By Steven Reinberg

HealthDay Reporter

THURSDAY, April 3, 2014 (HealthDay News) The number of calls to poison control centers for nicotine poisoning from e cigarettes has risen dramatically in recent years, U.S. health officials reported Thursday.

Calls related to poisoning from the liquid nicotine used in these devices were running at a rate of roughly one a month in 2010, but jumped to 215 in February of this year, according to the U.S. Centers for Disease Control and Prevention.

Even more troubling, more than half (51 percent) of the poison calls involved children aged 5 and younger, while 42 percent involved people aged 20 and older.

“The time has come to start thinking about what we can do to keep this from turning into an even worse public health problem,” said Dr. Tim McAfee, director of the CDC’s Office on Smoking and Health.

He added that many people are not aware that liquid nicotine is toxic. “We need to make sure we can avert the possibility of an unintended death from nicotine poisoning,” he said.

“We have not had an unintentional poisoning death from e cigarettes yet in the United States that we know of, but the potential is there given the amount of concentrated nicotine in these solutions it would not take a lot for a child death to occur,” McAfee noted.

CDC director Dr. Tom Frieden noted in a news release that e cigarettes are particularly attractive to kids because they come in candy and fruit flavors.

Dr. Vincenzo Maniaci, an emergency medicine specialist at Miami Children’s Hospital, agreed that the danger to children is real.

“The concentration of nicotine in these solutions is significant and they need to be made childproof and regulated,” Maniaci said. “Especially for kids under the age of 5, this amount of nicotine can be fatal.”

McAfee noted that the U.S. Food and Drug Administration is planning to propose regulations for e cigarettes. He added that he hopes these regulations will include how the product is packaged, including childproof caps and warning labels.

“These things can be hardwired into these products, rather than being left to the whim of the manufacturer,” he said.

In the meantime, McAfee advised keeping these devices, and their refills, out of the reach of children.

“These should be treated with the same caution one would use for bleach. In some ways, this is more toxic than bleach,” he said.

Poisoning from the liquid nicotine in e cigarettes can happen in one of three ways by swallowing it inhaling it or absorbing it through the skin or membranes in the mouth and lips or eyes, McAfee said. Once it is in a person’s system, nicotine can cause nausea, vomiting or seizures.

If those symptoms are occurring, the patient will typically be told to go straight to the emergency room, said Amy Hanoian Fontana, from the Connecticut Poison Control Center.

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“We do not yet know the harm that e cigarettes can cause to adults, let alone to children, but we do know they are not risk free,” Prof Dame Sally Davies, England’s chief medical officer, said.

“E cigarettes can produce toxic chemicals and the amount of nicotine and other chemical constituents and contaminants, including vaporised flavourings, varies between products meaning they could be extremely damaging to young people’s health.”

Katherine Devlin, president of the Electronic Cigarette Industry Trade Association, welcomed the changes in the law, saying they had been asking for it “for years”.

“It’s high time that it was mandated in law so that it can be robustly enforced,” she added, pointing out that product labelling made it clear e cigarettes were not for under 18s.

Anti smoking charity Ash also welcomed the changes, but chief executive Deborah Arnott called for a retail licensing system that would mean cigarettes could be legally sold only in shops, not in car boot sales or markets.

No EU ban

The UK currently has few restrictions on the use of e cigarettes, despite moves in some countries to ban them.

Restrictions have recently been mooted in Scotland and Wales, where health policy is a devolved issue.

A Welsh government spokesman said on Sunday it “fully” supported a ban on e cigarettes for under 18s and was considering how such legislation could be introduced in Wales.

In Northern Ireland, the NI Chest Heart and Stroke charity is pressing the health minister to introduce a similar ban.

The law change for England will be introduced in Parliament this week as an amendment to the Children and Families Bill.

Labour said the policy on banning cigarettes for children was a “watered down version of a policy that Labour called for last year” and that buying cigarettes for children should carry the same penalty as buying alcohol for underage drinkers.

But it said restricting the sale of e cigarettes to under 18s was a “sensible step”.

From 2016, the Medicines and Healthcare Products Regulatory Agency is expected to license e cigarettes as a medicine in the UK.

This will bring them in line with nicotine patches and gum, and allow the agency to apply rules around, for example, the purity of the nicotine in e cigarettes.

MEPs have rejected calls for a blanket ban on the sale of e cigarettes across the EU.

However, under a compromise deal, strict limits will be placed on the amount of nicotine they contain, and individual EU member states will be able to introduce a national ban if they see fit.

If three or more member states chose that path, it could trigger an EU wide ban.

‘Irresponsible adults’

Smoking remains one of the biggest causes of death and illness in the UK, with around 100,000 people dying each year from illnesses linked to the habit.

Experts want to crack down on the number of young people smoking by bringing the law in line with restrictions on the sale of alcohol.

The new rules on adults buying cigarettes for under 18s could be in force by the autumn and may mean anyone caught buying cigarettes for a child could be given a 50 fixed penalty notice or a fine of up to 2,500.

“We must do all we can to help children lead a healthy life,” public health minister Jane Ellison said.

Some 41% of 15 year olds who smoke say they usually buy their cigarettes from someone else, rather than from a shop, according to Department of Health figures.