A number of colleagues recently mentioned to me that they’ve heard that new smokeless tobacco products are very dangerous because they cause a lot of poisonings to children.
When I checked the Internet, sure enough — there were plenty of news headlines along the lines of “Tobacco mints tied to poisoning in kids” and “Tobacco candy poisoning kids, study shows.” I thought this looked interesting, particularly as I was unaware of any “tobacco candy.”
On looking into it, I found that the source article was one recently published by Professor Greg Connolly at Harvard University and colleagues. The study examined data on all accidental poisonings resulting from ingestion of tobacco products by children under 6 years old that were reported to poison control centers around the United States.
The study found that over the years 2006 to 2008 there was a total of 13,705 cases reported for all tobacco products, of which the type of tobacco used was unknown in 1,197 cases (8.7%). Of the 13,705 cases, 10,573 (77%) were caused by consuming cigarettes. 167 were caused by consuming cigars, and 1,768 (12.9%) were caused by consuming (presumably traditional forms of) smokeless tobacco.
The new varieties of snus and other novel tobacco products (Camel Orbs, Sticks and Strips) were not widely available in the United States during the period under study, but the authors mentioned that they had heard of 2 cases of mild poisoning of children aged 2 and 3 who had ingested some snus, and a single case of a 3 year old who was believed to have ingested Camel Orbs in 2009.
The paper serves a useful purpose in quantifying the number of accidental poisonings of young children (primarily less than 2 years old) by tobacco products. Clearly this points to the need for greater awareness among tobacco users to not leave these products where children can access them. It also points to the potential need for childproof containers for all tobacco products.
The thing that struck me as rather odd about this paper was that it focused so much on the harmfulness of the novel smokeless tobacco products. The paper included a photograph of Camel Orbs alongside a packet of TicTacs (candies), and certainly they are similar. One difference is that whereas TicTacs are contained in easily opened flip-top containers, the new smokeless tobacco products are contained in containers that are not only childproof, but are psychologist-proof and actually extremely difficult to open by anyone who tries. I suspect that one reason kids may be poisoned by these products is that it is so difficult to get the product out, and almost impossible to put it back in, leading consumers to leave the loose product laying around.
But the data contained in the report found at least 10,573 cases of children poisoned by cigarettes, as compared with one poisoned by Orbs. It seemed rather strange, given that data, for all the focus and media coverage to be on Orbs. Why no call for all cigarettes to be packaged in childproof containers rather than flimsy cardboard boxes?
The core message here should be that tobacco is a poison and should never be left accessible to the hands of children.
Connolly G., et al. “Unintentional child poisonings through ingestion of conventional and novel tobacco products.” Pediatrics, April 2010.