Seizures or convulsions are known potential side effects of nicotine poisoning and have been reported in relation to intentional or accidental swallowing of nicotine-containing e-liquids, according to a US Food and Drug Administration (FDA) statement.

The agency has observed a slight increase in the reports of seizures since June 2018 following the use of e-cigarettes, with 35 identified cases of seizures between 2010 and early 2019. The seizures, mostly in select youth or young adult users, had occurred after a few puffs or up to one day after use.Some cases involved users who had a prior history of seizure diagnosis, while a few others suffered seizures in association with use of marijuana or amphetamines.

The FDA is currently unable to identify a specific brand or sub-brand of e-cigarettes, but the cases warrant an investigation into whether there is in fact a connection between e-cigarettes and seizures, and any additional consequences to nicotine use as some e-cigarettes deliver high concentrations of nicotine.

FDA Commissioner Scott Gottlieb has termed the surge in teenage use of the popular nicotine devices an “epidemic”; plans are in place to curb the sale of flavoured e-cigarettes by restricting the availability of flavours other than tobacco, mint and menthol, to stores or online portals subject to strong age-verification protocols.

Electronic or e-cigarettes have been a divisive topic in the public health community since the devices first appeared in 2004, with partial focus on the benefit of shifting smokers to less harmful nicotine products, while others fear it would create a new generation addicted to nicotine replacements.