A new study shows 13,705 poisoning cases were reported from 61 regional poison control centers in the U.S. from 2006 to 2008 involving accidental ingestion of tobacco products in children under age 6. More than 70% of these poisonings involved infants less than 1 year of age.
Cigarettes are still the No. 1 source of tobacco poisoning, but researchers say smokeless tobacco products are becoming an increasingly common source of child tobacco poisoning, especially among older children.
Of particular concern are new dissolvable, compressed tobacco products that come in small pellets, such as Camel Orbs. Researchers say their packaging resembles mints and the products themselves have a candy-like appearance and added flavorings that make them attractive to young children.
"Infants are susceptible to accidental tobacco ingestion because of a natural curiosity and a tendency for oral exploration," write researcher Gregory N. Connolly, DMD, MPH, of Harvard University and colleagues in Pediatrics. "As taste discrimination develops, young children may be more attracted to flavored tobacco products. Ingestion of as little as 1 mg of nicotine by a small child can produce symptoms such as nausea and vomiting."
Severe cases of nicotine poisoning in children may include weakness, convulsions, unresponsiveness, and difficulty breathing and may lead to respiratory arrest and death.
Researchers say smokeless tobacco pellets contain an average of 0.83 mg of nicotine per pellet. The estimated minimal lethal dose of nicotine for children is about 1 milligram of nicotine per kilogram of body weight.
"In light of the novelty and potential harm of these dissolvable nicotine products, federal and other public health authorities are advised to study these products to determine the appropriate regulatory approach, on the basis of their potential to cause poisonings and create addiction among youths," the researchers write.