Management overview for nicotine poisoning

Nicotine poisoning is uncommon; it is most likely to occur in young children who accidentally chew or ingest nicotine-containing substances (eg cigarettes, gum, patches, liquid), or in adults who continue to smoke while on nicotine replacement therapy.

Ingestion of the highly concentrated liquid nicotine used in some electronic cigarettes (e-cigarettes) is of particular concern, especially in children—even a sip can result in life-threatening toxicity in a child.

Nicotine toxicity also occurs from exposure to neonicotinoid insecticides and, rarely, ingestion of plants that contain nicotinic alkaloids.

Nicotine poisoning presents with symptoms and signs of a nicotinic cholinergic toxidrome. No antidote exists for nicotine poisoning, and the mainstay of treatment is supportive care.