GEORGE TOWN: A total of 111 poisoning exposure cases related to electronic cigarettes and their liquids have been referred to the National Poison Centre (NPC), Universiti Sains Malaysia (USM) here, for the past nine years, since 2015.

NPC has been monitoring poisoning exposure cases related to electronic cigarettes and their liquids since 2015, when they were first made commercially available.

NPC chief pharmacist officer Sulastri Samsudin said two periods showed marked increase in cases reported, between 2020 and 2021, and between 2022 and 2023.

She said the first phase of increase by twice was in 2020 at 13.5 per cent and 2021 at 19.8 per cent compared with 6.3 per cent in 2019, which was during the Movement Control Order (MCO) due to the Covid-19 pandemic.

"The majority of cases then involved children aged below five. This situation can be attributed to the accessibility of these products to children due to unsafe storage.

"This is further compounded by the form of product packaging, especially liquid electronic cigarettes without safety features and the existence of interesting flavourings such as food and sweets..

"The second phase of increase was after the MCO, which was in 2022 and 2023. Although there was a slight decrease to 18 per cent in 2022; in 2023, the NPC recorded the highest number of electronic cigarette exposure calls of 30.6 per cent, a five-time increase compared with 2019.

"In the same year, nicotine was removed from the Poisons Act 1952," she said today.

Sulastri said the second phase also showed a change in the trend in the age category, where more teenagers aged 15 to 19 years experienced poisoning due to the deliberate use of electronic cigarettes.

She said over 95 per cent of reported cases were symptomatic.

The majority of symptoms shown by patients were consistent with symptoms of nicotine poisoning such as severe vomiting, drowsiness, diarrhoea, abdominal pain, fainting and convulsions.

She, however, said there were also patients who showed more severe symptoms such as psychosis, hallucinations, aggressive behaviour changes and were suspected of involving drug abuse into electronic cigarette liquid.

"Since 2021, the NPC had started receiving cases of exposure to electronic cigarettes linked to the drug, Magic Mushroom, or its active ingredient psilocybin, and recorded a total of 23 cases to date.

"Without any control over electronic cigarettes, the NPC cannot confirm the content of the substance," she added.

As such, Sulastri urged the government to speed up the implementation of the Control of Smoking Products for Public Health Act, which was approved last year to ensure greater control of electronic cigarette products.

Among others:* the use of safety covers for e-cigarette liquid refill containers;

* prohibit the use of food flavourings in electronic cigarette liquid;* limit the concentration of nicotine and the amount of liquid in electronic cigarette liquid and refill containers;

* ensure that products, especially chemicals, are tested and registered for monitoring purposes;* set a strict standard operation for the product production process;

* strengthen the monitoring system for cases of exposure to electronic cigarette poisoning; and* control the access of electronic cigarettes to minors.

"NPC once again calls for the speedy implementation of control over smoking products, especially electronic cigarettes, to prevent more Malaysians, especially the young people, from falling victim to nicotine addiction and poisoning," Sulastri said.

https://www.nst.com.my/news/nation/2024/03/1031234/npc-urges-govt-address-rising-cases-electronic-cigarette-poisoning