Study shows nicotine e-liquid exposure is low-risk

The Australian Tobacco Harm Reduction Association (ATHRA) is calling for nicotine e-liquids to be legalised for vaping after an Australian study found that accidental exposure is extremely uncommon and rarely serious.

The study in today's Medical Journal of Australia (1) reviewed all 202 calls to Australian Poisons Centres from 2009-2016. Calls about e-cigarettes and nicotine represented only 0.015% of all calls received. That is less than one in five thousand calls.

Most subjects who had exposure to nicotine had mild, self-limiting symptoms, although twelve had moderate symptoms, usually vomiting and sedation. No cases with severe symptoms were reported and there were no deaths.

According to Conjoint Associate Professor Colin Mendelsohn, Chairman of ATHRA, this is consistent with other studies suggesting nicotine has low toxicity.

‘Serious reactions from accidental or deliberate ingestion or skin and eye exposure are rare and most cases make a full and quick recovery'.

'Even suicide attempts with very large doses usually result in prompt vomiting. Thankfully there is usually a full recovery, but very rare fatalities have occurred in adults and children' he said.

In Australia, nicotine is classified as a Schedule 7 'dangerous poison', the same category as arsenic and strychnine under the Poisons Standard 2018. (2) It is illegal to possess or use it without a prescription, except in medicinal products or in tobacco for smoking.

'Clearly this classification is inappropriate' Dr Mendelsohn said. 'Nicotine e-liquid should be exempted from the Poisons Standard to reflect its real risk and made available for vaping as a less harmful alternative for adult smokers who are unable to quit'.

Legalising and regulating nicotine would also reduce the potential risks from nicotine poisoning according to ATHRA as there is no control over products that are banned.

'Regulation would mandate child-proof containers, clear safety warnings and quality and safety standards as we currently have for other potentially toxic household chemicals and medications.

Currently products are totally unregulated and there is a flourishing black market with no standards and misleading labelling’ (3) Dr Mendelsohn said.

These changes would make nicotine more readily available and safer for smokers who are trying to quit, as is the case in the UK, European Union, US, Canada and New Zealand.

‘It is irrational that Australian smokers are denied a far less harmful alternative to smoking when lethal cigarettes are freely available. Vaping nicotine has helped millions of smokers quit overseas and could save Australian lives’ (4) Dr Mendelsohn said.


Conjoint Associate Professor Colin Mendelsohn
Chairman, Australian Tobacco Harm Reduction Association
M: 0415 976 783 | E:

What is ATHRA?

Australian Tobacco Harm Reduction Association (ATHRA) is a registered health promotion charity established to reduce the harm from tobacco smoking in Australia. ATHRA aims to raise awareness of less harmful alternatives for adult smokers who are otherwise unable to quit.ATHRA’s broader goal is to encourage the complete cessation of tobacco smoking in Australia. For more information, visit

ATHRA is funded by unconditional donations from businesses and the general public. It does not accept donations from tobacco companies or their subsidiaries.

None of the directors has ever had any financial or commercial relationship with any electronic cigarette or tobacco company.


1. Wylie C, Heffernan A, Brown JA, Cairns R, Lynch A, Robinson J. Exposures to e-cigarettes and their refills: calls to Australian Poisons Information Centres, 2009–2016. Medical Journal of Australia.
28 January 2019.

2. Poisons Standard October 2018 (SUSMP no.22). Federal Department of Health 2018. Available from:

3. Chivers E, Janka MA, Franklin P, Mullins B, Larcombe A. Nicotine and other potentially harmful compounds in “nicotine‐free” e‐cigarette liquids in Australia. Medical Journal of Australia. 20019.

4. Farsalinos KE, Poulas K, Voudris V, Le Houezec J. Electronic cigarette use in the European Union: analysis of a representative sample of 27 460 Europeans from 28 countries. Addiction (Abingdon, England). 2016;111(11):2032-40.

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