CDC Report Finds Poison Center Calls Skyrocket for e-Cigarettes

Electronic cigarettes are devices that allow people to inhale nicotine, flavorings, and other chemicals without having to smoke a conventional cigarette.  Although e-cigarette health risks are not fully understood, calls to U.S. poison centers regarding e-cigarette exposures increased over a hundred-fold between September 2010 and February 2014.  The information was revealed in an April 2014 report from the Centers for Disease Control.

CDC report on e-cigarette exposures

The Centers for Disease Control (CDC) report looked at calls made to U.S. poison centers each month over a three-and-a-half year period.  In February 2010, poison centers first assigned e-cigarette exposure calls a specific code in order to distinguish such calls from other types of poison reports.  The number of e-cigarette calls per month rose steadily over the next three and one-half years.  By February 2014, e-cigarette exposure calls reached 215 per month – roughly two-thirds of the number of calls associated with conventional tobacco cigarettes.

E-cigarette exposure calls were more than twice as likely to come from health care facilities compared with conventional cigarette reports (12.8% v. 5.9%), which may indicate more serious health effects from the e-cigarettes.  Indeed, of those calls that reported the severity of the health effects, e-cigarette exposure calls were 60% more likely to contain such information as were calls regarding tobacco cigarettes.   The most common adverse health effects reported by e-cigarette callers were nausea, vomiting, and eye irritation.

The types of exposure reported differed significantly between e-cigarettes and conventional tobacco cigarettes.  E-cigarette exposures were far more likely to be reported as inhalations, eye exposures, and skin exposures.  By contrast, the vast majority of tobacco cigarette poison center calls involved cigarette ingestion (97.8%), whereas e-cigarette ingestion calls constituted 68.9% of calls.

The disparity between methods of exposure reflects the differing demographics of those exposed to the two products.  Roughly 95% of calls involving conventional cigarette exposure involved children under the age of 5.  Where e-cigarette poisoning was concerned, 42% related to people over age 20, and 51.1% involved children under 5.

Health risks of e-cigarettes

The FDA does not regulate e-cigarettes unless they claim to have some therapeutic effect.  As a result, there is virtually no regulation of the design, content, marketing, distribution, sales, or use of e-cigarettes in the United States.  Many states place no restrictions on the sale of e-cigarettes to minors.  Perhaps not surprisingly, e-cigarette use is increasing among both adolescents and adults.

In a 2013 CDC report, the agency noted that “E-cigarette experimentation and recent use doubled among U.S. middle and high school students during 2011–2012, resulting in an estimated 1.78 million students having ever used e-cigarettes as of 2012. Moreover, in 2012, an estimated 160,000 students who reported ever using e-cigarettes had never used conventional cigarettes.”

The FDA announced its intention to regulate e-cigarettes as “tobacco products” in April 2011, but no regulation has been proposed as yet.  Given the potential negative effects of nicotine on brain development, especially among adolescents, parents, physicians, public health specialists and others are no doubt eagerly awaiting the FDA’s action.