Nicotine poisoning
Nicotine is a bitter-tasting compound that naturally occurs in large amounts in the leaves of tobacco plants.
Nicotine poisoning results from taking too much nicotine. Acute nicotine poisoning usually occurs in young children who accidentally chew on nicotine gum or patches. Nicotine is rapidly absorbed after ingestion and inhalation. In young children, ingestion of 1 to 2 mg of nicotine has been associated with signs of toxicity (poisoning).
This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call the local emergency number (such as 911), or the local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Poisonous Ingredient
Nicotine
Where Found
Nicotine is found in:
- Chewing tobacco
- Cigarettes
-
E-cigarettes
E-cigarettes
Electronic cigarettes (e-cigarettes), electronic hookahs (e-hookahs), and vape pens allow the user to inhale a vapor that may contain nicotine as wel...
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- Nicotine gum (Nicorette)
- Nicotine patches (Habitrol, Nicoderm)
- Pipe tobacco
- Some insecticides
Insecticides
Insecticide is any chemical that kills bugs. Insecticide poisoning occurs when someone swallows or breathes in an insecticide or it is absorbed thro...
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Note: This list may not be all inclusive.
Symptoms
Symptoms of nicotine poisoning include:
-
Abdominal cramps
Abdominal cramps
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
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Agitation, restlessness, excitement, or confusion
Agitation
Agitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.
Read Article Now Book Mark Article - Breathing that may be difficult, rapid, or even stopped
- Burning sensation in mouth, drooling
-
Seizures
Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
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-
Fainting or even coma (lack of responsiveness)
Fainting
Fainting is a brief loss of consciousness due to a drop in blood flow to the brain. The episode most often lasts less than a couple of minutes and y...
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Decreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...
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- Muscle twitching and damage
- Palpitations (fast and pounding heartbeat often followed by slow heart rate)
- Vomiting
- Weakness
Home Care
Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care professional.
If the chemical is on the skin, wash with soap and lots of water for at least 15 minutes.
Before Calling Emergency
Determine the following information:
- The person's age, weight, and condition
- Name of product (as well as the ingredients and strength, if known)
- When it was swallowed or inhaled
- The amount swallowed or inhaled
However, DO NOT delay calling for help if this information is not immediately available.
Poison Control
Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.
Local poison control center
For a POISON EMERGENCY call:1-800-222-1222ANYWHERE IN THE UNITED STATESThis national hotline number will let you talk to experts in poisoning. This ...
Read Article Now Book Mark ArticleThis is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
If possible, take the package the nicotine came in with you to the hospital.
What to Expect at the Emergency Room
The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive:
- Activated charcoal
- Airway support, including oxygen, breathing tube through the mouth (intubation), and breathing machine (ventilator)
- Blood and urine tests
- Chest x-ray
- ECG (electrocardiogram, or heart tracing)
- Fluids through a vein (IV)
- Laxative
- Medicines to treat symptoms, including agitation, rapid heart rate, seizures, and nausea
Outlook (Prognosis)
How well a person does depends on the amount of poison swallowed and how quickly treatment was received. The faster a person gets medical help, the better the chance for recovery.
A nicotine overdose may cause seizures or death. However, unless there are complications, long-term effects from nicotine overdose are uncommon.
References
Aronson JK. Nicotine and nicotine replacement therapy. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Philadelphia, PA: Elsevier; 2016: pp.151-156.
Breuner CC. Substance abuse. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 140.
Chary MA, Erickson TB. Cocaine and other sympathomimetics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 144.
Review Date: 1/2/2023
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.