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The number of calls to poison centers involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014, according to a study by researchers at the Centers for Disease Control and Prevention. The number of calls per month involving conventional cigarettes did not show a similar increase during the same time period.

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In the study, published in the CDC's Morbidity and Mortality Weekly Report (2014;63:292-293), more than half (51.1%) of the calls to poison centers due to e-cigarettes involved young children under age five, and about 42 percent of the poison calls involved people age 20 and older.


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


The researchers (first author was Kevin Chatham-Stephens, MD, an Epidemic Intelligence Service Officer) noted that whereas 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," CDC Director Tom Frieden, MD, MPH, said in a news release. "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 the products are not required to be childproof, and they come in candy and fruit flavors that are appealing to children."


In the study, e-cigarette calls to poison centers were more likely than cigarette calls to include a report of an adverse health effect following exposure, the study showed. The most common adverse health effects mentioned in e-cigarette calls were vomiting, nausea, and eye irritation.


The data 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 researchers noted that the total number of poisoning cases is likely higher than reflected in the study, because not all exposures might have been reported to poison centers.


CDC Office of Smoking and Health Director Tim McAfee, MD, MPH, said, "The most recent National Youth Tobacco Survey showed that e-cigarette use is growing fast, and now this report shows that e-cigarette related poisonings are also increasing rapidly. Health care providers, e-cigarette companies and distributors, and the general public need to be aware of this potential health risk from e-cigarettes."