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CDC: Most e-cigarette calls to poison centers involved children 5 years and younger

June 22, 2023

The number of calls made to poison centers related to children who were exposed to e-cigarettes continues to increase, with most calls involving children under 5 years old, a new study found.

Researchers from the Food and Drug Administration analyzed e-cigarette-related exposure calls made to poison centers from April 1, 2022, to March 31, 2023, and found the number nearly doubled from 2018. Their findings were published Thursday in “Notes from the Field: E-Cigarette-Associated Cases Reported to Poison Centers” (Tashakkori NA, et al. MMWR Morb Mortal Wkly Rep. June 22, 2023).

Among the 7,043 exposures, 87.8% occurred among children ages 5 years and younger, 3% involved children ages 5-11 years, 2.2% were children 12-17 years and 2.9% were young adults ages 18-24 years. E-cigarettes often contain high concentrations of nicotine, which is highly addictive and can harm the developing brains of children, adolescents and young adults.

Inhalation or nasal exposure accounted for 61% of the cases, and ingestion or oral exposure made up 40% of the reports.

Overall, 43 cases of exposure resulted in hospital admission, while 582 cases involved treatment in a health care facility. One case resulted in death, a suspected suicide of a person 18 years or older.

An effect that was life-threatening or that resulted in severe symptoms was experienced in 12 cases. A moderate effect, including prolonged symptoms such as high fever, disorientation or gastrointestinal symptoms caused by dehydration, was found in 133 cases.

A previous study showed e-cigarette-related poisoning cases increased 25% from 2017-’18.

The study authors noted that continued surveillance is required to prevent poisoning exposure associated with e-cigarettes, particularly among young children. Adults who use e-cigarettes should store their e-cigarettes and e-liquids safely to prevent access by young children.

E-cigarette sales increase during pandemic

Another study published Thursday revealed that e-cigarette unit sales increased by 46.6% from January 2020 to December 2022 — from 15.5 million to 22.7 million units per four-week period (Ali FRM, et al. “E-cigarette Unit Sales by Product and Flavor Type, and Top-Selling Brands, United States, 2020–2022,” MMWR Morb Mortal Wkly Rep. June 22, 2023). Sales fluctuated during this period.

Researchers analyzed retail scanner data from Information Resources Inc., a market research company, to look at sales trends.

Unit share sales of menthol-flavored products were relatively stable during the study period. Unit share sales of tobacco- and mint-flavored products decreased from 28.4% to 20.1% and 10.1% to 5.9%, respectively, while shares of other flavors increased from 29.2% to 41.3%.

Data also showed that shares of prefilled cartridges decreased from 75.2% to 48% during the study period, while shares of disposable e-cigarettes increased from 24.7% to 51.8%.

Overall, use of the products was markedly higher among youths and young adults than among adults.

In January 2020, the Food and Drug Administration announced it would prioritize enforcement against illegal prefilled e-cigarette flavors other than tobacco and menthol, based on the prevalence of use of these products among youths at the time. After the announcement, retail sales of mint and other flavored prefilled cartridges halted, while notable increases were seen in sales of fruit- and mint-flavored disposable products.

Flavored disposable e-cigarettes have emerged as the most commonly used device type among U.S. middle and high school students who use e-cigarettes. The top selling e-cigarette brands for the four-week period ending Dec. 25, 2022, were Vuse, JUUL, Elf Bar, NJOY and Breeze Smoke.

Study authors said the data can be used to help guide strategies to prevent youths from accessing and using e-cigarettes, including restrictions on flavored tobacco products.

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