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CDC reports dramatic increase in poisonings from e-cigarettes

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E-cigarettes have gained in popularity because users believe that they are a healthier alternative to tobacco products. However, a new study by the Centers for Disease Control and Prevention (CDC) has raised concerns about their safety On April 3, the agency released a report describing an alarming increase in poisonings from e-cigarettes. The number of calls to poison centers involving e-cigarette liquids, which contained nicotine, soared from one per month in September 2010 to 215 per month in February 2014. During that same period, no increase in calls from tobacco products occurred.

The CDC noted that the majority (51.1%) of the calls to poison centers regarding e-cigarettes involved young children under age 5; furthermore, approximately 42% of the poison calls comprised individuals age 20 and older. The CDC study compared total monthly poison center calls involving e-cigarettes and regular cigarettes; it found that the proportion of e-cigarette calls soared from 0.3% in September 2010 to 41.7% in February 2014. Poisoning from regular cigarettes is usually due to young children eating them. Poisoning related to e-cigarettes was due to the liquid containing nicotine used in the devices; it can occur in three ways: by ingestion, inhalation or absorption through the skin or eyes.

“This report raises another red flag about e-cigarettes, the liquid nicotine used in e-cigarettes can be hazardous,” noted CDC Director Tom Frieden, MD, MPH. He added, “Use of these products is skyrocketing and these poisonings will continue. E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children.”

In addition to poisonings, e-cigarette calls were more likely than tobacco product calls to include a report of an adverse health event following exposure. The most common adverse health events due to e-cigarette calls were vomiting, nausea, and eye irritation.

The CDC obtained its data from the poison centers that serve the 50 states, the District of Columbia, and US Territories. The study reviewed all calls reporting exposure to conventional cigarettes, e-cigarettes, or nicotine liquid used in e-cigarettes. From September 2010 through February 2014, poison centers reported 2,405 e-cigarette and 16,248 cigarette exposure calls. The agency notes that the total number of poisoning cases is probably higher than the rate found in the study because not all exposures might have been reported to poison centers.

“The most recent National Youth Tobacco Survey showed e-cigarette use is growing fast, and now this report shows e-cigarette related poisonings are also increasing rapidly,” explained Tim McAfee, MD, MPH, Director of CDC’s Office on Smoking and Health. He added, “Healthcare providers, e-cigarette companies and distributors, and the general public need to be aware of this potential health risk from e-cigarettes.”

The CDC stresses that, with the dramatic increase in e-cigarette usage, strategies need to be developed to monitor and prevent future poisonings. The report noted that e-cigarette liquids containing nicotine have the potential to cause immediate adverse health effects; thus, they represent an emerging public health concern.

Some e-cigarette users have switched to e-cigarettes in an attempt to quit smoking; however a study published online on March 24 in the journal JAMA Internal Medicine by researchers at the University of California, San Francisco found that they were ineffective for that purpose. Another study, released on December 2013 raised the issue of harm from second hand smoke exposure from e-cigarettes.