Potentially poisonous e-cigarette liquid made by 17 different manufacturers comes in packaging that strongly resembles that of candies, cookies and other snacks popular with kids.

And after warnings sent to the companies in May, the US Food and Drug Administration has now banned the products.

The agency told the companies that labels and ads for the nicotine-containing e-liquids were false or misleading, and potentially dangerous. In addition, several of the companies were previously cited for illegally selling the products to minors, the FDA said.

Latest scientific research

In South Africa, e-cigarettes are not covered by the Tobacco Products Control Act or by the Medicines and Related Substances Control Act. The Vaping Industry Conference, held on the second of August 2018, had established itself as a neutral environment for scientists, policy makers, medical and public health professionals and stakeholders to come together and look at the latest scientific research and evidence on e-cigarettes and debate their impact. 

In South Africa, the following remains up for debate regarding e-cigarettes:

• E-cigarette safety and research
• If e-cigarettes are so good, why aren’t all smokers using them?
• The continuum of harm reduction and different policy/regulatory approaches
• Nicotine health impacts, including addiction
• Are there health risks through second-hand vapour for non-users? 

“Removing these products from the market was a critical step toward protecting our kids,” FDA Commissioner Dr Scott Gottlieb said in an agency news release. “We can all agree no kid should ever start using any tobacco or nicotine-containing product, and companies that sell them have a responsibility to ensure they aren’t enticing youth use.”

Examples of the products targeted in the warning letters included: One Mad Hit Juice Box, which resembled children’s apple juice boxes; Whip’d Strawberry, which resembled a dairy whipped topping; Twirly Pop, which resembled a Unicorn Pop lollipop and was shipped with one; and Unicorn Cakes, which included images of a strawberry beverage and unicorns eating pancakes, similar to those used by the My Little Pony television and toy franchise.

“When companies market these products using imagery that misleads a child into thinking they’re things they’ve consumed before, like a juice box or candy, that can create an imminent risk of harm to a child who may confuse the product for something safe and familiar,” Dr Gottlieb warned.

Nicotine affects a youngster’s developing brain

The FDA said it expects some of the companies to continue selling the products, but with revised labelling. The agency said it plans to continue to monitor the situation.

“We’re committed to holding industry accountable to ensure these products aren’t being marketed to, sold to, or used by kids,” Dr Gottlieb said.

The rising popularity of e-cigarettes and related devices has coincided with an increase in calls to US poison control centres and visits to emergency rooms related to e-liquid poisoning and other liquid nicotine exposure among children younger than six, National Poison Data System figures show.

Small children who are exposed to or ingest e-liquids can suffer severe harm, including seizures, coma, respiratory arrest and death from cardiac arrest, according to the FDA.

The FDA also noted that more than two million middle and high school students in the United States were current users of e-cigarettes and similar products in 2016, and that availability of flavoured-liquids is a major reason why youngsters use the devices.

There is evidence that nicotine affects a youngster’s developing brain and may rewire it to be more susceptible to nicotine addiction later in life, the FDA said.

Dr Gottlieb said his agency expects “to take additional, robust enforcement actions over the next few months that target those who we believe are allowing these products to get into the hands of children”.

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