The safety of e-cigarettes has caused much debate in recent months. Now, a report from the Centers for Disease Control and Prevention reveals that the number of phone calls to poison centers involving e-cigarette liquids containing nicotine has dramatically increased, from one call per month in 2010 to 215 calls per month in 2014.
E-cigarettes (electronic cigarettes) are battery-operated devices that simulate tobacco smoking. The devices contain a heating element and a liquid solution. When the user sucks on the device, a sensor activates the heating element, which vaporizes the liquid solution and enables the user to inhale it.
The liquid solutions come in many different flavors and typically contain nicotine, although there are solutions available that do not contain nicotine.
The use of e-cigarettes has boomed in recent years. The National Youth Tobacco Survey (NYTS) 2011-12, also from the Centers for Disease Control and Prevention (CDC), found that e-cigarette use has more than doubled among middle and high school students from 2011 to 2012.
Many observers believe that because e-cigarettes do not contain tar - the ingredient in conventional cigarettes that is the root of health problems linked to smoking - they are a healthier alternative and can encourage a smoker to quit the habit. But the jury is still out regarding their safety.
E-cigarettes still contain nicotine - the addictive stimulant found in tobacco. Because of this, there is concern that the devices may encourage individuals to take up conventional smoking. In 2012, Medical News Today reported on a study suggesting that e-cigarettes can still harm the lungs.
Now, this most recent report from the CDC raises further safety concerns and shows that those affected do not even have to be users of the device.
More than 50% of calls involved children 5 years of age and under
To reach their findings, the study researchers assessed data from the poison centers that serve all states across the US, as well as centers that serve the District of Columbia and US territories.
More than half of e-cigarette-related phone calls to poison centers involved children aged 5 years and under, according to the report.
The team focused on calls that reported exposure to conventional cigarettes, e-cigarettes or the nicotine liquid used in e-cigarettes.
Between September 2010 and February 2014, the poison centers reported 2,405 calls related to e-cigarettes and 16,248 calls related to cigarette exposure. The researchers note that these numbers are likely to be higher, since it is possible that not all exposures would have been reported to poison centers.
The researchers found that the number of total monthly calls relating to e-cigarette poisoning increased from 0.3% to 41.7% during the study period, while the number of calls relating to conventional cigarette poisoning did not show a similar increase.
Furthermore, the report reveals that more than half of these calls (51.1%) involved children aged 5 years and under. Approximately 42% of the calls involved individuals aged 20 years and over.
According to the investigators, child poisoning from traditional cigarettes is usually a result of children eating them, while poisoning related to e-cigarettes involves the nicotine-containing liquid, which is either ingested, inhaled or absorbed through the skin and eyes.
Calls relating to e-cigarettes were more likely to involve reports of adverse health effects after exposure - such as vomiting, nausea and eye irritation - than calls linked to conventional cigarettes.
Commenting on the findings, Dr. Tom Frieden, director of the CDC, says:
"This report raises another red flag about e-cigarettes; the liquid nicotine used in e-cigarettes can be hazardous.
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."
The researchers conclude that creating strategies to monitor and prevent future poisonings is "critical."
They add that health care providers, the public health community, those involved in manufacturing, selling, distributing or marketing e-cigarettes and the general public should be vigilant that e-cigarettes "can cause adverse health affects and represent an emerging public health concern."
Earlier this year, a spotlight feature from Medical News Today discussed how policy makers should react to the rapid increase in e-cigarette usage.