The Emerging Method of Suicide by Electronic Cigarette Liquid: a Case Report

Park, Eun-jung; Min, Young-Gi

doi:10.3346/jkms.2018.33.e52

Cited by 15 publications

(9 citation statements)

References 7 publications

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“…138 It has been recently recognized that adolescents who use e-cigarettes are at higher risk for mental health concerns 139,140 and that suicides and attempts by nicotine ingestion have occurred in teenagers and young adults. 134,141,142 Therefore, health care providers need to be aware that adolescent e-cigarette users may represent a subset of children at increased risk for depression and suicide and that liquid nicotine can be used as a vehicle for suicide attempts.…”

Section: Acute Nicotine Ingestion In Children and Adolescentsmentioning

confidence: 99%

The Effects of Nicotine on Development

et al. 2020

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Recently, there has been a significant increase in the use of noncombustible nicotine-containing products, including electronic cigarettes (e-cigarettes). Of increasing popularity are e-cigarettes that can deliver high doses of nicotine over short periods of time. These devices have led to a rise in nicotine addiction in adolescent users who were nonsmokers. Use of noncombustible nicotine products by pregnant mothers is also increasing and can expose the developing fetus to nicotine, a known teratogen. In addition, young children are frequently exposed to secondhand and thirdhand nicotine aerosols generated by e-cigarettes, with little understanding of the effects these exposures can have on health. With the advent of these new nicotine-delivery systems, many concerns have arisen regarding the short-and long-term health effects of nicotine on childhood health during all stages of development. Although health studies on nicotine exposure alone are limited, educating policy makers and health care providers on the potential health effects of noncombustible nicotine is needed because public acceptance of these products has become so widespread. Most studies evaluating the effects of nicotine on health have been undertaken in the context of smoke exposure. Nevertheless, in vitro and in vivo preclinical studies strongly indicate that nicotine exposure alone can adversely affect the nervous, respiratory, immune, and cardiovascular systems, particularly when exposure occurs during critical developmental periods. In this review, we have included both preclinical and clinical studies to identify age-related health effects of nicotine exposure alone, examining the mechanisms underlying these effects.

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Section: Acute Nicotine Ingestion In Children and Adolescentsmentioning

confidence: 99%

The Effects of Nicotine on Development

et al. 2020

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“…Life-threatening nicotine intoxication in young children due to accidental ingestion of e-liquid has been reported [13]. Another concern is nicotine intoxication resulting from suicide attempts using e-liquids [14]. With the introduction of e-cigarettes, e-liquids containing highly concentrated nicotine have become widely available.…”

Section: Introductionmentioning

confidence: 99%

Nicotine intoxication by e-cigarette liquids: a study of case reports and pathophysiology

Maessen

Wijnhoven

Neijzen

et al. 2019

Clinical Toxicology

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Background: Electronic cigarettes (e-cigarettes), the smokeless alternative to conventional tobacco cigarettes, have become increasingly popular. E-cigarettes vaporise e-liquid, a solution of highly concentrated nicotine, propylene glycol (PG) and vegetable glycerine (VG). With the popularity of e-cigarettes, e-liquid refills have become easily accessible and several cases of intoxication due to the ingestion of e-liquid have been reported. We provide an overview of these cases, their pathophysiology and patients' characteristics. Methods: We carried out a retrospective evaluation of the scientific literature reporting on cases of liquid nicotine intoxication, using the following inclusion criteria: (1) the article is or contains a case report, (2) describes an intoxication with e-liquid, (3) the substance contains nicotine, and (4) intake is oral, intravenous or subcutaneous. Results: We found 26 case reports describing a total of 31 patients who suffered from e-liquid intoxication. All intoxications up to the age of six were reported as unintentional, whereas nearly all cases from ages 13 to 53 were due to suicide attempts. The three most prevalent symptoms of e-liquid intoxication were tachycardia, altered mental status and vomiting. Eleven cases resulted in the death of the patient. In the survivors, the highest plasma concentration of nicotine was 800 mg L À1 , while the lowest concentration in the non-survivors was 1600 mg L À1 . Conclusions: There is a mismatch between the generally accepted lethal oral nicotine dose of 60 mg, resulting in approximately 180 mg L À1 plasma concentration, and the 4.4-to 8.9-fold higher lethal plasma concentrations we found in cases of e-liquid intoxication. In these severe intoxications, plasma cotinine concentration does not act as a more reliable indicator of nicotine intoxication than nicotine itself. The ages of the patients display a bimodal distribution. In patients above the age of 10, intoxication results mainly from suicide attempts rather than accidental ingestion. The role of PG and VG in e-liquid intoxications is remarkably unclear. However, the similarity across nicotine and PG toxicity symptoms leads us to believe a cumulative effect cannot be excluded. ARTICLE HISTORY

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“…E‐cigarette intoxication represents a topic of increasing interest nowadays because of, in the last decade, the easy accessibility of advertisements and the sales of e‐cigarettes online 36 . Also, instructions for nicotine abuse for suicidal purposes 19 have determined more opportunities for young adults to come into contact with it, with the result of an increase in accidental or intentional poisoning through the ingestion and/or injection of e‐liquid.…”

Section: Discussionmentioning

confidence: 99%

Severe neurological nicotine intoxication by e‐cigarette liquids: Systematic literature review

et al. 2020

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Electronic cigarettes (e-cigarettes), also named 'e-cig', 'smoke-less-cigarettes' and 'electronic nicotine delivery systems' (ENDS) were developed by a Chinese pharmacist in 2003 and introduced to Western countries in 2004, as a source of nicotine alternative to conventional tobacco products. In recent years, the popularity of e-cigarettes has been increasing among middle and high school students and adults. 1 In fact, e-cigarettes are supposed to have fewer adverse effects on human health than traditional tobacco products and are also easily available. In contrast to combustible tobacco cigarettes, e-cigarettes do not burn and do not contain most of the estimated unhealthy constituents that are present in tobacco smoke. Thus, e-cigarettes are generally considered safer, despite exposure to nicotine and a variety of other potentially harmful constituents. The U.S. Food and Drug Administration (FDA)

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The Emerging Method of Suicide by Electronic Cigarette Liquid: a Case Report

Cited by 15 publications

References 7 publications

The Effects of Nicotine on Development

The Effects of Nicotine on Development

Nicotine intoxication by e-cigarette liquids: a study of case reports and pathophysiology

Severe neurological nicotine intoxication by e‐cigarette liquids: Systematic literature review

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