Nicotine-Replacement Therapy Can Be Dangerous to Young Children
Published October 16, 2023 (current as of December 31, 2024)
Nicotine-replacement therapy (NRT) is available as an over-the-counter (OTC) medicine to help people quit smoking. These products are available in various forms such as patches that are applied to the skin or lozenges and gum that are taken by mouth. Unlike most OTC medicines, these products do not come in child-resistant packaging.
Figure 1. An example of a container of Nicorette mint-flavored lozenges. The medicine comes in a plastic container with a flip top similar to ones that also hold candies and mints.
NRT can be dangerous to young children. The lozenges are very similar in size and shape to candy breath mints, and the gum is very similar to flavored chewing gum (Figure 1). People who use these products often carry them within a child’s reach, such as in their purse, car, or desk drawer, or leave them out on the counter. Overdoses of these products can cause an irregular heartbeat, breathing difficulties, and, in some cases, death, especially in children.
Although these products have been available for many years, parents may not be aware of the risks to children. Here are a few cases that have been published in the news over the years:
Buy products that have child resistant packaging and use it. Remember, child-resistant does not mean child-proof.
Secure purses and suitcases that may contain nicotine-replacement medicine. Be aware of products that visitors may bring into your home.
Don’t leave any medicine unattended while answering the door or phone.
Avoid taking medicine in the presence of children.
Avoid throwing unused nicotine-replacement products or other medicines out in open trashcans in the kitchen or bathroom, within reach of a child.
Teach children never to take medicine unless an adult gives it to them. Many poisons look like food or drinks. They should ask an adult before taking candy, food, and drinks from other children.
If you suspect your child took a nicotine-replacement product or other medicine, immediately call 800-222-1222 to reach a Poison Control. If your child has collapsed or is not breathing, dial 911 first.
To learn more about what you can do to prevent poisonings, please visit Poison Control.
More Safety Articles
Inhalers with Steroids Can Cause Temporary Vocal Cord Damage
Certain medicines can cause damage to the vocal cords. The vocal cords are two bands of elastic muscle tissue that sit side-by-side in the voice box at the back of the throat. When you are silent, the vocal cords remain open so you can inhale air into your lungs. When you speak or make other sounds, the vocal cords close and vibrate as you exhale air from your lungs.
Look-Alike Medicines...Use Your Nose to Uncover Mix-Ups
Too close for comfort. A mother discovered that her infant daughter had been taking an allergy medicine instead of an antacid for a month. The baby's doctor had prescribed the antacid Zantac (ranitidine) syrup to help with spitting up and crying. When the mother called the pharmacy for a refill, she requested the same grape flavor of medicine that her daughter had been taking.
One of the most frequent errors in the pharmacy is giving a correctly filled prescription medicine to the wrong customer. Recently, we received another report of this type of error. A parent of a 16-year-old teen picked up what was supposed to be an antibiotic to treat his acne, minocycline. The next month, when looking at the prescription label to call in a refill of the medicine, the teen’s mother realized the prescription medicine was for a different person, and the medicine dispensed was not minocycline. Instead, Xarelto (rivaroxaban), a medicine used to prevent blood clots after surgery or in people at risk of having a stroke, was listed on the label. Fortunately, the teen was not injured. However, the risk of bleeding from taking Xarelto in error for a month is certainly significant.
After nearly 2 weeks in a neonatal intensive care unit, a newborn baby was discharged to home with a prescription for liquid phenobarbital (20 mg per 5 mL) twice a day to prevent seizures. Before leaving the hospital, the baby’s doctor reviewed the prescription with the parents. He made sure the parents knew the baby’s dose (6.5 mg) and how much of the liquid medicine to give the baby for each dose (1.6 mL).