Fears Children Falling 'Dangerously Ill' From Nicotine Poisoning
As the amount of people smoking e-cigarettes increases, so too does the fear people are being poisoned by them.
The Australian Poisons Information Centres conducted a retrospective analysis of calls received between 2009 and 2016 and found calls regarding e-cigarette poisoning increased significantly during that period.
"We are definitely more concerned about concentrated nicotine in liquid form because a child can swallow or have a mouthful of liquid nicotine and become quite dangerously ill if it is concentrated," Manager of Queensland Poisons Information Centre Carol Wylie told 10 daily.
While the centre's number of calls remained stable at 164,000 cases annually, an increased figure of 202 calls were related to e-cigarettes.
Of these, 38 percent were relatives of children concerned about a child's exposure to the e-cigarette liquid, which can contain high levels of concentrated nicotine.
E-cigarettes are legal in Australia. But e-cigarettes containing nicotine are not because the chemical classified as a Schedule 7 Dangerous Poison in the Poisons Standard.
Liquids with nicotine can be legally imported into Australia if nicotine is needed for therapeutic use, which requires consent from a doctor.
"Schedule 7 Poisons should be only available to specialised or authorised users who have the skills necessary to handle them safely," a spokesperson from the Therapeutic Goods Administration told 10 daily.
In Australia e-cigarettes (containing nicotine) have not been approved as therapeutic goods. Liquids containing nicotine for use in e-cigarettes are prohibited from retail sale through state and territory drugs, poisons and controlled substances legislation.
As e-cigarettes with nicotine are illegal there are no regulated warning labels provided with the products.
This poses a number of problems for poison centres.
First, they are unable to accurately manage a possible poisoning without knowing the amount of chemical a person may have consumed.
Second, studies published as recently as January 2019, have shown products that are labelled 'nicotine-free' in Australia can contain the chemical in some instances.
The level of confidence in what amount of nicotine are in the products is also a problem. There have been several studies showing what is on the label might not be what is in the bottle
"We just don't have the confidence that what is on the printed label is accurate," Wyile said.
The uncertainty surrounding e-cigarette liquid also poses problems with predicting the possible health side effects.
"The fact that people can buy these things and nobody knows what's in them, and they claim not to have nicotine, but they do, is the reason nicotine is listed as a poison on the Australian Poison Schedule," Director for Public Policy at Cancer Council Australia, Paul Grogan told 10 daily.
It is a serious toxin.
"You can't make a judgement about a product like this very early. You actually need longer-term data to get a better indication of the harms of the products."
Grogan said the colourful packaging and fruity flavours of e-cigarettes that appeal directly to young people are also a cause for concern.
The high concentration of nicotine in some e-cigarettes exposes users to a possible nicotine addiction amid mixed claims of devices assisting people to quit cigarettes.
Smoking among Australia's 12-17 age group is currently at two percent, Grogan said.
"We have got a lot to lose by making these things attractive to younger people who weren't really at risk of nicotine addiction in the first place," he said.
He said there is a concern at "unfounded claims" e-cigarettes are an effective tobacco smoking quitting device. They could lead to people who might have quit to continue their smoking addiction in other ways.
"It is a work in progress in science at the moment," he said.
The Cancer Council of Australia supports current medical research that hasn't found concrete scientific benefits of e-cigarettes helping smokers quit.
A recent study out of the United Kingdom published in the New England Journal of Medicine, however, found quite the contrary.
The study worked with 900 smokers and found that e-cigarettes were almost twice as effective as nicotine replacement therapy (NRT) in helping them quit.
Professor Colin Mendelsohn, Chairman of the Australian Tobacco Harm Reduction Association said 80 percent of those who quit smoking were still using their e-cigarette 12 months later.
"It is much better to continue vaping long-term to avoid relapse to smoking", Dr Mendelsohn said in a statement.
"Vaping is not risk-free, but it is far less harmful than smoking."
But Grogan doesn't believe there's enough evidence available to support such a claim.
"There are lots of anecdotal claims," Grogan said.
"But to be able to be conclusively seen as a cessation device you actually have to get people to quit long term ... and the evidence just isn't there."
You can contact the Poisons Information Centre on 13 11 26.
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