Electronic cigarettes have sickened rising numbers of young children, a study of U.S. poison center calls has found. Most cases involve swallowing liquid nicotine. While most kids weren’t seriously harmed, one child died and several had severe complications including comas and seizures. “This is an epidemic by any definition,” said lead author Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. The researchers say the results highlight a need for better parent awareness about the importance of keeping the devices out of sight and reach of young kids. They also recommend stricter regulation and applauded long-awaited restrictions the U.S. Food and Drug Administration issued last Thursday.

The study examined poison center calls about exposure to nicotine and tobacco products among children under age 6 from January 2012 through April 2015. The most worrisome findings involved e-cigarettes — battery-powered devices that turn nicotine into an inhalable vapor. Some feature colorful packaging and flavored nicotine that can attract young children. The results were published Monday in the journal Pediatrics. The FDA rules issued last week will require federal review of the devices and their ingredients, imposing restrictions similar to those affecting traditional cigarettes. The agency intends to issue rules to require nicotine exposure warnings and child-resistant packaging. That action would supplement the Child Nicotine Poisoning Prevention law, which takes effect this summer and will require child-resistant packaging of liquid nicotine containers.