ArticleBMJ open2021
Retrospective review of nicotine exposures in California from 2012 to 2018 and analysis of the impacts of e-cigarette regulations.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- A systematic review and network meta-analysis of population-level interventions to tackle smoking behaviour.Nature human behaviour · 2024Pooled it
- A systematic review for the impacts of global approaches to regulating electronic nicotine products.Journal of global health · 2023Pooled it
- Marketing by online tobacco retailers: An observational cross-sectional study.Tobacco induced diseases · 2026Article
- An Observational Study of Regulatory Violations Related to Online Tobacco Product Marketing and Retailer Responses to US FDA Warning Letters.Tobacco use insights · 2024Article
- Extraction of a metallic susceptor after accidental ingestion of the heated tobaccostick TEREA™: a case report.BMC pediatrics · 2023Article
- Trends and characteristics of ocular exposures related to e-cigarettes and e-liquids reported to Poison Control Centers in the United States, 2010-2019.Clinical toxicology (Philadelphia, Pa.) · 2022Review
- Content and trend analysis of user-generated nicotine sickness tweets: A retrospective infoveillance study.Tobacco induced diseases · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo review the association between US e-cigarette regulations and the number of reported nicotine exposures, and identify higher-risk products
designRetrospective review of de-identified medical records.
settingCalifornia
participantsCases reported to California Poison Control System in 2012-2018. PRIMARY AND SECONDARY OUTCOME MEASURES: Suspected nicotine toxicity; route of exposure and product characteristics.
resultsWe examined 5277 exposures, of which 3033 involved combustible cigarettes, 1489 involved e-cigarettes and 818 involved other substances (ie, chewing tobacco, nicotine patches, nicotine lozenges, hookah, etc). Implementation of the Child Nicotine Poisoning Prevention Act of 2015 was not significantly associated with reduced exposures. Exposures for e-cigarettes increased significantly after the 2017 Food and Drug Administration Compliance Policy (p=0.003, coefficient (coeff)=0.61). Total exposures for all tobacco and nicotine products also increased significantly after the policy change (p=0.01, coeff=1.26). Nicotine exposure outcomes classified as being of minor and moderate severity increased significantly after implementation of the 2017 Compliance Policy (p=0.004, coeff=0.54 and p=0.002, coeff=0.56, respectively). Ingestion was the most common route of exposure (87.7%), followed by inhalation (8.1%), dermal (6.5%), ocular (2.1%) and other (intranasal, rectal, sublingual and unknown) routes (0.2%); some cases reported multiple routes of exposure. Exposure cases involving e-cigarettes fell into three problem categories: product design, labelling and the appeal of flavours.
conclusionsOur analysis found that despite previous studies suggesting that the Child Nicotine Poisoning Prevention Act appeared to have reduced exposures for e-cigarettes, there was no significant change in exposures after its implementation. In contrast, there was a 30% increase in California e-cigarette exposures following the 2017 Compliance Policy. We conclude that current regulations are insufficient to reduce nicotine toxicities due to e-cigarette use.
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Registered trials
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