A new challenge: suicide attempt using nicotine fillings for electronic cigarettes

Schipper, Eleonora M.; Graaff, Laura C. G. de; Koch, Birgit C. P.; Brkic, Zina; Wilms, Erik B; Alsma, Jelmer; Schuit, Stephanie C. E.

doi:10.1111/bcp.12495

Cited by 24 publications

(13 citation statements)

References 6 publications

(6 reference statements)

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“…Current knowledge of e-cigarette exposures and their associated toxicity is based on case reports, small case series, and retrospective poison center data [2,3,7,[9][10][11]. Several published reports have described e-cigarette exposures causing topical irritation [8,12], GI symptoms [5,7,13,14], myocardial infarction [15], and severe nicotine toxicity manifesting as respiratory arrest [1,7,16], and even death [16][17][18][19][20][21]. Prior reports from US poison centers indicates that a large proportion of calls involve children, especially those younger than 5 years of age [2,22,23].…”

Section: Discussionmentioning

confidence: 99%

An epidemiologic and clinical description of e-cigarette toxicity

Hughes

Hendrickson

2018

Clinical Toxicology

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Introduction: E-cigarettes are battery-powered electronic nicotine delivery systems that simulate smoking by vaporizing nicotine-containing solutions. Systematic published data on e-liquid toxicity and exposures are limited to case reports and retrospective studies. Prospectively-collected data on the type of exposure, symptomatology, duration of symptoms, and concentration/flavor of e-fluids has not been published. Methods: This was a prospective observational study over a 42-month period (07/01/2014-12/31/ 2017). For all calls to a single poison center that involved e-cigarette devices or refill fluid, a data collection instrument was filled out by the specialist in poison information (SPI). Results: Two hundred sixty-five total cases were identified, including 193 children and 72 adults. The majority of both pediatric (72%; 139/193) and adult (61%; n ¼ 44/72) exposures involved e-liquid refill containers or fluid. Fifty-six percent (n ¼ 108/193) of pediatric exposures involved ingestion of refill liquid. Though children who ingested e-liquid received only a small amount, initial symptoms were evident in 32% (n ¼ 35/108) of cases. Children who did not ingest or inhale the products were less likely to develop toxicity. Only 2 children who were asymptomatic on initial call became symptomatic on follow-up. Most patients symptoms resolved within 4 hours. Seventy-one specific products/brands were identified with nicotine concentrations ranging from 0 mg/mL to 60 mg/mL with one product containing 3000 mg in a single bottle. A variety of flavors were identified, including several with names that may be attractive to toddlers or adolescents. Discussion: E-cig exposures tend to produce irritant effects from topical exposures and nicotine toxicity from ingestions, as well as some dermal and "sucking" toddler exposures. Conclusion: Exposure to e-cig fluid or device frequently causes mild symptoms and rarely may produce systemic nicotine toxicity.

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Section: Discussionmentioning

confidence: 99%

An epidemiologic and clinical description of e-cigarette toxicity

Hughes

Hendrickson

2018

Clinical Toxicology

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“…Several case reports have described suicide attempts involving the liquid found in e-cigarettes. Two of these individuals had very high levels of nicotine in their venous circulation after they intravenously injected or ingested the liquid [23,24], and two other cases involved individuals who had ingested nicotine in much higher quantities than the immediately dangerous to life or health concentration (IDLH) level, but did not die [25,26]. E-cigarettes can cause increases in blood pressure and heart rate and have the potential to cause cardiac events and arrhythmias in people who have or are at risk of cardiac disease [27].…”

Section: E-cigarettesmentioning

confidence: 99%

Tobacco control and lung cancer

Fukuda¹,

Mukae²,

Ashizawa³

2017

Oncol Res Rev

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Tobacco smoking is a major risk factor for early death, and smoking cessation is an important public health issue as it has health benefits. Passive smoking is a significant health concern for children and non-smoking adults. Lung cancer is the world's leading cause of cancer-related mortality, and tobacco exposure is responsible for the majority of cases of the disease. However, the incidence of lung cancer in patients that have never smoked is increasing. Smoking prevention measures aim to reduce the overall number of smokers and the age-adjusted frequency of lung cancer. The use of equipment designed to prevent smoking, including e-cigarettes and devices against passive smoking, is warranted to protect children.

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“…As well as causing potential harm to users, nicotine is also a powerful poison, with an increasing number of reports of accidental ingestion of nicotine solutions by children, some of which have been fatal (Gupta et al, 2014). There have even been reports of intentional intake of the fluids during suicide attempts (Schipper et al, 2014). Other problems associated with e-cigs arise from substandard and unregulated manufacture leading to injuries caused by explosions (Brown and Cheng, 2014) and loss of property owing to fires started by exploding battery chargers (BBC News, 2014).…”

Section: Nicotinementioning

confidence: 99%

Electronic cigarettes and the role of the cardiac nurse

Cope¹

2016

British Journal of Cardiac Nursing

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No Smoking Day Electronic cigarettes and the role of the cardiac nurse Key Points w Electronic cigarette use is increasing w Electronic cigarettes generate a water vapour containing nicotine w There is no carbon monoxide and other toxins are reduced w Nicotine may cause detrimental effects w Safety of e-cigarettes is yet to be established w Role as a smoking cessation aid needs further investigation CALL FOR PEER REVIEWERS Are you a cardiac nurse, researcher or educator with a Masters degree? If so, we would be very interested to hear from you as we aim to expand our group of committed peer reviewers. We offer a 'buddy' support system for first time reviewers and have recently updated our reviewer guidelines to assist you further.

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A new challenge: suicide attempt using nicotine fillings for electronic cigarettes

Cited by 24 publications

References 6 publications

An epidemiologic and clinical description of e-cigarette toxicity

An epidemiologic and clinical description of e-cigarette toxicity

Tobacco control and lung cancer

Electronic cigarettes and the role of the cardiac nurse

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