Frequency and outcomes of accidental ingestion of tobacco products in young children☆
Highlights
► Accidental ingestion of tobacco products by young children is an ongoing concern. ► Twenty-seven years of surveillance data were analyzed. ► The frequency and severity of outcomes appears to be relatively low. ► Adults should keep tobacco products out of the reach of children.
Introduction
Cigarettes, cigars, smokeless, and other tobacco products have been widely used in the United States for well over 100 years (US Department of Health Education and Welfare, 1964). Accidental ingestion of these products by young children could lead to acute toxicity due to their nicotine content. Consequently, cases involving children ingesting tobacco products, and other nicotine containing products, have been monitored for decades, and studies have been published assessing the frequency and severity of such accidental ingestion events (Malizia et al., 1983, Smolinske et al., 1988, Wain and Martin, 2004, Woolf et al., 1997).
Concerns have recently been raised about the potential toxicity of both conventional and “novel” smokeless tobacco products which may be accidentally ingested by young children (Connolly et al., 2010). Because some of the newer smokeless tobacco products have only recently been introduced into the market, there is limited information concerning the potential consequences resulting from accidental ingestion of these products by children. However, all tobacco products share the common characteristic of containing nicotine, which is the primary focus of concern associated with possible acute toxicity resulting from accidental ingestion by young children (Goepferd, 1986, Smolinske et al., 1988). The levels of nicotine contained in newer smokeless tobacco products are within the range of levels occurring in conventional smokeless products (Stepanov et al., 2008).
This assessment reviews available published literature related to the frequency and outcomes associated with accidental ingestion of tobacco products among young children.
Section snippets
Data assessment
The American Association of Poison Control Centers (AAPCC; http://www.aapcc.org) is a non-profit, national organization founded in 1958 that represents the poison control centers of the United States and the interests of poison prevention and treatment of poisoning. Among its activities, the AAPCC maintains a National Poison Data System. Data in this system are compiled from exposure case data from 61 regional poison centers serving the entire population of the 50 United States, America Samoa,
Exposure events and outcomes associated with all tobacco products
Data on numbers of contacts and outcomes for the years 1983–2009 are summarized in Table 1. Over a period of 27 years, the AAPCC has reported 217,340 contacts involving tobacco products. The majority of these, approximately 89%, have occurred in children <6 years old. Medical outcome categories were assigned to approximately 63% of the total reported contacts.
Over a period of 27 years and out of 217,340 contacts, six fatalities have been ascribed to exposure to “tobacco products”. Of these, four
Discussion
Accidental poisonings in young children from ingestion of household products is an ongoing concern. Over 27 years of annual reporting, the AAPCC population consisted of 50,935,385 exposure-related contacts for all agent categories combined. Because of the widespread use of tobacco products by adults, potential ingestion by children is also a concern. Indeed, case reports involving both tobacco and pharmaceutical nicotine products have been published (Malizia et al., 1983, Smolinske et al., 1988,
Conflict of interest
The author is an employee of Altria Client Services.
Funding sources
None.
Acknowledgment
The author acknowledges the editorial assistance of Eileen Y. Ivasauskas of Accuwrit Inc.
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Some of the content of this manuscript has been presented as a poster at the Annual Meeting of the Society for Research on Nicotine and Tobacco on February 17, 2011 and as an abstract in the book of abstracts provided to the registered meeting attendees.