• by Thom Forbes  @tforbes, May 2, 2018

The U.S. Food and Drug Administration and the Federal Trade Commission yesterday issued a joint warning to more than a dozen manufacturers, distributors and retailers who they say are endangering children by marketing e-cigarette liquids to resemble kid-friendly products such as juice boxes, candy and whipped cream. 

“Young children exposed to nicotine in e-liquids can experience severe harms such as death, seizure, and coma,” the agencies warn in a release on a web page featuring pictures of the e-liquid products next to legitimate ones (not that Trolli Gummi Candy and the like is particularly healthy).

Examples of some of the products being sold through multiple online retailers include: One Mad Hit Juice Box, which resembles children’s apple juice boxes such as Tree Top-brand juice boxes; Vape Heads Sour Smurf Sauce, which resembles War Heads candy; and V'Nilla Cookies & Milk, which resembles Nilla Wafer and Golden Oreo cookies, according to the agencies. Other products include Whip’d Strawberry, which resembles Reddi-wip topping, and Twirly Pop, “which not only resembles a Unicorn Pop lollipop but is shipped with one,” the feds say.

“It is easy to see how a child could confuse these e-liquid products for something they believe they’ve consumed before — like a juice box,” FDA commissioner Scott Gottlieb said in a conference call with reporters. “These are preventable accidents that have the potential to result in serious harm or even death. Companies selling these products have a responsibility to ensure they aren't putting children in harm’s way or enticing youth use, and we'll continue to take action against those who sell tobacco products to youth and market products in this egregious fashion.”

According to a recent analysis of National Poison Data System data published by the American Academy of Pediatrics, there were a total of 8,269 e-cigarette and liquid nicotine exposures among children younger than 6 between January 2012 and April 2017. The annual exposure rate increased by about 1,400% from 2012 to 2015 and then decreased by about 20% from 2015 to 2016.

“Child poisonings from ingesting liquid nicotine have recently increased. Such poisonings can be deadly and can cause seizures, comas and respiratory arrest. There is no evidence the products under scrutiny this week caused any child deaths, officials said,” Katie Thomas reports for the New York Times.

“Nevertheless, ‘it takes a very small amount of these e-liquids, in some cases less than half a teaspoon, to be at the low end of what could be a fatal effect for a kid, and even less than that to make them very, very sick,’ Mitch Zeller, the director of the F.D.A.’s Center for Tobacco Products, said on the call,” Thomas continues.

“Nicotine is poisonous because it mimics one of the chemical messengers that nerves use to communicate. Too much, and it can mess up signals like the ones that tell your heart how fast to beat and your muscles to move, and can lead to vomiting, abdominal cramps, drooling, seizures, problems breathing, paralysis, and even death,” Rachel Becker writes for The Verge. 

“The risk is real, says medical toxicologist Edward Boyer, an associate professor at Brigham and Women’s Hospital in Boston,” Becker continues. “‘This is not new, it’s not hidden — it’s common, and it’s well described,’ Boyer says. ‘This is by no stretch of the imagination a scare tactic.’”

The government agencies are demonstrating renewed vigor in cracking down on kid-friendly nicotine products in the wake of renewed pressure by groups such as the Campaign for Tobacco-Free Kids. 

“Today’s actions and the FDA’s actions last week are positive steps forward that can make a major difference if they serve as the building blocks of a comprehensive, proactive effort to prevent these problems from happening in the future,” CTFK president Matthew L. Myers says in a statement that also points to a suit filed recently aimed at expediting FDA review of e-cigarettes and cigars.

Yesterday’s action “follows a crackdown on sales of the Juul brand to underage teens in 7-Eleven stores, Shell gas stations and vape retailers,” Jayne O’Donnell writes for USA Today. “… More than 2 million middle and high school students used e-cigarettes and other ‘electronic nicotine delivery systems’ (ENDS) in 2016.”

E-cigarette marketers, meanwhile, claim that their products help smokers break their addictions to conventional cigarettes.

“Nicholas Warrender, owner of Lifted Liquids, a Wisconsin manufacturer of e-liquids, got one of the warning letters — about the company’s Vape Heads Sour Smurf Sauce e-liquid, which had packaging that resembled WarHeads candy. But Warrender said that he recognized the problem last year and changed the design in November to feature a man in a beard, which he said signaled adult use of the product,” Laurie McGinley writes for the Washington Post.

“Warrender said he has been trying to contact the FDA but that reaching the agency was like ‘trying to pull teeth out of a chicken.’ He said he was only trying to help adults stop smoking regular cigarettes.”

Which itself is like pulling teeth out of a chicken.