Common for Children to be Admitted to Hospital with Nicotine Poisoning

There are several cases a week of children being admitted to the hospital with nicotine poisoning after ingesting nicotine pouches, RÚV reports. Ragnar Grímur Bjarnason, chief physician at the Children’s Hospital, says most poisonings occur at home and many parents don’t realise that nicotine is a strong toxic chemical that can have much more serious consequences for children than adults.

Snus, a moist tobacco powder, is illegal in Iceland, but nicotine pouches are very similar. These are small, hand-or premade sachets filled with loose tobacco powder and then held between the upper lip and the gum for extended nicotine release. Although cigarette smoking has declined in Iceland, nicotine pouches have seen an increased popularity in recent years, particularly among young people. In 2021, nearly a third of Icelanders aged 18-34 were using nicotine pouches on a daily or nearly daily basis.

See Also: Health Minister Presents Bill to Regulate Nicotine Pouch Sales

Nicotine poisonings among children are not a new phenomenon, says Ragnar Grímur. “Naturally, when everyone was vaping, the oils were being left out all over the place. They smelled good and were pretty colours. So at that time, we were getting a lot of those poisonings. They’re also flavoured and taste much better than cigarettes in an ashtray, which was the main cause of [nicotine] poisoning a few decades ago.”

Nicotine poisoning is very serious for children and can necessitate intensive care or even be life-threatening.

“Most people who have tried nicotine know what the most common reactions are,” says Ragnar Grímur. “There’s nausea, vomiting, dizziness, and discomfort. But in children, it can also have very serious effects on the central nervous system.”

Nicotine Products to Be Banned in Schools

A new parliamentary bill by Minister of Health Willum Þór Þórsson recommends the addition of nicotine products (including nicotine pouches) to a law on e-cigarettes and e-liquids, Vísir reports. The aim of the bill is to decrease the use of nicotine pouches by children and young adults.

Flavours appealing to children to be banned

In a new parliamentary bill, Minister of Health Willum Þór Þórsson proposes an amendment to Act No. 87/2018 on Electronic Cigarettes and Refill Containers for Electronic Cigarettes. Among changes to the legislation is a ban on the import, manufacture, and sale of nicotine products and e-cigarettes containing flavours that may appeal to children (such as candy and fruit).

According to a report appended to the bill, the purpose of the ban is to decrease the use of nicotine products among children and young adults: research has shown that flavouring, especially fruit and candy, play a significant role in the popularity of e-cigarettes among children and young adults.

“It is logical to assume that the same holds for the popularity of nicotine pouches,” the report notes.

Banning nicotine products in educational institutions

The new bill also proposes a ban on the sale of nicotine products in preschools, elementary schools, junior colleges, and other educational facilities associated with sports, daycare, recreation, and social events for children and young adults. Universities are not included on the list.

The bill places particular emphasis on educating children and young adults within elementary and junior colleges on the risks associated with the use of e-cigarettes and nicotine products; and on educating responsible parties in pedagogy, education, and healthcare.

E-Cigarette Ban May Bolster Black Market Sales

e-cigarette

In a letter to Minister of Health Svandís Svavarsdóttir, the Icelandic Federation of Trade maintains that enforcing existing laws and regulations on e-cigarettes is more important than tightening regulation: “Existing laws stipulate state monitoring of e-cigarettes and e-liquids to ensure consumer safety and to prohibit sales to children and teenagers,” the IFT states.

The letter was penned after a group of members requested that the IFT emend “misrepresentations in statements made by the Directorate of Health, the Minister of Health, and the Icelandic media in regard to the recent lung-injury outbreak in the U.S. associated with e-cigarette use.

“The U.S. Food and Drug Administration has concluded that the cause of the outbreak may most likely be traced to illegal marijuana products (THC liquids) that are sold on the black market without any kind of supervision,” the IFT maintains.

Instead of tightening regulation, the government should, the IFT argues, “encourage consumers to restrict their purchasing to regulated entities that operate in accordance with existing laws and regulations. IFT members emphasise the importance of selling only CE-certified products.”

The IFT agrees with Director of Health Alma Möller who characterised the results of a recent poll–indicating that 10% of Icelandic 10th graders use e-cigarettes habitually–as worrying. “It’s clear that minors are obtaining these e-cigarettes and related products by illegal means. The IFT is in agreement with the Director of Health in that public oversight, ensuring that the laws are followed, is necessary.”

Möller has recommended that the Directorate of Health tighten existing regulation, ban flavoured e-liquids and improve existing labels on e-cigarettes. The IFT points out that the current legislation on e-cigarettes forbids text or photo advertisements on e-cigarettes that target children and teenagers. Furthermore, advertising e-cigarettes and e-liquids is illegal.

“The Director of Health recommends banning flavoured e-liquids. Such a thing, however, has nothing to do with public health. Neither does it prevent individuals from obtaining such e-liquids. In the event of flavoured e-liquids being banned, individuals–children and teenagers included–may attempt to illegally obtain such liquids, which are not subject to public supervision. Flavoured liquids that have been smuggled into the country are not subject to laws and regulations regarding e-cigarettes and thus the law will not prevent unscrupulous parties from putting such liquids into the hands of children and teenagers. The consequences could be completely antipodal to the intentions.”

Twenty percent of Icelandic secondary school students are habitual users of e-cigarettes.

New Laws on E-Cigarettes Go Into Effect Today

New laws governing the import, use, and safety of e-cigarettes, as well as provisions meant to discourage young people from using these products go into effect today, RÚV reports. These are the first laws in Iceland to specifically address e-cigarettes and their use and conform to existing laws on e-cigarettes that have been put in place by the European Council.

Under the terms of the new law, the Minister of Health will be responsible for setting regulations with further provisions regarding the quality, safety, and ingredient descriptions for e-cigarette products. These provisions will take effect on June 1. Those who import e-cigarettes and their refills and accessories have also been given a deadline for conforming to the new regulations on package labeling. E-cigarette products that do not conform to the new provisions will be legally saleable until September 1, 2019.

Minister of Health Svandís Svavarsdóttir says that the new laws on e-cigarettes are very similar to those that are in place for traditional ones. Cigarette packaging must, for instance, clearly indicate that nicotine is highly addictive.