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E-cigs linked to spike in calls to poison centers

CDC says more monitoring of nicotine exposure through e-cigarette liquid is needed

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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