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Study Warns of Child Poisoning from Candy-like Flavored Tobacco Products

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A study published in the April 19, 2010 online issue of the medical journal Pediatrics urges public health authorities to study dangers of dissolvable nicotine products whose candy-like appearance and added flavoring may entice young children and cause accidental poisoning.

Manufacturers market dissolvable nicotine products as an alternative to traditional cigarettes or cigars. They are hard pellets made of finely ground tobacco and nicotine flavored with mint, cinnamon or other flavor and meant to dissolve in the mouth.

By analyzing 2006-2008 records from the National Poison Data System, compiled by the American Association of Poison Control Centers, study researchers found 13,705 cases of ingestion of tobacco products, 70% of which involved infants under the age of one. Cigarettes were the most common cause of the poisoning, smokeless products came second and were increasing in occurrence.

Researchers expressed concern over flavored products such as Camel Orbs, Sticks and Strips.

The study compared packaging of two products in a photograph, Camel Orbs, which is currently in test marketing by R.J. Reynolds, and the product Tic Tac® to illustrate the similarities.

According to the study, ingestion of as little as 1 mg of nicotine by a small child can produce symptoms such as nausea and vomiting. Severe toxic effects of nicotine ingestion may include weakness, convulsions, unresponsiveness and impaired respiration and ultimately may lead to respiratory arrest and death.

“The estimated minimal lethal pediatric dose is 1.0 mg of nicotine per kilogram of body weight,” the study said. A kilogram is equal to about 2.2 pounds.

Camel Orbs, which according to the promotional literature contains 1 mg of nicotine per pellet, as well as Camel Sticks with 3.1 mg of nicotine per stick and Camel Strips with 0.6 mg of nicotine per strip.

In a letter to Margaret Hamburg, Commissioner of the U.S. Food and Drug Administration (FDA), U.S. Senator Frank Lautenberg, of New Jersey, expressed concern regarding dissolvable tobacco products, such as Camel Orbs, Sticks and Strips. He urged the FDA to remove these products from the market until they knew more of their effect on young children and teenagers.

“When a tobacco product that looks like candy is potentially deadly to children, government needs to act,” said Lautenberg in a press release. “These tobacco candies could hook a new generation of teenagers. We need to consider clearing them from store shelves until the effect on young children and teenagers is better understood.”

R.J. Reynolds Tobacco Company released a statement denouncing the study, saying that there are many other products, such as cosmetics and dietary supplements, responsible for more accidental deaths than tobacco product ingestions.

“Tobacco products, along with many other types of goods, need to be kept out of the hands of children,” the release said.

The company says it has prevented accidental ingestion of its products by child resistant packaging in accordance with Consumer Product Safety Commission (CPSC) guidelines and printing the statement, “Keep out of reach of children” on the packaging.

Paul L. Perito, Chairman, President and COO of Star Scientific who produces Stonewall Hard Snuff® and Ariva®, wrote a blistering press release accusing study authors of selectively examining and reporting data from the 2006-2008 annual reports of the American Association of Poison Control Centers.

“These products have been on the market for almost nine years – which hardly makes them "novel" – and in that time, we have not encountered one case of nicotine "poisoning" of a child,” Perito said. “Ariva® and Stonewall® are blister-packaged for exactly this reason – to prevent to the extent possible access to our products by toddlers and children.”