US researchers writing in a leading journal concluded that a new form of pelleted tobacco product that in some cases looks like candy could poison children and lure young people into nicotine addiction.

You can read about the study, by researchers from the Harvard School of Public Health (HSPH), the Food and Drug Administration (FDA), the Northern Ohio Poison Control Center and the Centers for Disease Control and Prevention (CDC), online in the 19 April ahead of print issue of Pediatrics.

Last year, RJ Reynolds, one the biggest tobacco companies in the US, started market testing a new pelleted product made with finely ground tobacco flavoured with mint or cinnamon that dissolves in the mouth like breath mints. The product, called Camel Orbs, contains 1 mg of nicotine per pellet, which is about the same as that contained in the average nicotine lozenge marketed to people trying to quit smoking.

However, according to a CNN news report, Orbs, and other products in the range, Camel Strips (0.6 mg nicotine per strip) and Sticks (3.1 mg nicotine per strip) appear to be a new trend in the tobacco industry to create smokeless nicotine products that people can use in places where it is no longer legal to smoke, like bars and restaurants.

1 mg of nicotine is enough to make a small child feel nausea and vomit, said the researchers, who in their background information stressed that one of the biggest causes of poisoning that leads to calls to poison control centers throughout the US is babies and children swallowing tobacco products. The figures for 2007 show over 6,700 reported cases of tobacco-related poisoning among children aged 5 and under.

A poison control center in Portland, Oregon has already reported a case where a three-year old ingested an Orbs pellet. The center is in a region where the tobacco product is being test marketed.

Lead author and director of the Tobacco Control Research Program at HSPH, Professor Gregory Connolly, told the media that the introduction of these new products could be disastrous for public health, particularly for infants and adolescents.

Connolly said that while the product might be described as a “tobacco” product, to a four-year old child it looks like candy.

“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 also noted that intentional use of smokeless tobacco products among adolescents went up 6 per cent per year from 2002 to 2006.

For the study the researchers worked out how much nicotine, based on median body weight, children would have to ingest to experience symptoms of poisoning:

  • A one-year old child could get mild to moderate symptoms of poisoning from 8 to 14 Orbs, 14 Strips or 3 Sticks, while ingesting 10 to 17 Orbs, 17 Strips or 3 to 4 Sticks, could cause severe poisoning and death.
  • A four-year old child could get mild to moderate symptoms of poisoning from 13 to 21 Orbs, 14 Strips or 4 Sticks, while ingesting 16 to 27 Orbs, 27 Strips or 5 Sticks, could cause severe poisoning and death.

The manufacturer argues that the packaging is child resistant, but the researchers said that adults could leave them lying around opened, and that this together, with their appealing candy-like appearance and flavoring, increases the chances that children will ingest them.

In an interview reported by CNN, Reynolds spokesman David Howard, said he didn’t think Camel Orbs looked “at all” like Tic Tac mints.

Howard stressed that the product was marketed to adults and came in child-resistant containers, and said it was unfair to criticize a product because of its flavoring, and pointed to smoking cessation aids like Nicogum. Besides, nearly every household has products that can poison children, such as cleaning products, medicines, health and beauty products, he said.

But that is not the point, commented one expert, who said children will be influenced by the behavior of the adults they observe.

Dr Jonathan P Winickoff, a Harvard medical professor and chairman of the American Academy of Pediatrics Tobacco Consortium, told CNN that, the last time he checked, he didn’t see adults going around “drinking toilet bowl cleanser in front of their kids”.

Winickoff also commented that accidental poisoning of young children was no the only cause for concern, intentional use by kids and teenagers was likely to be another public health problem from introduction of dissolvable nicotine products.

He said teenagers will look at the products and think they are harmless, and not realize they are exposing their brains to nicotine and priming themselves to become nicotine addicts.

“If teens ended up using smokeless product because they are attracted to candy flavors and they end up getting addicted to nicotine, the public health benefit of smokeless tobacco is neutralized,” said Winickoff, who was not involved in the study.

“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.

Source: HSPH, CNN.

Written by: Catharine Paddock, PhD