E-Cigarette Injuries on the Rise — Physician’s First Watch

Medical News |
April 18, 2014

E-Cigarette Injuries on the Rise

By Amy Orciari Herman

Over 50 complaints of electronic cigarette injuries were made to the FDA between March 2013 and March 2014 — roughly equivalent to the number seen in the preceding 5 years combined — Reuters reports.

Complaints included difficulty breathing, headache, cough, dizziness, sore throat, nose bleeds, chest pain, and allergic reactions. One woman noted that her young son's voice had been raspy since his father started using the devices. In addition, one consumer reported that an e-cigarette "blew up in my mouth while inhaling, burning my ... gum, lip and fingers," while another blamed the devices for blackened taste buds.

The director of the FDA's Office of Science called the increase in injuries significant, according to Reuters, noting that poison control centers have also seen a rise in e-cigarette-related calls.

Most e-cigarettes are made in China, and the quality is inconsistent, the story notes.

Reader Comments (4)

Dr.Mitchell.B.Barlow,ND-Retired Other Healthcare Professional, Unspecified, SoCal, Arkansas, Florida, Las Vegas, NV

I have seen so many 12 Step Recovery patient's praise the e-cigarette because of their use affords opportunity to avert tars and nicotine. However, it appears that research is finding that e-cigarettes are connected with many other chemically produced symptoms that are showing up across the medical community. Addicted patients should consider 'fasting' and detox as part of their 'recovery' rather than 'downgrading' from tars and nicotine to 'e-cigarettes' as their chosen rehabilitation and recovery strategy.

Isaac Brito, MD Physician, Internal Medicine

Although I've never used e-cigs nor tobacco cigarettes, I have seen a few anecdotal users complaining similar symptoms . On the other hand, I strongly agree with L.M. Colasanti comments on this topic. Definitely more studies are lacking concerning these issues. Meanwhile I'm inclined to discourage the use of electronic cigarettes and treat smokers with the well studied approaches, including behavioral and cognitive therapy and FDA approved drugs.

L.M. Colasanti, MA Other

Let me begin by acknowledging that I am an e-cigarette user. After more than 50 years of smoking, last Fall I decided to try them and have been smoke-free ever since. But I write, not as an e-cig user, but someone who tries to teach my students the difference between anecdote and a pattern of evidence, between fact and speculation. I was disconcerted, then, to find that the NEJM abridgement of this Reuters article failed to mention a critical passage that begins the third paragraph, viz.: "The health problems were not necessarily caused by e-cigarettes. And it is not clear that the rate of adverse events has increased." In addition, if 21% of U.S. adult smokers have tried e-cigarettes, that would mean that, even if all 50 complaints had come only from e-cigarette users {which they did not} and even if all the complaints correctly attributed the source of the complaint to e-cigarettes, the equivalent of fewer than 0.00057% of e-cig users lodged such complaints.

There are, I think, three legitimate concerns regarding e-cigarettes, and one ought not allow anecdote or hyperbole to cloud them. First comes the question of quality control. As with any product, we owe it to the public to insure that the ingredients of e-cigs are what they claim to be, without unlabeled additives, etc., and that they conform to recognized standards. {The brand I chose, I chose in part because they voluntarily submitted the composition of their ingredients -- all USP Kosher Grade -- to the FDA and produce in an FDA-registered facility.} Second, since e-cigs are obviously designed to be inhaled, gold-standard, long-term studies are essential to discover what, if any, side-effects and contraindications are to be found and ought to be accompanying these products or, if, indeed, there are adverse reactions that might require more stringent access requirements or, perhaps, even the banning of e-cigs entirely. {I should say, however, that banning e-cigs while allowing tobacco cigarettes to continue to be sold would undermine any public health claim credibility.}

Finally, there is the repeatedly expressed concern that e-cigs represent a gateway to tobacco cigarettes among youth. Data released recently by the CDC suggests that cigarette smoking is inversely correlated with level of education. Therefore, a concerted educational campaign might well offset some of that risk. Unfortunately, that same CDC data also showed that educational level correlated positively with increased alcohol consumption, so education alone cannot be expected to keep individuals from adopting potentially harmful behaviors.

DR Christoph Nielen Physician, Cardiology, Germany, Moenchengladbach

I´m sorry NEJM.

but that is all true , what L.M. Colasanti deplored.

Christoph Nielen

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