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How new rules could kill the vaping boom

Sep 29th, 2015
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http://fortune.com/2015/09/29/vaping-fda-rules/

If proposed FDA rules are finalized, as expected, most vaping shops will not survive, many say.

When Randy Freer was trying to quit smoking, he wanted to try vaping—battery-operated devices that deliver nicotine by vaporizing liquids. (Some ex-smokers find the combo of the flavors and the ability to dial down the nicotine helps them quit.) But Freer found he couldn’t keep a supply of the vaporizers he liked—they were always out of stock.

So being the entrepreneurial type, he created his own e-liquids to vape. In 2012, he launched P.O.E.T. (Pursuit of Excellent Taste), a small business based in Seal Beach, California, that sells e-liquids. Three years later, he says his company sells to some 130 stores internationally as well as online, and has $500,000 in annual sales.

But all that could disappear if the Food and Drug Administration (FDA), as expected, finalizes its rules on e-cigarettes and other vaping products. The rules would require federal approval for most flavored liquid nicotine juices and e-cig devices sold in vape shops.

“If that [FDA rule] goes through, it’ll put me back into the job market,” Freer says.

He and practically everyone else in the vaping business. According to one estimate, the approval process would require such an extensive data collection for each item that it could businesses cost $2 million to $10 million, the Wall Street Journal reported.

“Essentially the FDA regulation is a guaranteed death knell for over 99% of the companies in the industry,” says Gregory Conley, president of the American Vaping Association, an advocacy group. That would affect the estimated 8,000 to 12,000 vape shops in the United States and the estimated 1,000 manufacturers and wholesalers of vaping equipment.

Tobacco giants produce the e-cigarette brands, which look like cigarettes and are sold in supermarkets. But, second generation vaporizers—the kind sold by small and mid-sized businesses, like Freer’s — are larger, more like fountain pens, and users can customize them with different flavored e-liquids. They also have bigger batteries and cartridges so they can last longer.

Under the FDA proposed rules, there would be a retroactive premarket review of any e-cigarette or vaping product on the market after 2007, unless they can show the product is “substantially equivalent” to one on the market before 2007. Since the industry has evolved so quickly, today’s products have little equivalence to products on the market before 2007. “It essentially means that the FDA is retroactively requiring all products on the market to submit a new tobacco product application,” says Conley.

Pressure on the vaping industry

The FDA is proposing different compliance dates to give a little leeway for small businesses, so the regulations may not be noticeable to vapers for a couple of years. But there is a lot of pressure to restrict vaping and e-cigarette sales.

All US states except for Maine, Pennsylvania and Michigan have laws that prohibit selling e-cigarettes and vaping products to minors. This year, there were roughly 200 bills introduced across 40 states that addressed some aspect of e-cigarette and vapor product regulation. “The overall theme of this legislation is an effort to fold vapor products into existing laws that apply to combustible cigarettes and other tobacco products,” says Alex Clark, legislative director of the Consumer Advocates for Smoke-free Alternatives Association, an advocacy organization that promotes the right to cigarette alternatives.

The bills include taxing e cigarettes and vaping devices, prohibiting vaping where smoking is banned, prohibiting flavoring and advertising that is intended to appeal to minors, requiring licensing of vaping shops, labeling laws, and child resistant packaging. Jumping on the regulation bandwagon, the National Park Service just announced that it would ban vaping from its parks.

Consumer advocates are pushing for regulations, saying vaping presents major health concerns. In a recent report by the Center for Environmental Health, entitled, “Smoking Gun: Cancer-causing chemicals in e-cigarettes,” the group said it found the majority of e-cigarettes and other vaping products tested contained high levels of cancer-causing chemicals formaldehyde and acetaldehye. The group said it was “concerned about the unregulated marketing of e-cigarettes, and especially sales to teens and young people, while little is known about the health hazards from inhaling e-cigarette smoke.”

Yet many e-cig users say it helps people quit smoking and believe these e-cigs are at least safer than regular cigarettes. They say that taking them off the market will hurt the chances of quitting for millions of current smokers. Dr. Gregory Masters, an oncologist in Newark, Del., recently told WebMD he understands the conflicted public opinion. “I do have safety concerns for e-cigarettes because nicotine is bad for you, and we don’t know all of the risks with e-cigarettes,” said Masters. “I struggle when I get asked by patients, should I use e-cigarettes? I don’t want to condone e-cigarettes as a healthy alternative, but could it be a less dangerous alternative? It could be.”

Laurie Tarkan is an award-winning health journalist who writes for The New York Times, national magazines, and websites. She is the three-time recipient of the National Health Information Awards, and won the Rose Kushner Award for Writing Achievement in the Field of Breast Cancer.

Use of Investigational Tobacco Products

Sep 16th, 2015
by Editor.
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Federal Register, Volume 80 Issue 177

Sep 14th, 2015
by AdminCTA.
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http://www.gpo.gov/fdsys/pkg/FR-2015-09-14/html/2015-23001.htm

[Federal Register Volume 80, Number 177 (Monday, September 14, 2015)]

[Notices]

[Pages 55124-55125]

From the Federal Register Online via the Government Publishing Office [www.gpo.gov]

[FR Doc No: 2015-23001]

———————————————————————–

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2013-D-1600]

Enforcement Policy for Certain (Provisional) Tobacco Products That the Food and Drug Administration Finds Not Substantially Equivalent; Guidance for Industry and Tobacco Retailers; Availability

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice.

———————————————————————–

SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry entitled “Enforcement Policy for Certain (Provisional) Tobacco Products that FDA Finds Not Substantially Equivalent.” This guidance provides information to tobacco retailers on FDA’s enforcement policy regarding certain so-called provisional tobacco products that become subject to not substantially equivalent (NSE) orders issued under the Federal Food, Drug, and Cosmetic Act (the FD&C Act).

DATES: Submit either electronic or written comments on Agency guidances at any time.

ADDRESSES: Submit written requests for single copies of this guidance to the Center for Tobacco Products, Food and Drug Administration, Document Control Center, 10903 New Hampshire Ave., Bldg. 71, Rm. G335, Silver Spring, MD 20993-2000. Send one self-addressed adhesive label to assist that office in processing your request or include a fax number to which the guidance document may be sent. See the SUPPLEMENTARY

INFORMATION section for information on electronic access to the guidance. Submit electronic comments on the guidance to  http://www.regulations.gov. Submit written comments to the Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. Identify comments with the docket number found in brackets in the heading of this document.

FOR FURTHER INFORMATION CONTACT: Annette Marthaler, Center for Tobacco Products, Food and Drug Administration, Document Control Center, 10903 New Hampshire Ave., Bldg. 71, Rm. G335, Silver Spring, MD 20993-2000, email: CTPRegulations@fda.hhs.gov.

SUPPLEMENTARY INFORMATION:

I. Background

FDA is announcing the availability of a guidance for industry entitled “Enforcement Policy for Certain (Provisional) Tobacco Products that FDA Finds Not Substantially Equivalent.” This guidance provides information to tobacco retailers on FDA’s enforcement policy regarding certain so-called provisional tobacco products that become subject to NSE orders issued under the FD&C Act. We received several comments to the draft guidance (79 FR 10534, February 25, 2014), and those comments were considered as the guidance was finalized.

II. Significance of Guidance

This guidance is being issued consistent with FDA’s good guidance practices regulation (21 CFR 10.115). The guidance represents the current thinking of FDA on “Enforcement Policy for Certain (Provisional) Tobacco Products that FDA Finds Not Substantially Equivalent.” It does not establish any rights for any person and is not binding on FDA or the public. You can use an alternative approach if it satisfies the requirements of the applicable statutes and regulations.

III. Comments

A. General Information About Submitting Comments

Interested persons may submit either electronic comments regarding this document to http://www.regulations.gov or written comments to the Division of Dockets Management (see ADDRESSES). It is only necessary to send one set of comments. Identify comments with the docket number found in brackets in the heading of this document.

B. Public Availability of Comments

Received comments may be seen in the Division of Dockets Management between 9 a.m. and 4 p.m., Monday through Friday, and will be posted to the docket at http://www.regulations.gov. As a matter of Agency practice, FDA generally does not post comments submitted by individuals in their individual capacity on http://www.regulations.gov. This is determined by information indicating that the submission is written by an individual, for example, the comment is identified with the category “Individual Consumer” under the field titled “Category (Required),” on the “Your Information” page on www.regulations.gov. For this docket, however, FDA will not be following this general practice.

Instead, FDA will post on http://www.regulations.gov comments to this docket that have been submitted by individuals in their individual capacity. If you wish to submit any information under a claim of confidentiality, please refer to 21 CFR 10.20.

C. Information Identifying the Person Submitting the Comment

Please note that your name, contact information, and other information identifying you will be posted on http://www.regulations.gov if you include that information in the body of your comments. For electronic comments submitted to http://www.regulations.gov, FDA will post the body of your comment on http://www.regulations.gov along with your State/province and country (if provided), the name of your representative (if any), and the category identifying you (e.g., individual, consumer, academic, industry). For written submissions submitted to the Division of Dockets Management, FDA will post the body of your comments on http://www.regulations.gov, but you can put your name and/or contact information on a separate cover sheet and not in the body of your comments.

IV. Electronic Access

Persons with access to the Internet may obtain an electronic version of the guidance at either http://www.regulations.gov or http://www.fda.gov/TobaccoProducts/GuidanceComplianceRegulatoryInformation/default.htm.

Dated: September 9, 2015.

Leslie Kux,

Associate Commissioner for Policy.

[FR Doc. 2015-23001 Filed 9-11-15; 8:45 am]

BILLING CODE 4164-01-P

Public support for graphic health warning labels in the U.S.

Sep 11th, 2015
by Editor.
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http://www.ncbi.nlm.nih.gov/pubmed/25217818

Abstract

BACKGROUND:

In 2009, the U.S. Food and Drug Administration was required to mandate that graphic health warning labels be placed on cigarette packages and advertisements.

PURPOSE:

To assess public support in the U.S. for graphic health warning labels from 2007 to 2012.

METHODS:

Data from 17,498 respondents from 13 waves of the National Adult Tobacco Survey, a list-assisted random-digit-dial survey, were used. Overall support for graphic health warning labels, as well as support by smoking status, and by sociodemographics and smoker characteristics are estimated. Analyses were conducted in 2014.

RESULTS:

Since 2007, a majority of the public overall has been in favor of labels. Support increased significantly among the public overall and among non-smokers from 2007 through 2009 (p<0.001), after which it remained flat. Among smokers, support levels increased from 2007 through 2011 (p<0.001), but decreased significantly from 2011 through 2012 (p<0.001). Support was high regardless of smoking status, although among smokers, support varied by level of smoking, interest in quitting, and whether labels were seen as an important reason to quit. Support varied by sociodemographic characteristics, particularly among smokers. Younger, less-affluent, and less-educated smokers supported labels at higher levels than their counterparts.

CONCLUSIONS:

A majority of U.S. residents support graphic health warning labels for cigarette packs, though support among smokers declined after 2011.

Food and Drug Administration’s (FDA) Deeming Tobacco Products proposed rule

Aug 8th, 2015
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FDA questions evidence for lower-risk tobacco product

Apr 7th, 2015
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http://www.mailonsunday.co.uk/wires/ap/article-3029030/FDA-questions-evidence-lower-risk-tobacco-product.html

WASHINGTON (AP) — U.S. health regulators have questions about the data submitted by tobacco maker Swedish Match in its bid to become the first company to market a smokeless tobacco product as less harmful than cigarettes.

Food and Drug Administration scientists say they have “concerns” about how the company studied its snus tobacco product and its proposal to modify cancer warning language on the packaging.

Snus are teabag-like pouches or loose tobacco that users stick between their cheek and gum to absorb nicotine. They are popular in Scandinavian countries and are part of a growing smokeless tobacco market in the U.S.

The FDA has scheduled a two-day meeting to review Swedish Match’s data intended to show that snus do not carry the same risks of mouth cancer, gum disease and tooth loss as other tobacco products.

In an application filed in June, Swedish Match, whose North American headquarters is in Richmond, Virginia, proposed a new warning emphasizing that snus are less risky than smoking: “No tobacco product is safe but this product presents substantially lower risks to health than cigarettes.”

But in a scientific review posted Tuesday, FDA staff question whether that language “adequately reflects the health risks of using snus.”

Swedish Match also wants FDA clearance to remove a warning about mouth cancer from its product. But agency staffers note that the studies submitted by the company may have underestimated cases of mouth cancer as users quit using snus.

Among other changes, Swedish Match wants the FDA to permit dropping another warning that smokeless tobacco products can cause gum disease and tooth loss. But regulators note a number of shortcomings with the company studies of that issue, including small populations that were often made up of adolescents and young adults. Additionally regulators say the company “does not provide an argument as to why it is biologically plausible that effects of snus on gum disease and tooth loss would be significantly different from other smokeless tobacco products.”

The agency will ask an advisory panel to weigh in on these and other issues. The FDA is not required to follow the advice of the group, which is composed of outside experts specializing in tobacco control, public health and cancer care.

The advisory panel’s review and FDA’s ultimate action on the application are being closely watched by both the public health community and tobacco companies, which are looking for new products to sell as they face declining cigarette demand due to tax increases, health concerns, smoking bans and social stigma.

Under a 2009 law, the FDA was given authority to evaluate tobacco products for their health risks and approve ones that could be marketed as safer than others. The agency has received 17 applications for such products, according to an agency spokeswoman, but none has been given the OK yet. Ten are currently pending review. Agency officials have previously noted that some tobacco products could pose less of a health risk to users than smoking.

Available Evidence Suggests That Possible Regulation of Cigarettes Not Likely to Significantly Change U.S. Illicit Tobacco Market

Feb 19th, 2015
by Editor.
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http://www8.nationalacademies.org/onpinews/newsitem.aspx

WASHINGTON — Although there is insufficient evidence to draw firm conclusions about how the U.S. illicit tobacco market would respond to any new regulations that modify cigarettes—for example, by lowering nicotine content—limited evidence suggests that demand for illicit versions of conventional cigarettes would be modest, says a new congressionally mandated report from the National Research Council and Institute of Medicine.

Tobacco use has declined in the past few decades due to measures such as high taxes on tobacco products and bans on advertising, though there are still more than 1 billion people worldwide who regularly use tobacco, including many who purchase their products illicitly. Illicit tobacco markets can undermine public health efforts to reduce tobacco use, while depriving governments of revenue. In the United States, the revenue losses are borne mostly by the states.

As the U.S. Food and Drug Administration considers possible regulations for tobacco products, the agency asked the National Research Council and the Institute of Medicine to examine the U.S. and international markets for illicit cigarettes and the evidence on how illicit markets react to various policies and regulations.

Currently, the U.S. illicit tobacco market primarily consists of bootlegging from Native American reservations and low-tax states, such as Virginia, to high-tax states, such as New York. Bootlegging is the legal purchase of cigarettes in one jurisdiction and their consumption or resale in another, without the payment of applicable taxes or duties in the jurisdictions where they are resold. Large-scale international smuggling, counterfeit cigarettes, and “illicit whites” — cigarettes legally produced under unique brand names or no brand name — which are prevalent in many other countries, are largely absent from the U.S. market, the report says.

The portion of the total U.S. tobacco market represented by illicit sales is between 8.5 percent and 21 percent, or 1.24 billion to 2.91 billion packs of cigarettes annually, concluded the committee that conducted the study. This share has nearly tripled over the past two decades.

The illicit tobacco market is not evenly distributed across states: it may constitute as much as 45 percent of all tobacco sales in high-tax states, such as New York, while it is low in many other states. The committee classified 22 states and the District of Columbia as net exporters, and 28 states as net importers. In 2011 the net importing states lost an estimated $2.95 billion in state and local cigarette excise taxes, with New York accounting for nearly half of this total. The net exporting states gained an estimated $0.82 billion.

The people involved in the segments of the distribution process of illicit tobacco generally do not have serious criminal records, and this market is not associated with violence, either abroad or in the United States, the report says. Although many claims have been made regarding the relationship between illicit tobacco trade and terrorism, the link between the U.S. illicit tobacco market and terrorism appears to be minor, and there is also no evidence of sustained links between the global illicit tobacco trade and terrorism.

Enforcement efforts are challenged by the changing nature of illicit tobacco markets, the need to coordinate across various agencies and levels of government, and the fact that illicit tobacco trade has been a low priority. Law enforcement efforts to investigate the illicit trade tend to be weak and uneven, and criminal prosecution of those involved is a low priority for prosecutors. Although the committee was able to obtain only limited information on enforcement activity and successes by agencies, it concluded that the risks of detection and prosecution for tobacco smugglers are small.

Comprehensive interventions adopted by several countries show that it is possible to reduce the size of the illicit tobacco market through tobacco-specific enforcement resources and collaboration across jurisdictions. For example, Spain reduced the illicit share of its market from 15 percent in 1995 to 2 percent in 2001 through licensing and control measures, enforcement efforts, and legal agreements. The United Kingdom used stamping and marking requirements on cigarettes, agreements with tobacco manufacturers, enhanced enforcement efforts, and public education campaigns to reduce the size of its illicit market from 21 percent in 2000 to 9 percent in 2013.

“In the future, non-price regulation of cigarettes – such as product design, formulation, and packaging – could, in principle, contribute to the development of new types of illicit tobacco markets if incentives for such illicit trade are not controlled or mitigated,” said Peter Reuter, committee chair and professor in the school of public policy and department of criminology at University of Maryland. “However, based on the limited available evidence we reviewed, if new regulations were introduced, any increase in the demand for illicit tobacco may only be modest.”

In trying to assess the possible effects of regulations on the illicit market, the committee examined experimental studies on how modifying cigarettes might affect their product appeal for consumers. Such modifications as reducing ignition capacity–requiring that cigarettes extinguish when not actively puffed–and decreasing filter ventilation have shown only modest impact on product appeal when considered in isolation from other product features. Reducing nicotine levels or mentholation has been shown in experimental studies to have a stronger effect on reducing product appeal. Behavioral responses to reduced nicotine or mentholation have been mixed in short-term studies, with some smokers indicating that they intend to quit while others are able to tolerate product changes with little to no change in individual cigarette consumption.

Cigarette packs with large graphic warning labels or in plain packaging have also been shown to reduce product appeal. In countries that have implemented regulations on packaging, some smokers have been observed to use stickers or branded containers to conceal graphic health warnings – strategies that subvert the intent of the law to reduce tobacco use, but which are an alternative to purchasing illicit products.

In order to better understand the nature of existing illicit tobacco markets and the ways they may evolve in the future, additional research and data are needed across a broad range of areas, including deeper knowledge on the individual and criminal networks that traffic in illicit tobacco in the U.S., an examination of how smokers respond to the permanent loss of specific product features they previously found desirable, and the relationship between e-cigarette use and the use of conventional tobacco products.

The study was sponsored by the U.S. Food and Drug Administration. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies. They are private, independent nonprofit institutions that provide science, technology, and health policy advice under a congressional charter granted in 1863. The National Research Council is the principal operating arm of the National Academy of Sciences and the National Academy of Engineering. For more information, visit www.national-academies.org. A committee roster follows.

Contacts:
Dana Korsen, Media Officer
Chelsea Dickson, Media Associate
Office of News and Public Information
202-334-2138; e-mail news@nas.edu
http://national-academies.org/newsroom
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E-Cig Liquid Nicotine Linked To 1-Year-Old’s Death; Poison Control Centers Say FDA Should Move Forward With Regulations

Dec 15th, 2014
by Editor.
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http://www.medicaldaily.com/e-cig-liquid-nicotine-linked-1-year-olds-death-poison-control-centers-say-fda-should-314392

E-cigarettes, with their reputation for being safer than regular cigarettes, have seen record gains in usage. Their use among middle and high school students more than tripled between 2011 and 2013, going from 79,000 to 263,000 students, according to an August study. And on Thursday, the Centers for Disease Control and Prevention (CDC) released a report showing that 10 states and the District of Columbia don’t restrict e-cig sales to minors, giving over 16 million children access to the devices and liquid nicotine. The Food and Drug Administration (FDA) has stalled passing any sort of regulations on these products, and it’s because of this that a 1-year-old toddler from upstate New York died last week.

The toddler, from Fort Plain, N.Y., died last Tuesday after ingesting liquid nicotine. It’s believed he’s the first child in the U.S. to die from the product, which is sold in bottles, separate from the e-cigarette devices. After the child was found unresponsive, he was immediately taken to a hospital where he was pronounced dead, ABC News reported. Although the nicotine is commonly used for e-cigarettes, Fort Plain police didn’t specify in a statement whether it was associated with the device.

The child’s death brings to the forefront these regulation issues, which have largely gone under the radar since the FDA first proposed new ones in August. “One teaspoon of liquid nicotine could be lethal to a child, and smaller amounts can cause severe illness, often requiring trips to the emergency department,” the American Association of Poison Control Centers said in a statement on Friday, according to ABC News. “Despite the dangers these products pose to children, there are currently no standards set in place that require child-proof packaging.”

The Association also said that rates of nicotine exposure, either through ingestion, inhalation, or absorption through skin had risen since 2011, when there were only 271 exposures. As of Nov. 30, there had already been 3,638 exposures in 2014. “They’re not that difficult to get into,” Dr. Donna Seger, director of the poison control center at Vanderbilt University Medical Center, told ABC News. With many of these bottles containing colorful, flavored nicotine, such as chocolate, berry, and cotton candy, it’s no wonder kids see them and think they’re something else. Making the issue worse is that it’s not always clear how concentrated the liquid is with nicotine — they come in strengths ranging from 6 to 24 milligrams.

Nicotine poisoning has been associated with symptoms from nausea and vomiting to more dire conditions, such as a slowed heart rate, low blood pressure, seizures, lethargy, paralysis, and coma. According to ABC News, some states have begun implementing laws requiring child-resistant packaging. New York Gov. Andrew Cuomo is expected to sign one of these bills within the next few weeks.

E-Cigarette Gateway to Addiction

Apr 14th, 2014
by AdminCTA.
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E-cigs linked to spike in calls to poison centers

Apr 4th, 2014
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CDC says more monitoring of nicotine exposure through e-cigarette liquid is needed

https://www.consumeraffairs.com/e-cigarette-warnings-and-lawsuits

There’s been a huge increase in the last few years in the number of calls to poison centers involving e-cigarette liquids containing nicotine.

A CDC study published in the agency’s Morbidity and Mortality Weekly Report says calls shot up from 1 per month in September 2010 to 215 per month this past February. And, the report says, the number of calls per month involving conventional cigarettes did not show a similar increase during the same time period.

Sen. Barbara Boxer (D-Calif.) called the increase in poisoning cases “alarming” and said the report “should serve as a wake-up call to the American people that it is time for the FTC and the FDA to regulate these products to help prevent more tragedies.”

“I am particularly concerned that many e-cigarettes are packaged in bright colors and flavored to smell like candy or fruit, which puts children at higher risk of poisoning,” Boxer said.

In February, Boxer introduced the Protecting Children from Electronic Cigarette Advertising Act to prohibit the marketing of e-cigarettes to children and teens.

The trade group for e-cigarette manufacturers, the Smoke Free Alternatives Trade Association (SFATA), said it supports stronger safety measures. In a statement, executive director Cynthia Cabrera said the manufacturers “support federal age restrictions on the purchase of vapor products, childproof caps and proper labeling to safeguard against accidental ingestion of e-liquid by minors or adults.”

Kids at risk

More than half (51.1%) of the calls to poison centers due to e-cigarettes involved young children 5 years and under, and about 42% of the poison calls involved people age 20 and older.

The analysis, which compared total monthly poison center calls involving e-cigarettes and conventional cigarettes, found the proportion of e-cigarette calls jumped from 0.3% in September 2010 to 41.7% in February 2014.

Poisoning from conventional cigarettes is generally due to young children eating them. Poisoning related to e-cigarettes involves the liquid containing nicotine used in the devices and 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,” said CDC Director Tom Frieden, M.D., M.P.H. “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.”

A sweeping study

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

Poison centers reported 2,405 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, CDC says, 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,” said Tim McAfee, M.D., M.P.H., Director of CDC’s Office on Smoking and Health. “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 report shows that e-cigarette liquids containing nicotine have the potential to cause immediate adverse health effects and represent an emerging public health concern. That, according to CDC, makes developing strategies to monitor and prevent future poisonings critical.

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