Calls to U.S. poison control centers because of e-cigarette exposure increased from 1 per month in September 2010 to 215 per month in February 2014, according to a new study published in the April 3 edition of the Morbidity and Mortality Weekly Report.
"Calls about exposures to e-cigarettes, which were first marketed in the United States in 2007, now account for 41.7% of combined monthly e-cigarette and cigarette exposure calls to [poison control centers]," wrote the investigators, led by Dr. Kevin Chatham-Stephens of the CDC (MMWR Morb. Mortal. Wkly Rep. 2014;63:291-2).
Researchers from the Centers for Disease Control and Prevention analyzed data from 2,405 e-cigarette calls to poison control centers in all 50 states, the District of Columbia, and U.S. territories from September 2010 to February 2014. Although calls regarding overexposure are much more common with conventional tobacco products (16,248 calls over the same period of time), the investigators noted that 42% of the e-cigarette exposure calls involved people aged 20 years and older, whereas 94.9% of tobacco exposure calls involve children younger than 5 years.
In addition, health care facilities were responsible for significantly more of the e-cigarette exposure calls than for cigarette exposure calls, 12.8% vs. 5.9%. And callers were significantly more likely to report adverse health effects with e-cigarette exposures (57.8% of calls) than with cigarette exposures (36% of calls).
Poisoning cases can occur either from an exposure to the device itself or to the nicotine liquid contained in a small cartridge that the user inserts into the e-cigarette. Exposure to the liquid can occur through inhalation, ingestion, or absorption, and the most common adverse health effects in e-cigarette exposure calls were vomiting, nausea, and eye irritation.
“New data released today from the federal government confirms pediatricians’ concerns about e-cigarettes and their liquid nicotine refills: they are poisoning children at an alarming rate," Dr. James M. Perrin, president of the American Academy of Pediatrics, said in a statement.
“As pediatricians, we do everything in our power to keep our young patients safe from poisonous products, like household cleaners and prescription medications. Why should we act differently when it comes to liquid nicotine? The e-cigarette industry specifically targets children and teens with appealing flavors like cotton candy and gummy bear, and neither these products nor their liquid nicotine refills are currently regulated by the federal government," he said.
"Pediatricians call on the U.S. Department of Health and Human Services to convene Centers for Disease Control and Prevention, Food and Drug Administration, and other federal agencies and develop a national plan of action to keep children safe from e-cigarette poisoning. With more and more children being exposed to these dangerous products each month, we cannot afford to wait another day,” concluded Dr. Perrin, professor of pediatrics at Harvard Medical School, Boston.
Currently, e-cigarettes and their components that are marketed for therapeutic purposes such as smoking cessation are not regulated by the FDA Center for Tobacco Products, but are instead regulated by FDA Center for Drug Evaluation and Research.
*This article was updated 4/3/2014.