Nicotine poisoning: how much is too much?

Nicotine is what makes smokers addicted to smoking: it is the chemical in the leaves of the tobacco plant that makes cigarettes hard to resist. It is found in all cigars, smokeless tobacco products such as chewing tobacco or snuff, and in most e-cigarettes, nicotine gum, nicotine patches, and nicotine lozenges.
 
Simply put, nicotine poisoning happens when there is too much nicotine in your body. Whether it is too much depends on your body weight and the source of the nicotine.

Usually, with proper care, a person can recover fully. But severe poisoning can have lasting effects.

How much nicotine is too much?

The U.S. CDC says that 50 to 60 milligrams of nicotine is a fatal dose for an adult weighing about 150 pounds. But some studies suggest the lethal dose may be much higher.

You are unlikely to overdose on nicotine just from smoking cigarettes. When you smoke, your body absorbs only about one-tenth of the nicotine in a cigarette, roughly 1 milligram. Overdosing from nicotine gum or patches is also very rare, but it can happen if you do not follow the instructions carefully.

Because children are smaller, less nicotine can cause poisoning in them, and the same is true for pets. A child can be harmed even by eating a cigarette butt from the floor. Older children may also get too much nicotine by experimenting with chewing tobacco.

E-cigarettes may pose a greater risk. They use a battery to heat liquid nicotine, usually in a container that produces vapor for inhalation. But swallowing this liquid nicotine, or e-liquid, is toxic and harmful, and it can also cause injury if it gets on the skin or into the eyes.

E-liquid packaging is often colorful or smells like candy, so it is not surprising that children may drink it. One teaspoon of liquid nicotine can be fatal for an average toddler weighing 26 pounds.

Symptoms of nicotine poisoning

Nicotine poisoning generally falls into two categories. Mild symptoms usually last one to two hours, while severe poisoning can last up to 24 hours.

Early symptoms usually appear within the first 15 minutes to one hour.

· Nausea or vomiting

· Stomach pain

· Drooling

· Rapid, heavy breathing

· Faster heartbeat

· High blood pressure

· Pale skin

· Headache

· Dizziness, loss of balance, or confusion

Later symptoms begin gradually, usually 30 minutes to 4 hours after exposure.

· Diarrhea

· Shallow breathing

· Slow heartbeat

· Low blood pressure

· Drowsiness

· Feeling weak, having sluggish reflexes, or being unable to control muscles

· Seizures

What should you do about nicotine poisoning?

· If you suspect someone has taken too much nicotine, seek emergency help right away, especially if it is a child and you find that they have:

1. Swallowed any type of tobacco or nicotine product

2. Got liquid nicotine in their eyes

3. Got liquid nicotine on their skin

· If the poisoned person cannot be awakened, is having trouble breathing, or is having seizures, call emergency services immediately.

· Do not try to make someone who swallowed nicotine vomit, and do not give them antacids. Let them drink water and make sure their airway stays open. They may start vomiting on their own.

· If nicotine gets into the eyes, rinse them with plenty of warm water for at least 15 minutes.

· If liquid nicotine gets on the skin, wash the area with soap and water, warm or cool, and rinse for at least 15 minutes. Do not scrub hard, as this may cause a rash, abrasion, or wound.

Preventing nicotine overdose

Of course, the best approach is to prevent this from happening in the first place. If you smoke or use other nicotine products, take some basic precautions.

· Do not smoke, chew tobacco, or use e-cigarettes around children. #p#Page Break Title#e#

· Keep nicotine products out of your home and car environment where children can access them. Keep everything—cigarettes, snuff, nicotine gum—out of children’s sight. Lock up liquid nicotine containers and use child-resistant packaging.

· Store tobacco and e-cigarette products where children and pets cannot reach them. For example, never throw cigarette butts on the street or discard products in open trash cans.

· In the United States, you can call the Poison Control Center hotline at 800-222-1222 from anywhere in the country for immediate help. In China, call 120 for emergency assistance.