Nicotine Poisoning: How Much E-Liquid Does It Take?

Since the NY Times “scare piece” last week, which implied that the liquid used in e-cigarettes was like “selling poison by the barrel,” there’s been an ongoing debate about electronic cigarette safety.

While many news organizations echoed the fears sparked by the NY Times article, surprisingly, it also received a lot of criticism.

Even though there was a 300-percent rise in e-liquid poisonings in 2013, critics were quick to point out that the number pales in comparison to those caused by other household products.

So how serious is the danger and how much e-liquid does it actually take to cause an overdose?

Nicotine Compared to Other Products

The NY Times reported that the e-liquid used in electronic cigarettes led to more than 1,300 calls to poison control centers in 2013 – up from 447 in 2012 – with that number expected to double this year, according to the National Poison Data System (NPDS).

As scary as that statistic sounds, e-liquid makes up only a tiny fraction of household poisonings each year. Here are the numbers:

Annual Household Poisonings:

1. Analgesics / Pain Killers (322,016)
2. Cosmetics / Personal Care Products (218,269)
3. Household Cleaning Agents (193,443)
4. Alcoholic Beverages (54,445)
5. Toothpaste (20,306)
6. Pens / Ink (11,848)
7. Energy Drinks (3,028)
8. Liquid Nicotine (1,300)

* Statistics from 2012 NPDS Annual Report

Although a rise in any type of poisoning is worrisome, and the NY Times should be applauded for raising the public’s awareness about nicotine overdoses, even if the number doubled (or tripled!) in 2014, it would pale in comparison to the vast array of products that poison consumers each year.

The NY Times makes the assertion that bright colored e-liquid bottles and sweet flavorings like cereal and strawberry e-juices are especially attractive to small children, but there are dozens of other “hazardous” products that have the same appeal. In fact, in 2013 children under 5 were exposed to 10,356 poisonings from highly concentrated packets of laundry detergent, another number that’s dramatically higher than nicotine.

So How Much Nicotine Is Deadly?

Despite the scary headline, not a single person has died from accidental e-liquid poisoning – not an adult or even a small child. Only one person has “knowingly” died from liquid nicotine poisoning, and according to the Times, it was “a suicide by an adult.”

Although it’s certainly not an enjoyable or pleasant experience, most people that are exposed to high doses of liquid nicotine suffer from non-deadly symptoms such as headache, dizziness, sweating, abdominal pain, nausea and vomiting.

The Centers for Disease Control and Prevention says that 60 milligrams of nicotine is enough to kill a 150-pound adult, and that’s alarming since some e-liquid formulas pack as much as 72 milligrams.

But according to Bernd Mayer, a German toxicologist, 60 milligrams is unlikely to be a lethal amount. He’s evaluated the “science” behind the CDC number and suggests that a lethal dose may be 10 times higher than their estimates.

Nicotine is a toxic compound that should be handled with care, but the frequent warnings of potential fatalities caused by ingestion of small amounts of tobacco products or diluted nicotine-containing solutions are unjustified and need to be revised in light of overwhelming data indicating that more than 0.5g of oral nicotine is required to kill an adult.

In several case studies, including one where a person ingested 1,500 mg of nicotine, it wasn’t lethal, causing only “abdominal pain and vomiting.”

Let’s Look At The Facts…

Nicotine is a POISON that can certainly be deadly, but it takes an enormous amount of nicotine to kill someone, no matter whose number you believe. As a vapor, only a small percentage is absorbed by the body and it gets metabolized very quickly, making it nearly impossible to receive a lethal dose.

Concentrated e-liquid is a bigger concern since it can be quickly ingested or absorbed by the skin, but almost none of the liquid being produced today contains enough nicotine to be lethal.

The NY Times acknowledged this fact, pointing out that most e-liquid ranges between 1.8 percent and 2.4 percent, concentrations that can definitely cause sickness, but rarely death – even in small children.

Very few vendors sell concentrations higher than 3.6 percent, and for the most part, the only companies producing 7.2 and 10 percent e-liquid (above the 60mg threshold) are selling to manufacturer’s and DIY’ers who dilute the the product to produce their own, custom-made e-juice blends.

The Times should be praised for raising awareness, but there’s certainly not a “crisis” here, as they suggest. Nicotine can be harmful, especially in high doses, but most bottles of e-liquid have far too little nicotine to be considered deadly.

Unless you’re buying e-liquid above 3.6 percent, or in large bottles that are fully ingested (which is highly unlikely!), there isn’t a whole lot to worry about here. Either way, it should be treated with caution and always stored securely. No one wants a sick or vomiting child, even if the chances of DEATH are slim to none.