What Happens During Nicotine Overdose?

Are you a smoker who can polish off a pack every day and worry about hitting your body’s limit?

If you use cigarettes, NVPs, or NRT products, you might be at risk for nicotine overdose or poisoning. 

So, how can an overdose happen, and how can you steer clear of it? 

Let’s get into it in today’s post.

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Nicotine Overdose: How it Happens

Nicotine overdose isn’t just a concern for adults and teens; it can happen to little kids too.

They might accidentally swallow a piece of nicotine gum, which can have 2 to 4mg of nicotine—enough to cause nicotine poisoning.

Remember, nicotine can enter your body in different ways—by inhaling it, swallowing it, chewing (like with gum), or even through skin contact.

If nicotine gets on your skin or in your eyes, it can lead to serious problems, especially with liquid nicotine, which is the number one cause of overdose.

Be cautious about buying illegal NVPs because they can have as much as 357mg per disposable unit. 

These unregulated vapes are dangerous, especially if they leak, malfunction, or are accidentally swallowed by a child or pet.

What are Illegal NVPs?

As of 1 March 2024, it’s now illegal to buy NVPs except from registered pharmacies. 

But, you might still see them being sold illegally in local shops or corner stores.

These products often come under the radar from criminal groups that also deal drugs, and are made with really low-quality materials and poor hygiene.

They’re aimed at teenagers and even kids as young as 5 years old.

These dangerous vapes can have very high nicotine levels, and some even contain heavy metals like nickel and lead, along with traces of human saliva. 

Illegal vapes are made and sold purely for profit, with a wholesale price of just $1 but marked up by more than 3,500%.

How Much Nicotine Is Too Much Nicotine?

Nicotine overdose is rare, especially through smoking or vaping. And to this day, no one’s quite sure what the exact limit is.

The Centers For Disease Control and Prevention (CDC) once suggested a lethal dose for adults is 50 to 60mg through inhalation, but this was based on outdated studies, including a 1969 test on mice and rats, and a 1949 study with no solid data.

Overdose risks vary depending on age, size, and how nicotine is taken, with ingestion and intravenous use being the most dangerous.

In a 2008 case, a 42-year-old adult with a history of alcoholism and drug abuse died after ingesting 2 to 4 drops of pure nicotine, each containing 23 to 33mg. 

An Archives of Toxicology review in 2014 found the lethal dose could be between 6.5 and 13mg per kilogram, roughly 450mg for a 70kg person. 

In a 2019 study published in Clinical Toxicology, nicotine overdose survivors who are aged 13 to 53 had ingested between 0.8 to 1.6mg per litre of nicotine.

How Much Nicotine Is in Every Cigarette?

A single cigarette can contain as much as 12 to 15mg of nicotine with only 1 to 2mg absorbed by the body via inhalation. If you’re a 20s pack-a-day smoker, you’re probably consuming about 10 to 20mg of nicotine over the course of an entire day.

But as with cigarettes and combustion, it’s not the nicotine that would cause harm – it’s the chemicals in the smoke you inhale.

How Much Nicotine Is in Every Illegal Vape?

A single illegal NVP can contain as much as 357mg per disposable unit, which can be extremely dangerous if it were to leak or be ingested quickly – especially to teenagers and young children.

Because of the poor quality of illegal vapes in the market, their actual nicotine content varies depending on the product, and their tendency to remain leakproof and safe is also very poor.

A 2016 study showed that some of the devices yielded 10mg of nicotine per decilitre with 10 puffs – a higher amount than a single cigarette stick. 

But, another study in 2019 opposes this finding and suggests that 30 puffs are needed for an illegal NVP to deliver the same nicotine amount as a single cigarette stick.

As you can see, there really aren’t any crystal clear findings at the moment.

Factors That Increase the Risk of Nicotine Overdose 

While the actual amount of nicotine enough to cause overdose is still undetermined, the following factors can increase or decrease that risk:

Nicotine Concentration

As mentioned, every cigarette contains up to 15mg per stick wherein 1 to 2mg is absorbed in the body. However, there are some cigarette brands that could pack in higher doses of nicotine in their products. 

The same can be said for illegal NVPs, which aren’t tested and do not abide by any medical standards and manufacturing practices.

Also remember that the ingestion of pure or liquid nicotine might have the highest risk of nicotine overdose as suggested by the studies above – inhalation, chewing, and topical intake may possibly reduce the nicotine you absorb.

Individual Tolerance

Young children will have a significant intolerance of nicotine as opposed to a fully-developed adult human. It’s possible that a nicotine gum or patch is enough to trigger overdose in young children. 

For adults, it can be a significantly higher amount.

Weight

If you’re stockier or bigger, it might take more than the average amount of nicotine to cause an overdose. 

However, with the many unknowns when it comes to the actual amount that triggers poisoning, it’s possible that your size might not insulate you against the effects of small amounts of nicotine ingestion.

For instance, if you have a negative response to nicotine absorption via inhalation, it could prove to be fatal.

Symptoms of Nicotine Overdose

Nicotine overdose symptoms can range from mild to extreme. Here is a list to help you know when to see a GP or call emergency services for immediate aid and recover from your symptoms.

• Nausea and Vomiting
• Increased Heart Rate
• Hypertension
• Dizziness and Lightheadedness
• Excessive Salivation
• Diarrhoea

How to Help Someone With Nicotine Overdose

If you discover that someone has suffered from nicotine overdose, make sure to call your local emergency services immediately.

While waiting for help, try to keep the person calm and in a comfortable position. If the person is conscious and able to swallow, give them water to drink to help dilute the nicotine in their system. 

Do not induce vomiting. Instead, monitor their breathing and pulse and update the first responders about the person’s latest condition.

Pharmacy NVPs: A Medically Supported Way to Wean Off Nicotine

NVPs that you can buy from your local pharmacy are a legitimate path towards smoking cessation. While they’re second-line solutions after going through nicotine replacement therapy (NRT), pharmacy NVPs are thoroughly tested for inhalation safety, are medically supported, and are locally insured – each product is manufactured with the highest medical standards.

While a pharmacy NVP cartridge can contain up to 50mg of nicotine, this is very slowly consumed via inhalation over the course of one to three days. 

With this gradual intake method, you’ll learn to feel your body, understand your cravings and thresholds, and self-titrate as needed.

Here’s how you can go about it.

Go Through First-Line Solutions First

Some motivated smokers can handle cold turkey just fine and see success within a few tries, but oftentimes, smokers have strong withdrawals that can draw them back to lighting a stick.

That’s where NRT products come in. These are readily available and stocked at your local pharmacy.

NRT products are the most trusted quitting option available for motivated smokers. They might not imitate cigarettes, but they contain a small dose of nicotine that may be enough to alleviate your withdrawals. These come in the form of patches and gums for easy and convenient nicotine delivery.

While NRTs can be effective, they don’t work for everyone. If these haven’t done the trick for you, you may now be eligible for a nicotine prescription to use nicotine vaping products (NVPs).

Chat to a GP

As mentioned, NRT products have worked for many successful ex-smokers. But, you might have ingrained behaviours and triggers that only something that mimics a cigarette can successfully address, such as the hand-to-mouth motion, and needing something to use while having a drink with friends. 

That is where NVPs become very handy in helping you fight the urge to consume tobacco.

You need a nicotine prescription before you can purchase NVPs, so you’ll need to consult with a GP to help you on your smoking cessation journey. 

If your GP deems it necessary, they can write you a nicotine prescription for NVPs. 

Chat to your usual GP about this, or book a telehealth consult with an Authorised Prescriber of nicotine.

Visit Your Local Pharmacy

Once you have your nicotine prescription, you can pop down to your local pharmacy. Over 2,200 pharmacies across Australia hold these products in-store, but any pharmacy can order these in for you if they don’t currently stock them.

Both your pharmacist and GP can advise you on how best to use the product, such as the initial setup, and the number of puffs to take when you feel withdrawals.

Summary

Nicotine overdose is a very rare occurrence for any nicotine user – the most likely harms come from inhaling the thousands of chemicals found in cigarette smoke.

If you’re ready to start on your quit journey, we’re always here for you.

Smokefree Clinic gives you access to many medically reviewed and trustworthy resources that can inform and aid you in your path to wellness, so have a look around! 

If you’re ready to get started, Smokefree can connect you to friendly Australian healthcare professionals who excel in helping patients quit smoking for good, including via the use of pharmacy NVPs.

Click here to book in with a doctor today.

Link Reference

• https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/quit-smoking-medications/how-to-use-quit-smoking-medicines/how-to-use-nicotine-gum.html
• https://www.tga.gov.au/news/media-releases/new-regulation-vapes-starting-january-2024
• https://www.vice.com/en/article/n7zb37/we-got-your-vapes-tested-in-a-lab-heres-what-we-found
• https://www.health.gov.au/sites/default/files/2023-06/current-vaping-and-smoking-in-the-australian-population-aged-14-years-or-older-february-2018-to-march-2023.pdf
• https://www.news.com.au/lifestyle/health/health-problems/aussie-kindergarteners-caught-in-vaping-trend-principal-claims/news-story/ee3b6b89457c9e6e089b535abe89170b
• https://www.bbc.com/news/health-65614078
• https://www.newshub.co.nz/home/new-zealand/2023/08/paddy-gower-on-vaping-shocking-facts-uncovered-about-the-known-and-unknown-health-risks-of-e-liquids.html
• https://www.cdc.gov/niosh/idlh/54115.html
• https://pubmed.ncbi.nlm.nih.gov/5795527
• https://pubmed.ncbi.nlm.nih.gov/19954906/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880486/
• https://www.tandfonline.com/doi/full/10.1080/15563650.2019.1636994
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795520/
• https://pubmed.ncbi.nlm.nih.gov/27693003/
• https://rc.rcjournal.com/content/64/3/328
• https://www.iso.org/iso-13485-medical-devices.html