E-cigarettes

CDC Hypes 'Dramatic Increase' in Nicotine-Guzzling Children

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Last week I faulted The New York Times for hyping the threat that e-cigarette fluid poses to children, a threat that pales in comparison with those posed by many common household products. Business reporter Matt Richtel warned that  "reports of accidental poisonings, notably among children, are soaring," citing a "300 percent" rise between 2012 and 2013. Today the U.S. Centers for Disease Control and Prevention outdoes Richtel, highlighting a "dramatic increase" of 21,400 percent:

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…

More than half (51.1 percent) of the calls to poison centers due to e-cigarettes involved young children 5 years and under, and about 42 percent of the poison calls involved people age 20 and older….

"This report raises another red flag about e-cigarettes—the liquid nicotine used in e-cigarettes can be hazardous," said CDC Director Tom Frieden, M.D., M.P.H. "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."

As the reference to "another red flag" makes clear, Frieden is not alerting us to an emerging threat so much as seeking to sully a product he dislikes for reasons that have very little to do with public health. He relies on the same trick as Richtel: When you start with a small number, increases that are small in absolute terms look huge in percentage terms. It is hardly surprising that a new, increasingly popular product that is potentially hazardous to children would generate scary-looking trends like these.

The total number of calls to poison control centers related to e-cigarettes during the 42-month period covered by the CDC study was 2,405, or 57 per month. These cases were not necessarily serious enough to require medical attention. The study says "the most common adverse health effects in e-cigarette exposure calls were vomiting, nausea, and eye irritation." According to the Times, about a quarter of such calls lead to hospital visits.

Poisoning reports involving e-cigarette fluid are still a tiny fraction of poisoning reports involving products the CDC is not warning us about, such as analgesics, cosmetics, cleaning fluids, anthistamines, pesticides, vitamins, and plants, all of which generate thousands of calls to poison control centers each month. In all these cases, the solution to preventing the poisoning of little children is the same: keep little children away from poison. 

When it comes to adults, caution in handling e-cigarette fluid, which can be absorbed through the skin or eyes, seems appropriate, although not always. According to the Times, the only fatality caused by e-cigarette fluid so far was a suicide by a man who injected it.