; ePub 2016 May 9; Kamboj, Spiller, et al

Severe outcomes are being reported in young children who are frequently and increasingly exposed to e-cigarettes and nicotine liquid, and prevention strategies are needed to regulate these products to help prevent child poisoning. This according to an analysis of 29,141 calls received by the National Poison Data System for exposures associated with nicotine and tobacco products among children aged <6 years in the US. Researchers found:

• Cigarettes accounted for 60% of exposures, followed by other tobacco products (16.4%) and e-cigarettes (14.2%).

• Monthly number of exposures associated with e-cigarettes increased by 1492.9% during the study period.

• Children aged <2 years accounted for 44% of e-cigarette exposures, 91.6% of cigarette exposures, and 75.4% of other tobacco exposures.

• Children exposed to e-cigarettes had 5.2 times higher odds of a health care facility admission and 2.6 times higher odds of having a severe outcome than children exposed to cigarettes.

Citation: Kamboj A, Spiller HA, Casavant MJ, Chounthirath T, Smith GA. Pediatric exposure to e-cigarettes, nicotine, and tobacco products in the United States. [Published online ahead of print May 9, 2016]. Pediatrics. doi:10.1542/peds.2016-0041.

Commentary: The use of e-cigarettes has increased dramatically over the last 5 years in both adults and teenagers. In fact, the rate of current use for e-cigarettes in high school has increased from rare use at 1.5% of students in 2011 to being commonly used at 16% of students in 2015.1 In addition to the direct negative effects of nicotine on health, this study shows the potential for adverse consequences in children who may accidentally ingest nicotine from these devices that are now increasingly found around many homes as a consequence of use by parents and older siblings. It is a good thing that the FDA now has jurisdiction over e-cigarettes, that they will no longer be sold to persons under 18 years of age, and that there is increased recognition that e-cigarettes have many potential adverse health consequences.2Neil Skolnik, MD

1. Singh T, Arrazola RA, Corey CG, et al. Tobacco use among middle and high school students—United States, 2011–2015. [Published online ahead of print April 15, 2016]. MMWR Morb Mortal Wkly Rep. 2016;65:361–367. doi:

2. FDA takes significant steps to protect Americans from dangers of tobacco through new regulation. FDA Web site. May 5, 2016. Accessed May 9, 2016.