For more than 50 years the Surgeon General has warned consumers of the risks associated with smoking cigarettes . Since that time, many products introduced as alternatives. One of the most recent, and popular options is the use of e-cigarettes . But poison control officials say the reusable sticks contain enough nicotine to be bad for your health.

Manufacturers promote electronic cigarette as mimicking the sensation of smoking without exposing the user to the dangerous chemicals found in traditional cigarettes. But their main stimulant, liquid nicotine, could be just as dangerous to consumers, the New York Times reports.

Concerns about liquid nicotine go much farther than just affecting the person smoking. Poison control officials warn that even small amounts of the liquid pose a significant risk to the public if ingested or absorbed through the skin. Children, who may be drawn to refillable e-liquid’s bright color packaging and flavors, are at a higher risk of death from coming into contact with the toxin.

Most liquid nicotine levels in e-cigarettes range between 1.8% and 2.4%; enough to cause sickness in children and adults. Higher concentrations, 7.2% or more, which can be found through online retailers, could be lethal for children and adults.

Since 2011, there has been one death in the United States associated with liquid nicotine, the Times reports. In that case, an adult committed suicide by injecting the liquid.

“It’s not a matter of if a child will be seriously poisoned or killed,” says Lee Cantrell, director of the San Diego division of the California Poison Control System and a professor of pharmacy at the University of California, San Francisco. “It’s a matter of when.”

In 2013, the number of accidental poisonings linked to liquid nicotine rose 300% from the previous year to 1,315 cases, many of which involved children. Minnesota reported 74 e-cigarette and nicotine poisoning cases last year, of those cases 29 involved children two and younger.

The number of accidental poisoning cases doesn’t look to be slowing down. In the first two months of this year, 23 of the 25 cases reported in Oklahoma involved children ages four and younger.

Officials say an increase in poisonings is a reflection of the more common use and the evolution of e-cigarettes in the United States. Because newer models can be refilled with a liquid combination of nicotine, flavoring and solvents, consumers may be at more risk of coming into direct contact with the toxins.

In the past, Consumerist has reported on issues with e-cigarettes, many of which have had more to do with the device itself than with liquid nicotine. The most common reports involved the products exploding while being used.

However, when an e-cigarette breaks users face the risk of shock and toxin poisoning. The Times reports a woman in Kentucky was admitted to the hospital with cardiac problems after her skin absorbed e-liquid when her e-cigarette broke.

Currently, there are no federal regulations protecting consumers from the products. However, many cities across the country have banned the products from being used in public places like parks and the subway.

Last October, 40 State Attorneys General agreed that e-cigarettes need to be regulated. The Food and Drug Administration plans to regulate the products but so far nothing has been announced. Additionally, it’s unknown how regulators would enforce rules with manufacturers outside the United States or operating online.

Some e-cigarette advocates say they would welcome regulations such as childproof bottles, warning labels and manufacturing standards.

Dr. Neal L. Benowitz, a professor at University of Southern California, tells the Times that manufacturing standards would likely include mandating proper precautions like wearing gloves while mixing e-liquids.

“There’s no risk to a barista no matter how much caffeine they spill on themselves,” Benowitz, who specializes in nicotine research, says. “Nicotine is different.”

Selling a Poison by the Barrel: Liquid Nicotine for E-Cigarettes [The New York Times]