Common nicotine-containing products: Estimated concentration and toxic amount after ingestion in children

Nicotine source	Concentration*	Toxic amount
E-cigarette solution	0.5 to 36 mg/mL	Ingestion or oral exposure to any amount^¶
Nicotine dermal patch	8 to 114 mg per patch	Any swallowed portion^¶
Cigarette	7 to 15 mg per cigarette	≥3 cigarette butts; ≥1 cigarette
Cigar	7 to 40 mg	1 cigar butt
Gum	2 or 4 mg per stick	½ to 1 stick (2 mg) or ¼ to ½ stick (4 mg)
Snuff (wet)	12 to 16 mg/g	0.125 g (½ small pinch)
Chewing tobacco	6 to 8 mg/g	0.25 g (small pinch)
Orb (flavored)	1 mg per pellet	1 to 2 orbs
Snus (flavored tobacco pouch)	4 to 16 mg/g^Δ	½ pouch
Snus (loose)	11 to 27 mg/g^Δ	0.125 g (½ small pinch)

* Precise nicotine content varies by brand.

¶ Any dermal exposure to concentrated e-cigarette solution or longer than 20 minutes to a transdermal nicotine patch can result in serious toxicity.

Δ Between 20 to 40% of nicotine is extracted during normal oral use depending upon the specific product.

References:

Maessen GC, Wijnhoven AM, Neijzen RL, et al. Nicotine intoxication by e-cigarette liquids: a study of case reports and pathophysiology. Clin Toxicol (Phila) 2020; 58:1.
Digard H, Proctor C, Kulasekaran A, et al. Determination of nicotine absorption from multiple tobacco products and nicotine gum. Nicotine Tob Res. 2013; 15:255.
Taghavi S, Khashyarmanesh Z, Moalemzadeh-Haghighi H, et al. Nicotine content of domestic cigarettes, imported cigarettes and pipe tobacco in iran. Addict Health 2012; 4:28.
Woolf A, Burkhart K, Caraccio T, Litovitz T. Childhood poisoning involving transdermal nicotine patches. Pediatrics 1997; 99:E4.
Nicorette Gum. https://www.nicorette.com/products/nicorette-gum.html (Accessed on January 15, 2021).

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