National Estimates of ENDS Liquid Nicotine Exposures, U.S., 2013-2017.

Introduction:
This text provides an analysis of the regulatory landscape for electronic nicotine delivery systems (ENDS) in the United States. It discusses the roles of the Food and Drug Administration (FDA) and the Consumer Product Safety Commission (CPSC) in regulating these products and identifies gaps in the current regulatory framework. The text also summarizes a study on the population burden of nonburn exposures and poisoning related to ENDS liquid nicotine exposure among individuals aged 5 years and older.

Key Points:

* The FDA regulates the manufacturing, marketing, and distribution of tobacco products, including ENDS, to protect public health and reduce tobacco use by minors.
* The CPSC regulates child-resistant packaging for liquid nicotine containers and household consumer products that pose a hazard. However, it does not regulate nicotine poisonings in individuals aged 5 years and older.
* The NEISS-AIP expands reportable exposures to include nicotine exposure-related incidents in all ages, allowing for the estimation of the population burden of these exposures for individuals aged 5 years and older.
* From 2013 to 2017, an estimated 2,718 (95% CI=1,177, 4,259) cases related to ENDS liquid nicotine exposure among individuals aged 5 years and older were treated in U.S. EDs.
* Exposures were predominantly among those who were aged 25 years and older (51.7%), white (74.1%), and male (51.9%).
* Although most case patients were treated and released from the hospitals, 7.5% were admitted. The most common diagnosis was poisoning (82.7%).
* The most common symptoms were cardiovascular (29.7%).

Main Message:
The text highlights the need for improved regulation of ENDS, particularly in the area of liquid nicotine exposure. The study findings suggest that there is a significant population burden of nonburn exposures and poisoning related to ENDS liquid nicotine exposure among individuals aged 5 years and older. The lack of regulation of nicotine poisonings in individuals aged 5 years and older by the CPSC indicates a gap in the current regulatory framework. It is essential to address this gap and implement measures to prevent liquid nicotine exposure and poisoning, particularly in vulnerable populations such as children and adolescents.

Chang JT, Wang B, Rostron BL, et al. National Estimates of ENDS Liquid Nicotine Exposures, U.S., 2013-2017. American journal of preventive medicine. 2020;59(5):742-745. doi:10.1016/j.amepre.2020.05.027