Laserfiche WebLink
E-cigarettes: an evidence update <br /> <br />63 <br />9. E-cigarettes, nicotine content and <br />delivery <br />Background <br />We have undertaken a review of available evidence concerning nicotine released by <br />EC. The review is divided into four parts, covering nicotine that EC use (vaping) <br />releases into ambient air, nicotine content of e-liquid, nicotine content in e-vapour, and <br />nicotine delivery to EC users (vapers). The main concern with nicotine in EC relates to <br />the question of whether EC use exposes users or bystanders to the risk of nicotine <br />poisoning. For this reason, we start with a short introductory review of this topic. <br /> <br />Toxicity of nicotine <br />Nicotine in the form of tobacco and more recently NRT has been available to thousands <br />of millions of people and large numbers of them, including small children, have ingested <br />considerable doses of nicotine. Fatal nicotine poisoning, however, is extremely rare. <br />This fact strongly contradicts the often-repeated claim that an ingestion of 30-60mg of <br />nicotine is fatal. The source of this claim proved difficult to locate – textbooks just cite <br />older textbooks. Eventually, the assertion was found to be based on dubious self- <br />experiments conducted in the 1890s [69]. <br /> <br />We are aware of one unconfirmed newspaper report of a fatal poisoning of a two-year <br />old child [70] and of three published case studies of small children who drank e-liquid. A <br />two-year old was admitted to hospital with vomiting, ataxia, and lethargy, and was <br />discharged after 24 hours of observation [71]. In the second report, an 18-month old girl <br />drank 24mg nicotine in e-liquid, vomited and was irritable, and recovered fully within an <br />hour or so [72]. The third article presented a case of a 30-month old child suspected to <br />have ingested e-liquid. The quantity of e-liquid was uncertain and the child was <br />asymptomatic with all clinical observations reported to be normal [73]. <br /> <br />With the increase in EC use, there has been an increase in calls to poison centres <br />following accidental exposures but these remain lower than calls following such <br />exposure from tobacco and none resulted in any serious harm [74] (see next chapter for <br />UK data). Serious nicotine poisoning seems normally prevented by the fact that <br />relatively low doses of nicotine cause nausea and vomiting, which stops users from <br />further intake. <br /> <br />Apart from accidental poisoning, nicotine has also been used in suicide attempts. <br />Suicide attempts with large amounts of pesticides containing nicotine sulphate often <br />succeed [75] but completed suicides using e-liquids are extremely rare. Where adults