Vape juice, also known as e-liquid, is the flavored fluid used in electronic cigarettes and vaping devices. It consists of a base of propylene glycol and vegetable glycerin, flavorings, and often a concentrated form of nicotine. Accidental swallowing of this liquid is a serious concern because the highly concentrated nicotine presents a rapid poisoning risk. The immediate danger of ingestion is almost entirely due to the presence of nicotine.
Essential Actions Immediately Following Ingestion
The first step after accidental ingestion is to rinse the mouth thoroughly with water to remove any residual liquid. It is also helpful to drink a small amount of water to help dilute any liquid that has already been swallowed. However, consuming large amounts of liquid is not recommended.
Do not attempt to induce vomiting unless specifically instructed by a medical professional or a poison control center. Vomiting increases the risk of the liquid being inhaled into the lungs, which can cause further complications. Immediately contact the national toll-free Poison Help hotline (1-800-222-1222) or emergency services.
When calling, be prepared to provide the exact product information, including the brand, the estimated amount swallowed, and the precise nicotine concentration in milligrams per milliliter (mg/mL). Promptly seeking guidance is necessary because the severity of the exposure varies widely based on the amount and concentration of nicotine ingested.
Assessing the Primary Danger: Nicotine Concentration
The primary hazard of accidentally swallowing vape juice is acute nicotine poisoning, or nicotine toxicity. Vape liquids contain concentrated nicotine, which is rapidly absorbed into the bloodstream through the mucous membranes and the gastrointestinal tract. The severity of the poisoning is determined by the total dose of nicotine ingested, calculated from the liquid volume and its concentration.
Concentrations in vape juice can range from 0 mg/mL up to 50 mg/mL or more, meaning even a small amount of high-concentration liquid can deliver a dangerous dose. For a typical adult, the estimated lethal dose is historically cited as 50 to 60 milligrams (mg) of nicotine, though some research suggests the actual fatal threshold may be higher. A small child is much more vulnerable, with a potentially lethal dose estimated to be as low as 6 mg of nicotine.
A single teaspoon of liquid nicotine can be fatal for an average-sized toddler, demonstrating the extreme toxicity of the concentrated chemical. The risk is elevated because e-liquids are often sold in volumes of 10 mL or more, containing hundreds of milligrams of nicotine in total. This high concentration makes accidental ingestion a medical emergency, especially for children or individuals with smaller body masses.
Physical Signs of Accidental Ingestion
The symptoms of nicotine poisoning can manifest quickly, often within 15 minutes to one hour following ingestion. Initially, the effects are typically stimulatory, as nicotine acts on the central nervous system. Early signs include nausea, vomiting, increased salivation, abdominal pain, and a burning sensation in the mouth and throat. Mild symptoms may also include headache, dizziness, paleness, and muscle twitching.
If a large amount of nicotine was ingested, more severe symptoms can develop within 30 minutes to four hours. These signs indicate a dangerous progression toward the depressor phase of toxicity. Severe effects include a rapid heart rate followed by a slow heart rate, low blood pressure, and breathing difficulties.
In the most severe cases, the person may experience seizures, muscle weakness leading to paralysis, coma, and eventually respiratory failure. Since vomiting is common with nicotine ingestion, this natural defense mechanism often limits the total amount of nicotine absorbed. However, medical attention is still necessary to monitor and manage these systemic effects.
Irritation Caused by Base Liquids and Flavorings
Beyond nicotine, vape juice contains base ingredients like Propylene Glycol (PG) and Vegetable Glycerin (VG), which are generally recognized as safe for consumption by the Food and Drug Administration. These compounds are used widely in food and pharmaceuticals. However, ingesting them in the concentrated amounts found in e-liquid can still cause temporary discomfort.
When swallowed, the large volume of PG and VG can lead to gastrointestinal upset, including nausea, stomach cramps, and diarrhea. Propylene glycol is partially metabolized by the kidneys into lactic acid. Ingesting large amounts can potentially be problematic for individuals with pre-existing liver or kidney conditions.
The flavorings added to vape juice may cause irritation to the mouth, throat, and digestive lining. In rare instances, an individual may have a specific sensitivity or allergic reaction to these flavor additives or to the PG/VG base itself. While these non-nicotine ingredients cause unpleasant side effects and discomfort, they do not pose the same acute, life-threatening toxicity risk as concentrated nicotine.