Prevent Nicotine Poisoning

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Prevent Nicotine Poisoning

Nicotine poisoning occurs when a person consumes more nicotine than their body can handle and the overdose of the chemical causes toxic effects.1,2 When using tobacco products and other products that contain nicotine, it’s important to understand how much of the substance your body can safely tolerate and know how to recognize the signs and symptoms of nicotine poisoning. Below, we’ll walk through the causes, symptoms and treatment of nicotine poisoning and help you understand how much nicotine a person can safely handle. 

What Causes Nicotine Poisoning?

Nicotine poisoning is caused by ingesting high doses of nicotine (more than your body can safely process). Nicotine can be ingested and absorbed via the following products:1,2

  • Cigarettes

  • Electronic cigarettes (e-cigarettes)

  • Cigars

  • Chewing tobacco

  • Liquid nicotine

  • Tobacco leaves

  • Pipe tobacco

  • Various insecticides 

It is unlikely that a person will experience nicotine poisoning from smoking alone—although it’s not impossible—but there are a number of other ways that the chemical can enter the body, too.1 If nicotine is in liquid form, it can be absorbed if it is touched or comes into contact with exposed skin.1 Eating a cigarette or other tobacco products allows the body to absorb nicotine via the intestines.1 In contrast, chewing tobacco products or nicotine replacement products allow nicotine to enter the body via the mouth’s mucus membrane.1 As mentioned above, smoking tobacco products or using electronic cigarettes allows nicotine absorption via inhalation into the lungs.1 Nicotine poisoning most commonly occurs when someone is simultaneously using more than one type of product that contains nicotine.1 

Nicotine Poisoning Symptoms

The symptoms of nicotine poisoning occur in two phases: an early phase and a late phase.1 The early phase of nicotine poisoning occurs between 15 minutes to one hour after an overdose of nicotine is ingested.1 The late phase of nicotine poisoning can occur between 30 minutes to four hours after nicotine ingestion.1 Vomiting is the most common symptom of nicotine poisoning and occurs in 50% of nicotine poisoning cases.1 Mild cases of nicotine poisoning may cause symptoms to last between one to two hours.1 More severe cases of nicotine poisoning may have symptoms that last for 18 to 24 hours.1 

Early Phase Nicotine Poisoning Symptoms 1,2

  • Nausea

  • Vomiting

  • Abdominal pain

  • Increased salivation

  • Sweating

  • Increased blood pressure and/or heart rate

  • Pale skin

  • Rapid or heavy breathing

  • Loss of balance and/or difficulty walking

  • Loss of control of body movements

  • Tremors

  • Muscle twitching

  • Headache

  • Dizziness

  • Seizure

Late Phase Nicotine Poisoning Symptoms1,2

  • Low blood pressure

  • Slowed heart rate

  • Abnormal heart rhythm

  • Diarrhea

  • Muscle weakness and/or paralysis

  • Difficulty breathing and/or respiratory failure

  • Coma

  • Shock

How to Treat Nicotine Poisoning

If nicotine has come into contact with the skin, wash the area with soap and water for 15 minutes.2 In all other cases of nicotine poisoning, seek immediate medical attention.2 You should not attempt to treat nicotine poisoning at home.2 

A doctor can diagnose nicotine poisoning by measuring the levels of nicotine and cotinine in a person’s urine or blood.1 A medical professional may administer the following tests and treatments on someone who is experiencing nicotine poisoning:1,2

  • Activated charcoal to reduce nicotine absorption

  • Airway support like oxygen, intubation or a ventilator

  • Chest x-ray

  • Laxatives

  • Intravenous fluids for low blood pressure

  • Electrocardiogram and/or heart tracing

  • Other medications to treat symptoms as needed

In severe cases, nicotine poisoning may cause death.2 However, nicotine overdose is treatable and generally does not cause long-term complications if treatment is quickly administered.2 

How Much Nicotine Can a Person Safely Handle?

All products that contain nicotine are technically capable of causing nicotine poisoning, although in general nicotine poisoning is not common in adults and experiencing nicotine poisoning from smoking alone is rare.1 A lethal dose of inhaled nicotine, as stated by the National Institute for Occupational Safety and Health, is 50 to 60 milligrams of nicotine per kilogram for an adult that weighs 70 kilograms or 154 pounds.1 For children, ingesting as little as one to two milligrams of nicotine may cause nicotine poisoning symptoms because of their smaller size.1,2 

Store tobacco products and products that contain nicotine in their original containers so that you’re able to quickly access ingredient and dosing information.1 If you believe you or someone around you is experiencing nicotine poisoning, call the Poison Control hotline and seek immediate medical attention.2 

Sources
  1. Nicotine Poisoning. Cleveland Clinic.https://my.clevelandclinic.org/health/diseases/21582-nicotine-poisoning. Accessed 7/7/2022.
  2. Nicotine poisoning. MedlinePlus.https://medlineplus.gov/ency/article/002510.htm. Accessed 7/7/2022.