The number of calls to poison centers regarding e-cigarette liquids containing nicotine has increased dramatically in recent years from just one a month in 2010 to 215 a month by April 2014, according to the Centers for Disease Control and Prevention (CDC). According to the CDC, more than 50 percent of calls to poison centers involved children younger than 6 years old; about 42 percent of the calls involved people 20 years of age and older. However, the CDC says the total number of cases is likely higher, as not all incidents of poisoning are reported.
E-cigarettes, or electronic cigarettes, are battery-operated devices designed to simulate cigarette smoking. Users suck on the device, which activates a heating element inside that vaporizes a liquid solution that users inhale. The liquids come in a variety of flavors, most of which contain nicotine. The devices have increased in popularity in recent years, particularly because they are considered by some proponents to be a safer alternative to cigarette smoking because they do not contain tar.
But a new report indicates that increasing numbers of U.S. teens may be using e-cigarettes for recreational purposes. The cigarettes are battery operated and are designed to mimic the look and feel of a real cigarette. Instead of tobacco smoke, however, e-cigarettes deliver a vapor containing nicotine, flavorings, and other chemicals.
The CDC noted E-cigarette use among U.S. middle- and high-school teens doubled in 2012 from the previous year, indicating that many young people could be getting set up for a lifelong addiction to nicotine. The CDC reports that 10 percent of the high school students and 2.7 percent of middle school students it surveyed used e-cigarettes in 2012, up from 4.7 percent and 1.4 percent, respectively, in 2011. The CDC estimated that nearly 1.8 million middle- and high-school students tried e-cigarettes for the first time in 2012. CDC Director Tom Frieden observed:
The increased use of e-cigarettes by teens is deeply troubling. Nicotine is a highly addictive drug. Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes.
Currently, marketing campaigns by e-cigarette manufacturers such as Blu, which owns 40 percent of the market, show no signs of slowing down. Ad spending among e-cigarette makers grew 72 percent from 2011 to 2012, according to a Citibank marketing report. Aggressive marketing campaigns pitch e-cigarettes in flavors that taste like ice cream, such as “cherry crush” and “vivid vanilla.” Sales of e-cigarettes topped $1.5 billion in 2013. It’s quite obvious the “market” these ads are going after and that’s a very sad commentary.
Nicotine is a drug, and in its concentrated liquid form, poison experts warn it is also significantly toxic, even in small doses. E-cigarettes, which are not required to be childproof, feature flavors like spearmint, banana and bubble gum, making them appealing to small children. Gaylord Lopez, director of the Georgia poison center, had this to say:
What’s attractive to kids: It’s the smell. It’s the scent. It’s the color. A kid’s not going to know the difference between a poison and something they can drink.
Poisonings can occur when liquid nicotine is inhaled or absorbed through the skin or eyes. Poison control centers have even received calls from adults who spilled e-cigarette nicotine on themselves while filling up the devices. Others have been exposed to the liquid when the e-cigarette cartridge or refill bottles break. Adverse effects from e-cigarettes reported included vomiting, nausea and eye irritation. Lopez said:
You can start to feel sick in as little as four to five minutes. The fumes themselves can be poisonous, and if we inhale them for long enough we’re going to get a little sick to our stomach.
Under a 2009 law, the Food and Drug Administration (FDA) was given authority to oversee regulation of cigarettes, smokeless tobacco and roll-your-own tobacco. The agency was also given the authority to regulate other tobacco products, like e-cigarettes, but initially it did not propose any rule regarding these products. Finally, at the end of April, after months of wait and debate, the FDA presented a 240-page proposal to regulate e-cigarettes. Proposed oversight would include blocking the sale of e-cigarettes to minors and requiring e-cigarette makers to register with the FDA to disclose their products’ ingredients to the FDA.
Meanwhile, e-cigarette companies say they should not fall under the same regulations as tobacco-containing products because they offer what they consider to be a “safer” alternative. But those claims are now coming under fire. The new FDA proposal also will prevent e-cigarette makers from making claims that their products have lower health risks than other nicotine-containing products like traditional cigarettes, until they can show proof to back up those claims. The FDA also plans to require e-cigarette makers to obtain premarket approval for new tobacco products, which applies to other tobacco products manufacturers.
However, the proposal is currently up for review, with stakeholders having 75 days to provide feedback about the proposed regulations. This opens a window for the e-cigarette industry to request more time for research, delaying the stricter regulations. Matthew Myers is the president of Campaign for Tobacco-Free Kids, a group that has worked very hard for children. This group does good work. He said in a statement:
Responsibly marketed and properly regulated, it is possible that e-cigarettes could benefit public health if they help significantly reduce the number of people who use conventional cigarettes and die of tobacco-related disease. But in the absence of FDA oversight, the easy availability of nicotine in uncontrolled quantities, packaging and flavors and marketing that appeals to youth raises serious concerns.
Common sense and logical thinking should tell us all that something that smells like candy – but really isn’t – and has the potential for great harm should be regulated and its use by children prohibited to the extent possible. Certainly strong warnings are required. FDA oversight of e-cigarettes is long overdue. If you agree, contact your U.S. Senators and House of Representative members and let them know how you feel. Ask them to get involved and help get strong regulatory powers passed into law.
Sources: Reuters, Medical News Today, CNN, Law360, Bloomberg
