E-cigarettes present special health concerns for kids

WASHINGTON — It was a typical scene at a typical local mall: A woman strolling passed a kiosk was asked to take a look at the goods being sold.

But this was a stand selling e-cigarettes, and the woman was Dr. Marsha Seidelman, an internist and pulmonary specialist in the Silver Spring area.

“They told me they are completely safe,” she says with a sigh, adding that anyone in medicine knows better.

The Centers for Disease Control is reporting an alarming increase in e-cigarette use among teenagers. And a recent article in the New England Journal of Medicine raises concerns that liquid nicotine could be a gateway drug, particularly for adolescents.

The article reviewed research that shows nicotine creates chemical changes in the dopamine — or reward — center of the brain, as well as the amygdala, which controls emotions and empathy. Seidelman says “both are very important centers for addiction.”

Other worrisome statistics come from the nation’s poison centers. They report a significant increase in the number of calls relating to vials of liquid nicotine.

Most involve curious kids who simply find the vials around the house. Seidelman says the liquid that contains the nicotine is very concentrated — 1/5th of a teaspoon is enough to create problems for a toddler.

Seidelman says she is appalled by how easy it is to access the stuff, noting there are no significant rules about how it can be advertised or marketed. The Food and Drug Administration is looking into e-cigarettes, but several major medical associations say something must be done now. They want e-cigarettes to be banned or restricted until the FDA decides whether to treat them as a drug or a tobacco product.

Seidelman says there is no time to wait.

“At this point, there are not even rules about putting child-proof caps on the liquid nicotine, so there is a long way to go.”

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