Dissolvable Tobacco Orbs Pose Poisoning Risk to Children

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Last year, RJ Reynolds introduced a cinnamon or mint flavored, candy-like tobacco pellet as a way to give adults an option for smokeless nicotine. RJ Reynolds has also launched other smokeless tobacco products, such as the Camel Strips and Camel Sticks as more public places are enforcing a smoke-free environment. Unfortunately, a study by researchers at the Harvard School of Public Health in Boston has found that the products also pose a significant poisoning risk in children.

In a study of the reports to 61 US poison control centers between 2006 and 2008, Dr. Gregory N. Connolly and colleagues found that 13,705 children younger than 6 were accidentally poisoned by tobacco products. More than 70% of those were infants under one year of age.

Cigarettes were the most commonly reported substance ingested by the children. They were responsible for about 10,600 of the poisonings. Now that smoking rates have declined, more Americans are turning to smoke free products for nicotine. It is estimated that the smokeless tobacco market has risen between 5 and 6% in recent years.

The Camel Orbs, and smoke-free products like it, will likely lead to even more accidental poisonings, because they look and taste like candy or mints, but contain an average of 0.83 milligrams of nicotine each. In infants and small children, even just one milligram can cause nausea or vomiting. Large doses, approximately .5 milligrams of nicotine per pound of body weight, can lead to convulsions or potentially fatal respiratory arrest.

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In addition, Connolly found that the tobacco pellets contained a greater proportion of free, or un-ionized, nicotine, which is more quickly absorbed into the blood stream. This characteristic of the Orbs also raises a concern for older teens, who may find that they are extremely addictive.

One case of Orbs ingestion by a 3-year-old has already been reported to the Oregon Poison Control Center. Thankfully, the child did not require medical attention.

"These numbers are alarming," Connolly told Reuters Health. "Parents need to get the message: Don't leave these products around where children can reach them."

Remember that infants, toddlers, and small children put anything and everything into their mouths as a way of exploring the item. Keep cigarettes, smokeless tobacco products such as dips and Orbs, and nicotine gums where children cannot reach them. Clear cigarette butts from ashtrays and never leave a lit cigarette around a child for risk of burns.

In the case of accidental ingestion of any of these products, immediately call the Poison Control Center at 1-800-222-1222.

Source reference:

Connolly GN, et al "Unintentional child poisonings through ingestion of conventional and novel tobacco products" Pediatrics 2010; 125: 896–99.

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Comments

What about nicotine gum?
A professor of medicine like Dr. Connolly should know that swallowing a tobacco product triggers vomiting, making the poison exposure self-correcting. If more than one pellet is swallowed, they will likely all be expelled at once. Nevertheless, all products that contain nicotine should be kept out of reach of children and pets. Since 2004 there has not been a single death associated with nicotine or tobacco, and in 2003 the one related death was from ingesting a pharmaceutical nicotine product.