To the Editor: We agree with Catalano and colleagues1 that nicotine liquid needs to be regulated. However, we feel that their letter overstates the risk from nicotine poisoning.
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- 1. Catalano C, Cranswick NE, Robinson J, et al. Unintended consequences of a cautious approach to e‐cigarette laws. Med J Aust 2019; 210: 143–144. https://www.mja.com.au/journal/2019/210/3/unintended-consequences-cautious-approach-e-cigarette-laws
- 2. Mayer B. How much nicotine kills a human? Tracing back the generally accepted lethal dose to dubious self‐experiments in the nineteenth century. Arch Toxicol 2014; 88: 5–7.
- 3. Zins BJ, Sandborn WJ, Mays DC, et al. Pharmacokinetics of nicotine tartrate after single‐dose liquid enema, oral, and intravenous administration. J Clin Pharmacol 1997; 37: 426–436.
- 4. Hughes A, Hendrickson RG. An epidemiologic and clinical description of e‐cigarette toxicity. Clin Toxicol (Phila) 2019; 57: 287–293.
- 5. Wylie C, Heffernan A, Brown JA, et al. Exposures to e‐cigarettes and their refills: calls to Australian Poisons Information Centres, 2009–2016. Med J Aust 2019; 210: 126. https://www.mja.com.au/journal/2019/210/3/exposures-e-cigarettes-and-their-refills-calls-australian-poisons-information
- 6. Chivers E, Janka MA, Franklin P, et al. Nicotine and other potentially harmful compounds in “nicotine‐free” e‐cigarette liquids in Australia. Med J Aust 2019; 210: 127–128. https://www.mja.com.au/journal/2019/210/3/nicotine-and-other-potentially-harmful-compounds-nicotine-free-e-cigarette
- 7. Hajek P, Phillips‐Waller A, Pfzulki D, et al. A randomised trial of e‐cigarettes versus nicotine replacement therapy. N Engl J Med 2019; 380: 629–637.
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We are unpaid directors of the Australian Tobacco Harm Reduction Association (ATHRA), a health promotion charity established to reduce the harm from tobacco smoking (www.athra.org.au). ATHRA has received unconditional donations from e‐cigarette businesses in the past. Neither author has or has ever had a financial or commercial relationship with any e‐cigarette or tobacco company. [Correction added on 06 August 2019, after first online publication: new disclosures have been added.]