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Toddler's Tragic Death Sparks Divisive Liquid Nicotine Debate

The tragic death of a baby from liquid nicotine has exposed a "maelstrom" of conflicting theories about the best way to reduce smoking.

This week, a Coroner in Victoria handed down the tragic findings of a toddler who died after ingesting a toxic amount of liquid nicotine.

'Baby J', as he is identified, died in June last year when he was just 19 months old. His mum and dad, who are also not named, were trying to quit smoking, and were instead using e-cigarettes.

His mum was using a syringe to dilute the highly concentrated liquid nicotine, purchased online, into bottles of 'vape juice', which would then be used in the e-cigarettes. When she turned around, Baby J grabbed the open bottle of liquid nicotine and drank.

He suffered an irreversible brain injury, and died in hospital two days later, after his family made the decision to turn off life support.

Baby J died on June 10, 2018. Photo: Getty.

The horrific and preventable death, described by Coroner Phillip Byrne as a "tragic accident", exposed another issue brewing behind the scenes when it comes to dealing with smoking, which kills an Australian every 28 minutes.

It comes down to vaping, and whether it encourages smoking (bad) or is a less-harmful cessation tool (good).

Right now, e-cigarettes and liquid nicotine are illegal in Australia. However, they're easy to purchase online, with 79 percent of purchases made in the $50 million per year industry done via the internet. (One user who buys liquid nicotine online told 10 daily the website looked so legit, he wasn't even 100 percent aware it was illegal.)

Enter: two anti-smoking organisations. They have the same goal -- to get people to quit smoking -- but have fundamentally different views on liquid nicotine.

vaping
An estimated 250,000 Australians use e-cigarettes. Photo: Getty.

The Australian Tobacco Harm Reduction Association (ATHRA), a harm minimisation charity set up by four doctors, wants to see liquid tobacco legalised in order to encourage smokers to transition to what they say is a less harmful product.

Quit Victoria, established by the state health department in 1985,  refutes this, and says there is no evidence to support the idea that e-cigarettes as a cessation aide.

Coroner Byrne, in trying to establish the tragic events that led to Baby J's death, found himself in the middle of the "maelstrom".

As he was preparing to hand down his findings, he received an "11th hour" submission from ATHRA. Soon after, he received a submission from Quit Victoria.

Smoking-relating diseases kill more than 15,000 people every year. Photo: AAP.

Seeking clarity, he approached Safer Care Victoria, which is a government body. It advised that the best way to minimise accidental exposure to liquid nicotine was to maintain a broad ban.

"I see a conundrum," Coroner Byne noted.

"If the product is banned in Australia, how can we in this country enforce safeguards like tamper-proof packaging of a product manufactured overseas and accessed online illegally?"

ATHRA's chairman Colin Mendelsohn, a former GP and now professor in the school of public health at the University of New South Wales, said the issue went beyond tamper-proof packaging and into the safety of liquid tobacco more broadly.

Colin Mendelsohn says nicotine has a bad reputation in Australia. Photo: Supplied.

"It's the most effective quitting aid in the world," he told 10 daily.

"One of the great myths is that nicotine kills. It's relatively harmless. What kills people is the smoke -- the tar and the carbon monoxide."

However, Mendelsohn said people are purchasing highly concentrated liquid nicotine from overseas, usually around 100mg per ml which they then dilute into vape juice.

"In other countries, they just go into the local vape shop and buy liquid nicotine that's 6mg per ml, which is much less toxic," Mendelsohn said.

It is also impossible to verify the quality of products purchased from overseas online buyers.

On the other end of things, Quit Victoria says liquid nicotine is simply too risky to use. At high enough doses, it is very toxic, and can cause poisoning when swallowed or absorbed through the skin. Quit Victoria also notes that most e-cigarettes and e-liquid products are not made with basic safety features, and can be easily opened.

Many 'vape juices' have appealing flavours like grape or vanilla, with many Australian users injecting liquid nicotine into the bottles. Photo: Getty.

It was at this opposing view that Coroner Byrne arrived.

"At first blush, the legislation in Australia of liquid nicotine for use in vaping liquid has a logical attraction if it enables regulation of content and safeguard packaging," he said.

"However, with claim and counterclaim the issues are far more complex, indeed controversial, than I initially thought.

"To buy into the debate would be akin to sailing into the maelstrom. Consequently, I am not prepared to make any recommendation that would alter the status quo.

"Ultimately, legislative change is a matter for government."

The Victorian government, while not taking a legalisation approach, is urging the federal government to "do more" to protect children from dangers posed by e-liquids following the death of Baby J, including by making packaging consistent across the country.

"This has been a tragedy and our hearts go out to the child's family and friends," Health Minister Jenny Mikakos told 10 daily in a statement.

Contact the author: abrucesmith@networkten.com.au