Washington: The American Academy of Paediatrics (AAP) has strongly recommended that the minimum age to purchase tobacco products -- including e-cigarettes -- should be increased to 21 years nationwide.

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In a comprehensive set of policies announced on Monday, the AAP has stressed the need to protect youngsters from ill-effects of tobacco and nicotine.

"Tobacco use continues to be a major health threat to children, adolescents and adults," said Karen M. Wilson from Children's Hospital Colorado.

"The developing brains of children and teens are particularly vulnerable to nicotine, which is why the growing popularity of e-cigarettes among adolescents is so alarming and dangerous to their long-term health," Wilson said.

The AAP has urged the US Federal Food and Drug Administration (FDA) to regulate e-cigarettes and other electronic nicotine delivery systems the same as other tobacco products.

This includes age restrictions, taxes, bans on advertising to youth, and bans on flavoured products that are particularly attractive to youth.

Child-resistant packaging is critically needed to protect curious young children from exposure to liquid nicotine, according to the AAP.

Liquid nicotine is extremely toxic; as little as half a teaspoon can be fatal if ingested by an average sized toddler.

In 2014, there were more than 3,000 calls to the US poison control centres for liquid nicotine exposure, and one toddler died.

The AAP recommends smoke-free laws that already govern second hand smoke be expanded to include e-cigarettes.

"Protecting children from tobacco products is one of the most important things that a society can do to protect children's health," the AAP policy statement read.

The AAP recommendations have been published in the journal Paediatrics.