A story in today’s New York
Times sounds
the alarm about “a dangerous new form of a powerful stimulant”
that “is hitting markets nationwide, for sale by the vial, the
gallon and even the barrel.” This stimulant is “a powerful
neurotoxin,” warns business reporter Matt Richtel, and “tiny
amounts” of it, “whether ingested or absorbed through
the skin, can cause vomiting and seizures and even be lethal.” This
dangerous new drug, he explains, is the nicotine contained in
e-cigarette fluid, which already has killed…well, so far just one
guy who committed suicide by injecting the stuff. But “reports of
accidental poisonings, notably among children, are soaring.” They
increased “300 percent” from 2012 to 2013!
Another way of putting that: The number of accidental poisoning
reports related to e-cigarette fluid increased from about 338 in
2012 to 1,351 in 2013. None of these poisonings was fatal, and most
(73 percent) were not serious enough to require hospital treatment.
In 2012, by comparison, 311,347
poisoning reports involved analgesics, 221,314 involved
cosmetics, 193,802 involved cleaning substances, 96,997 involved
anthistamines, 88,694 involved pesticides, 68,168 involved
vitamins, and 49,374 involved plants. So if “e-liquids pose a
significant risk to public health,” as Richtel says, the risk posed
by common products such as aspirin, window cleaner, and bug spray
is gargantuan.
Richtel concedes that the nicotine levels of “most” e-cigarette
cartridges “range between 1.8 percent and 2.4 percent [by volume],
concentrations that can cause sickness, but rarely death, in
children.” But he claims “higher concentrations, like 10 percent or
even 7.2 percent, are widely available on the Internet.” Contrary
to Richtel’s implication, 10 percent is higher than 7.2 percent.
But never mind. How common are e-cigarette cartridges with nicotine
concentrations of 7.2 percent or more? Of the 13 “Top E-Cig Brands
for 2014” picked by by SmokeFreeVCU.org, none offers cartridges
that strong. The strongest fluid sold by 11 of the 13 companies is
2.4 percent or lower. Vapor
Zone offers 3.6 percent.
White Cloud sells cartridges in a “Double Extra” strength aimed
at the heaviest smokers. These cartridges, which the
company describes as
“the strongest in the industry,” contain 5.4 percent nicotine.
Richtel cites two examples of 10 percent solutions, both involving
large quantities sold by wholesalers, presumably to customers who
dilute the fluid before selling it to consumers.
This exaggeration figures in the article’s most memorable
warnings. In the third paragraph, Richtel says “a teaspoon of even
highly diluted e-liquid can kill a small child.” At the end of the
article he quotes Lee Cantrell, director of the San Diego division
of the California Poison Control System, as saying that “one
tablespoon could kill an adult.” According to a 2013
article in Archives of Toxicology, “a
careful estimate suggests that the lower limit causing fatal
outcomes [in adults] is 0.5–1 g of ingested nicotine”—i.e., at
least 500 milligrams. To get that dose from a tablespoon (15
milliliters), the concentration would have to be 33.3 milligrams
per milliliter, or more than 3.3 percent by volume, which is far
from typical.
Richtel does raise some legitimate concerns. He worries that
bottles of e-cigarette fluid are “kept casually around the house”
and that children “may be drawn to their bright colors and fragrant
flavorings.” Adults obviously should keep e-cigarette liquid, like
any other potentially dangerous substance, away from small
children. But Richtel seems determined to portray this particular
hazard, which by his own account has not caused a single accidental
death, as fundamentally scarier than familiar household products
that account for many more poisonings. Perhaps that is because
e-cigarettes are relatively new. Or perhaps Richtel, like many
activists and public health officials, is
offended by the superficial resemblance between vaping and
smoking, the very thing that makes e-cigarettes such a promising
harm reduction tool. Either way, his reaction is not rational. But
I suppose putting risk in perspective is more than we can
reasonably expect from a newspaper that
portrays energy drinks as lethal.
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