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J’accuse

The recent tragedy in New York – the infant who died after consuming e-liquid containing nicotine – gives us a somber reminder of the irresponsibility of the Food and Drug Administration. The agency whose mission is to protect the public from harmful substances, has instead spent inordinate amounts of time (and taxpayers' money) dithering about trace levels of toxicants – levels that couldn't hurt anybody – and failing in its responsibility to mandate child-proof containers.

The issue of childproofing stands outside the torrent of debate about vaping. Regardless of whether long-term vaping is minimally harmful, regardless of whether vaping is a gateway to smoking, regardless of questions about second-hand vapor – it is the responsibility of regulators to see that all substances that could harm a child who drinks it be packaged safely. The FDA has been derelict in its duty, and this tragedy may be laid at their door.

Alas, the unthinking public will impute responsibility to the vaping industry and the vaping community. As the reports from poison control centers have proliferated, and the shrill cries of vape-bashing journalists have trumpeted shocking headlines, the public has clearly decided that vaping itself is the culprit, rather than the failure to regulate it expeditiously. Indeed, it might be noted that there are those at the FDA who would be glad of another reason to blacken the reputation of vaping. It would seem unthinkable that an intent to smear lies behind the agency's delays. Or would it?

Some manufacturers are also to blame, of course. While responsible vaping supplies companies have hastened to introduce childproof containers, some have not, and this not only endangers children, but harms the vaping community in terms of an already embattled reputation. Perhaps it is time to consider criminal charges against suppliers who do not voluntarily follow responsible childproofing precautions. Phil Daman of the Smoke-Free Alternatives Trade Organization urges manufacturers to childproof, but no one requires it as yet.

The parents were also remiss. The child who died was one year old. An infant that age does not have the manual dexterity to unscrew the cap even of an ordinary bottle. That action requires grasping the bottle with one hand and turning the top with the other, which would require not only manipulative skill but problem-solving ability that is beyond even the most extraordinary 1-year-old - performing separate actions with the individual hands that achieve the goal only in conjunction. This means that the adult vaper in the household not only bought e-liquid in an non-childproof container, and not only left it out where the toddler could get at the bottle, but very likely left the container open. Vapers need to accept some responsibility, not only for the safety of their households, but also for the reputation of the community.

It is conceivable that the lethal agent was e-liquid containing nicotine at an unusually high level of concentration, says Daman. Ingestion of e-liquid at normal levels usually induces vomiting, which speedily ejects the toxins. All previous cases of nicotine poisoning have been resolved easily at home or at emergency rooms, and wiped up with a washcloth, never mind the journalists' shrill headlines. The standardization of concentration levels is also a problem that could be easily solved by responsible regulators, if we had any around. 

One hopes that this tragedy will not further delay the regulatory process. It is time for a childproofing mandate, as well as a national youth-sales ban, and moderate controls that will enhance, not impede, the ability of smokers to quit using vaporizers. Otherwise the death toll will rise even higher.

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