- Washington Report
President Barack Obama signed the bipartisan Child Nicotine Poisoning Prevention Act into law in late January, protecting children from the toxic liquid nicotine used to refill e-cigarettes. The law, which requires liquid nicotine refills to have child-resistant packaging, is a major win for children’s health and an important victory for pediatricians who advocated for its passage.
Coming in bright colors and flavors like cotton candy and gummy bear, liquid nicotine refills are finding their way into the hands of children at an alarming rate. Exposure to liquid nicotine, whether through ingestion or absorption through the skin, can lead to serious illness and even death. According to the American Association of Poison Control Centers, 3,067 exposures to e-cigarettes and liquid nicotine were reported in 2015, with more than half occurring in children under the age of 6. Tragically, one child in upstate New York died from liquid nicotine exposure in 2014.
The Academy called liquid nicotine poisoning an urgent, preventable public health crisis, and led the push for federal action to protect children. Susanne E. Tanski, M.D., M.P.H., FAAP, chair of the AAP Tobacco Consortium, represented the Academy at the first congressional hearing to address e-cigarettes and youths in 2014.
“Who can argue with protecting kids? Everyone wants their children to be safe and grow up healthy; children being poisoned flies in the face of that,” Dr. Tanski said. “E-cigarettes and their liquid nicotine refills were flooding the market, which created a sense of urgency that we needed to act on the poisoning aspect immediately.”
Unlike cleaning supplies and prescription medications, liquid nicotine refills were not required to have child-resistant packaging. Under the new law, the U.S. Consumer Product Safety Commission (CPSC) will enforce child-resistant packaging on the products starting in July.
“These products fell into a unique regulatory void,” said Kyran P. Quinlan, M.D., M.P.H., FAAP, chair of the AAP Council on Injury, Violence and Poison Prevention. “This legislation could not come soon enough. We were really happy Congress could pass the bill and begin to protect kids by having child-resistant packaging for the liquid nicotine that people may have in their homes.”
How AAP, pediatricians led the way
The Child Nicotine Poisoning Prevention Act originally was introduced in the 113th Congress but did not gain the steam it needed to advance into law. In the 114th Congress, Sens. Kelly Ayotte (R-N.H.) and Bill Nelson (D-Fla.) and Reps. Susan Brooks (R-Ind.) and Elizabeth Esty (D-Conn.) re-introduced the legislation and worked together to advance the bill.
In spring 2015, the legislation served as one of the main advocacy topics for the AAP Legislative Conference, where more than 130 pediatricians urged their federal legislators to support the bill.
During the AAP National Conference & Exhibition in October 2015, the Academy released a new policy statement on electronic nicotine delivery systems, most commonly e-cigarettes, which called for child-resistant packaging on liquid nicotine refills.
To amplify the Academy’s messages, pediatricians wrote to their local newspapers on the importance of protecting children from these dangerous products and also served as child health experts in news coverage on the issue.
The Academy continued to drive the advocacy momentum and engaged members in grassroots advocacy opportunities. On the morning of the U.S. House of Representatives’ vote on the final bill, the Academy contacted its Key Contact network, asking pediatricians to urge their U.S. representatives to pass the legislation. Within hours, the House passed the bill, sending it to President Obama for his signature.
“The bill and the success of its passage was based on education and relationships. It was individual pediatricians writing letters or meeting with their legislators to explain why liquid nicotine poisoning is such an important issue and bringing it to the forefront,” Dr. Tanski said.
Looking ahead, the Academy will work with CPSC to ensure the law’s implementation and will continue to advocate for the Food and Drug Administration’s long-awaited action to regulate all tobacco products, including e-cigarettes.
The 25th AAP Legislative Conference will be held April 3-5 in Washington, D.C. Participants will develop their advocacy skills through interactive workshops, hear from policy experts and leaders about child health priorities, network with advocates from across the country and go to Capitol Hill to urge Congress to support children’s health.
Visit www.aap.org/legcon for more information about the conference and to register.