Nicotine is what keeps smokers smoking: It’s the chemical found in the leaves of tobacco plants that makes cigarettes so addictive. It’s in all cigars, smokeless tobacco (such as chew or snuff), and most electronic cigarettes, or e-cigarettes. Nicotine gums, patches, and lozenges have it, too.
Simply put, nicotine poisoning happens when you have too much of it in your body. The amount that causes overdose depends on things like your body weight and where the nicotine came from.
Usually, someone who gets quick, proper care will recover fully. But a severe case of poisoning could have long-lasting effects.
How Much Is Too Much?
The CDC says 50 to 60 milligrams of nicotine is a deadly dose for an adult who weighs about 150 pounds. But some research suggests a lethal amount may be a lot higher.
It’s not likely you’ll overdose on nicotine just from smoking cigarettes. Your body absorbs only about one-tenth of the nicotine in a cigarette, around 1 milligram, when you smoke it. Overdosing from nicotine gum or a patch is rare, but it’s possible if you don’t follow the instructions carefully.
Because kids are smaller, it takes less nicotine to poison them (or pets, for the same reason). There’s enough in a cigarette butt to harm your little one if they decide to eat one off the floor, for example. An older child experimenting with chewing tobacco can also overdose.
E-cigarettes pose a bigger risk. They use batteries to heat liquid nicotine — usually in a cartridge or container — into a gas or vapor so you can inhale it. Swallowing this liquid nicotine can be toxic. It can also be harmful if you spill some on your skin or get a little in your eye.
Sometimes it comes in colorful packages or smells like candy, so it’s not surprising that kids will drink it. As little as 1 teaspoon of liquid nicotine can be fatal for the average 26-pound toddler.
Nicotine poisoning usually happens in two stages. Symptoms typically last an hour or two after a mild overdose and up to 24 hours for severe poisoning.
You’ll get early symptoms within the first 15 minutes to an hour.
- Feeling queasy or throwing up
- Mouth watering
- Quick, heavy breathing
- Faster heartbeat
- Higher blood pressure
- Pale skin
- Dizzy, off-balance, or confused
Late-phase symptoms are more like winding down. They happen 30 minutes to 4 hours later.
- Shallow breathing
- Slower heartbeat
- Lower blood pressure
- Feeling weak, slow reflexes, or unable to control muscles
What to Do for Nicotine Poisoning
Call the American Association of Poison Control Center at 800-222-1222 right away if you suspect an overdose or when someone, especially a child:
- Swallows any type of tobacco or nicotine product
- Gets liquid nicotine in their eye
- Spills liquid nicotine on their skin
If the person who is poisoned can’t wake up, has a hard time breathing, or has a seizure, call 911.
Don’t try to make someone who’s swallowed nicotine throw up or give them antacids to settle their stomach. Do let them drink water. Make sure their airway is clear. They will probably start vomiting on their own.
Rinse eyes splashed with nicotine well with a lot of warm water for at least 15 minutes.
Where liquid nicotine has gotten onto skin, wash the area well with soap and water (either warm or cool) and rinse for at least 15 minutes. Don’t scrub hard, because you don’t want to cause a rash, scrape, or cut.
Prevent a Nicotine Overdose
The best way, of course, is to simply not have it around. If you’re going to smoke or use other nicotine products, take some basic precautions.
Don’t smoke, chew, or inhale around your kids.
Keep your home and car nicotine-free. Store everything — packs of cigarettes, snuff tubs, nicotine gum — out of your kids’ sight and reach. Lock up liquid nicotine containers, and buy only refills that use child-resistant packaging.
Throw away tobacco and e-cigarette items carefully, so kids and pets can’t get to them. Never drop a cigarette butt onto the street, for example, or toss products into open trash cans.
Add the Poison Control Center’s help line number (800-222-1222) to your phone contacts and post it at home for emergencies. It will connect you to your local poison control center anywhere in the U.S.
- Mayo Clinic: “Nicotine Dependence."
- National Institute for Occupational Safety and Health: “Nicotine: Systemic Agent," “Nicotine."
- American Lung Association: “Nicotine," “E-cigarettes and Lung Health."
- National Cancer Institute: “Smokeless Tobacco and Cancer."
- American Cancer Society: “Nicotine Replacement Therapy to Quit Smoking."
- INCHEM: “Nicotine."
- Mayer, B. Archives of Toxicology, published online Oct. 4, 2013.
- Barceloux, D. Medical Toxicology of Drug Abuse: Synthesized Chemicals and Psychoactive Plants, John Wiley & Sons, March 2012.
- Children’s Safety Network: “Preventing E-Cigarette Poisoning among Children and Youth."
- American Association of Poison Control Centers: “Tobacco & Liquid Nicotine," “Electronic Cigarettes and Liquid Nicotine Data," “E-Cigarettes and Liquid Nicotine."
- Medscape: “E-Cigarettes Rising Cause of Nicotine Poisoning in Children."
- Kamboj, A. Pediatrics, published online May 2016.
- Healthychildren.org: “Liquid Nicotine Used in E-Cigarettes Can Kill Children," “Poison Prevention & Treatment Tips."