David Kirkpatrick

April 19, 2010

Anti-tobacco forces remain overwrought

Those opposing tobacco use would be very happy to see the plant somehow disappear from the planet. Failing that a global ban on smoking would suffice, I’m sure. And then there’s that pesky nicotine that addicted smokers and ex smokers crave. Hmm, what to do about that? Let’s attack the efforts that offer nicotine to people in a form other than tobacco products to save the children.

I don’t smoke cigarettes and never have, but I do smoke the occasional cigar and I have a pretty healthy collection of pipe tobacco aging gracefully so I do have something of a dog in the fight, but my libertarian side really gets worked up at all the nanny-statism and “we know what’s good for you” going on out there. With this November’s vote coming up wouldn’t it be an odd turn of events that it might be easier to smoke marijuana than smoke a bowl of G.L. Pease’s “Haddo’s Delight” in California?

Not to discount the possibility of kids being hurt by these products — that’s why the adults around those kids should act like adults and keep them out of reach — take a look at the amount of consumption required to start causing problems. If a kid can get into a product like this to that extent I’m going to bet nicotine poisoning is the least of that kid’s unconscious worries.

From the first link:

Tobacco company’s new, dissolvable nicotine products could lead to accidental poisoning

Candy-like appearance and flavorings may increase appeal to infants and youth

Boston, MA – A tobacco company’s new, dissolvable nicotine pellet–which is being sold as a tobacco product, but which in some cases resembles popular candies–could lead to accidental nicotine poisoning in children, according to a new study from the Harvard School of Public Health (HSPH), the Northern Ohio Poison Control Center, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). The researchers also say the candy-like products could appeal to young people and lead to nicotine addiction as well.

The study appears in an advance online edition of the journal Pediatrics on April 19, 2010 and will appear in a later print issue.

In 2009, the R.J. Reynolds Tobacco Company launched a dissolvable nicotine product called Camel Orbs, which according to the company’s promotional literature contains 1 mg nicotine per pellet and is flavored with cinnamon or mint. The company also introduced Camel Strips (to contain 0.6 mg nicotine per strip) and Sticks (to contain 3.1 mg nicotine per strip).

It appears that the product is intended as a temporary form of nicotine for smokers in settings where smoking is banned. However, the potential public health effect could be disastrous, particularly for infants and adolescents, said Professor Gregory Connolly, lead author of the study and director of the Tobacco Control Research Program at HSPH.

Ingestion of tobacco products by infants and children is a major reason for calls to poison control centers nationwide. In 2007, 6,724 tobacco-related poisoning cases were reported among children five years of age and under. Small children can experience nausea and vomiting from as little as 1 mg of nicotine.

“This product is called a ‘tobacco’ product, but in the eyes of a 4-year-old, the pellets look more like candy than a regular cigarette. Nicotine is a highly addictive drug and to make it look like a piece of candy is recklessly playing with the health of children,” said Connolly.

The researchers computed, based on median body weight, how much nicotine ingestion would lead to symptoms of poisoning in children: A one-year-old infant could suffer mild to moderate symptoms of nicotine poisoning by ingesting 8 to 14 Orbs, 14 Strips or 3 Sticks; ingesting 10 to 17 Orbs, 17 Strips or 3 to 4 Sticks could result in severe toxicity or death. A four-year-old child could have moderate symptoms by ingesting 13 to 21 Orbs, 14 Strips or 4 Sticks and could suffer severe toxicity or death by consuming 16 to 27 Orbs, 27 Strips or 5 Sticks. The researchers report that a poison control center in Portland, Oregon, a test market for Orbs, reported a case in which a three-year old ingested an Orbs pellet.

R.J. Reynolds claims that Orbs packaging is “child resistant,” but the researchers say adults could unknowingly leave the pellets out in the open where children could easily access them. The researchers also say that the candy-like appearance and flavoring and ease-of-use of the product could appeal to children.

###

“Unintentional Childhood Poisonings Through Ingestion of Conventional and Novel Tobacco Products,” Gregory N. Connolly, Patricia Richter, Alfred Aleguas Jr., Terry F. Pechacek, Stephen B. Stanfill, Hillel R. Alpert, Pediatrics, online April 19, 2010.

Harvard School of Public Health (http://www.hsph.harvard.edu ) is dedicated to advancing the public’s health through learning, discovery, and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children’s health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit:http://www.hsph.harvard.edu

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