The medical term that is used to describe the toxic effects of nicotine (a chemical in all tobacco products) is nicotine poisoning. A popular product (e-cigarette) that contains liquid nicotine causes an increase in poisonings. Moreover, nicotine poisoning occurs more commonly in children due to their smaller size. The most common symptoms include a fast heart rate, unsteadiness, increased salivation, and vomiting.
In other words, this condition occurs when there is too much nicotine in the body. Previously, nicotine poisoning was rare. Most of them happened when people used nicotine as an insecticide or due to accidental ingestion of tobacco or nicotine-containing plants.
Nowadays, nicotine poisoning has become a concern because there are multiple new nicotine products on the market (such as electronic cigarettes or e-cigarettes). Generally, the concentration of nicotine in these products is much higher than in most other tobacco products.
How is Someone Exposed to the Effects of Nicotine?
This substance often enters the body in the following ways. Examples include:
- Absorption – Nicotine can be absorbed through the skin. For instance, when liquid nicotine is spilled on the skin or touched.
- Inhalation – In such cases, it enters the body through the lungs from smoked products or electronic cigarettes.
- Ingestion and absorption through the mucous membrane in the mouth – It often occurs due to chewing tobacco products or liquid nicotine. In some cases, the nicotine may enter the body through the intestines.
The lethal dose of inhaled nicotine is 50 to 60 mg/kg in a 70 kg adult (about 154 pounds), according to the National Institute for Occupational Safety and Health.
Can a Person Overdose on Nicotine from Smoking Alone?
While it happens very rarely, it is not impossible. For instance, there is a reported case where two brothers smoked 18 pipes of tobacco in a row and were fatally poisoned. In general, children can become ill after eating one cigarette.
Symptoms
Usually, this condition happens in two stages. Each of these stages causes different symptoms. Check some examples below:
Early Phase Symptoms
- Nausea
- Vomiting (this symptom occurs in about 50% of people)
- Abdominal (belly) pain
- Increased salivation
- Sweating
- Pale skin color
- Hypertension (high blood pressure)
- Fast heart rate
- Hyperpnea (fast breathing)
- Ataxia (loss of full control of the body movements)
- Loss of balance and walking problems
- Tremors
- Headaches
- Dizziness
- Seizures
- Muscle twitching
Late Phase Symptoms
- Irregular heart rhythm (arrhythmia)
- Hypotension (low blood pressure)
- Bradycardia (slow heartbeats)
- Shock
- Diarrhea
- Muscle weakness
- Paralysis (in rare cases)
- Trouble breathing
- Coma
Immediately contact your healthcare provider if any of the previous symptoms occur. Otherwise, it may lead to serious health problems. In addition, the early phase often occurs within 15 minutes to 1 hour, and the most common symptom of nicotine poisoning is vomiting. The late phase may happen within 30 minutes to 4 hours.
Causes
In general, all tobacco products contain nicotine, which is harmful for out health. Theoretically, all tobacco products can cause nicotine poisoning if they are taken in large enough amounts. However, the leading cause of nicotine poisoning is liquid nicotine used in e-cigarettes. It is more likely to develop this condition due to electronic cigarettes because liquid nicotine is more concentrated. Moreover, chewing and snorting tobacco products also release more nicotine in the body compared to smoking.
This condition is an overdose of nicotine that occurs due to the overuse of tobacco products. For instance, if you are chewing too much gum that contains nicotine, it may lead to increased nicotine levels in the blood and poisoning. While the mortality risk in adults is low because of their larger bodies, if you are using a large amount of tobacco products at the same time, the risk of death significantly increases.
Doctors have identified that children are more prone to nicotine overdose because of their smaller body size. The most common causes of this condition are electronic cigarettes and taking liquid nicotine (either from absorbing spilled nicotine through the skin or through the mucous membrane in the mouth).
How Does Nicotine Poisoning Cause Death?
Typically, death occurs due to paralyzed muscles that are responsible for breathing, fluid buildup in the airways, and heart and blood vessel failure (also known as cardiovascular collapse).
How to Prevent Nicotine Poisoning?
Healthcare professionals often recommend the following tips to reduce the risk of developing this condition. Check some examples below:
- Keep all products that contain nicotine away from children and pets
- It is recommended to seal used products that contain nicotine in case children or pets dig them out of the trash
- Quit smoking – If you face problems with smoking cessation, discuss it with your healthcare professional.
- Always store nicotine products in their original container
If you or your child has been exposed to liquid nicotine, it is recommended to call 911 or the Poison Center’s hotline.
Diagnosis
First, physicians will perform a physical examination to check for abnormalities linked to this condition. They may also ask some questions about the symptoms and medical history. However, to confirm or rule out nicotine poisoning, doctors often perform a urine test (urinalysis) or a blood test that helps detect increased levels of nicotine or cotinine (nicotine metabolite) in the blood.
Treatment
While doctors often recommend activated charcoal to reduce the absorption of nicotine in the intestines, doctors may recommend additional treatments to relieve other symptoms of nicotine poisoning. These include:
- Intravenous (IV) fluids used to treat hypotension
- Atropine to treat slow heart rate
- Benzodiazepines to control seizures
- A ventilator to deliver more oxygen if a person experiences respiratory failure
Frequently Asked Questions
How long do nicotine poisoning symptoms last?
While mild symptoms last from 1 to 2 hours, in more severe cases, the symptoms may last up to 1 day.
Where is nicotine found?
Generally, nicotine is a natural toxic substance found in tobacco products. It also makes these products addictive. Tobacco products include cigarettes, cigars, e-cigarettes, chewing tobacco, snuff, pipe tobacco, tobacco plants, some insecticides that are banned in the U.S., and some nicotine replacement products (including gum, patches, lozenges, inhalers, and nasal sprays).
Why are e-cigarettes dangerous?
These are specific devices that resemble cigarettes. They contain a battery, heater, and liquid nicotine. When it is heated, the nicotine becomes a vapor, which is inhaled by users. It is important to understand that the liquid form of nicotine is very dangerous (especially for children). Even a little teaspoon of liquid nicotine can be fatal for a 26-pound child, according to the American Academy of Pediatrics. If you have any other questions, ask your healthcare provider.
