E-Cigarette-Related Poison Center Calls Surge

Laird Harrison

April 03, 2014

Calls to poison centers involving e-cigarettes have surged during the last 3 and half years, a new study shows.

The number of calls shot up from 1 per month in September 2010 to 215 per month in February 2014, researchers for the Centers for Disease Control and Prevention report in the April 4 issue of the Morbidity and Mortality Weekly Report.

"This report raises another red flag about e-cigarettes — the liquid nicotine used in e-cigarettes can be hazardous," said CDC Director Tom Frieden, MD, MPH, in a CDC press release. "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."

More than half (51.1%) of the calls to poison centers because of e-cigarettes involved children 5 years and younger, the researchers report. Many states do not restrict the sale of e-cigarettes to minors.

The number of calls per month involving conventional cigarettes did not show a similar increase during the same period.

Poisoning from conventional cigarettes is generally caused by young children eating them. Poisoning related to e-cigarettes involves the liquid containing nicotine used in the devices and can occur in 3 ways: ingestion, inhalation, or absorption through the skin or eyes.

Among the calls involving e-cigarettes, 16.8% were for inhalation, 8.5% for eye exposure, 5.9% for skin exposure, and 68.9% for ingestion (P < .001).

Calls about e-cigarettes included reports of adverse health events 57.8% of the time, with vomiting, nausea, and eye irritation being the most common complaints. In contrast, 36.0% of the conventional cigarette callers reported an adverse event (P < .001).

Data for this study came from the poison centers that serve the 50 states, the District of Columbia, and US Territories. The study examined all calls reporting exposure to conventional cigarettes, e-cigarettes, or the nicotine liquid used in e-cigarettes.

Poison centers reported 2405 e-cigarette and 16,248 cigarette exposure calls from September 2010 to February 2014. The total number of poisoning cases is likely higher than reflected in this 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," Tim McAfee, MD, MPH, director of the CDC's Office on Smoking and Health, said in the press release. "Health care providers, e-cigarette companies and distributors, and the general public need to be aware of this potential health risk from e-cigarettes."

The authors have disclosed no relevant financial relationships.

Morb Mortal Wkly Rep. 2014;63:292-293. Full text

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