There's a new wrinkle in the debate over the safety of electronic cigarettes.
New U.S. data show that the number of poisonings linked to e-cigarettes is rising sharply, fuelling calls for more research to determine how – and if – to regulate the products.
A report from the U.S. Centers for Disease Control and Prevention published this week states that the number of calls received by poison control centres in relation to e-cigarettes rose from one a month in September, 2010, to 215 a month in February, 2014.
E-cigarettes typically contain liquid nicotine and can come in candy or fruit flavours, which the CDC points out can be appealing to children. They can ingest or inhale the liquid and get sick as a result. The liquid nicotine can also be absorbed through the skin or the eyes. Just over half of the calls to the centres related to poisonings in children under 5.
"This report raises another red flag about e-cigarettes – the liquid nicotine used in e-cigarettes can be hazardous," CDC director Dr. Tom Frieden said in a statement. "Use of these products is skyrocketing and these poisonings will continue."
The most common health problems reported to poison control centres in relation to e-cigarettes were vomiting, nausea and eye irritation, according to the CDC.
In Canada, e-cigarettes containing nicotine are not permitted for sale. But many users are able to buy nicotine cartridges through online retailers.
The market for e-cigarettes in Canada, the United States and other countries around the world has been steadily growing. Many people report turning to e-cigarettes as a way to cut down or stop smoking. But several public health advocates fear that e-cigarettes will serve as a gateway to smoking for young people.
Part of the problem is there is little high-quality scientific data demonstrating whether e-cigarettes work as a smoking cessation device. Many of the studies that have been conducted have conflicting results. In addition, many studies have had major design flaws, such as being too small or not being randomized or controlled.
Frank Welsh, director of policy with the Canadian Public Health Association, said if e-cigarette manufacturers want to be regulated and used as smoking cessation devices, they will need to invest in the research to prove those claims. Otherwise, it's difficult for an agency such as Health Canada to regulate them.
Calling e-cigarettes smoking cessation devices is "subjective without any solid background information concerning a risk assessment," Welsh said.
Some advocates say Health Canada should be more active on the issue of e-cigarettes because the use of them is soaring and the lack of a regulatory framework may create a void.
Earlier this week, Calgary's city council voted to study the health risks of e-cigarettes, given that they are being used more frequently in bars, restaurants and other public places.
Health Canada has said little on the subject of e-cigarettes except a notice in 2009 to consumers not to use them because they haven't been fully studied. That's simply not good enough, according to many e-cigarette users and advocates of the idea they can be used as a smoking cessation tool. They argue that the market for this product is already there and federal leadership could prevent e-cigarettes from being used by adolescents.