In 2013, 16 elementary school children were hospitalized with a sudden illness. All the students were vomiting after having eaten “mints” given to them by a fellow classmate. Upon further research, these were found to be NiQuitin nicotine mints, similar in appearance to Tic-Tacs, which contained between 1.5-4 mg of nicotine per mint.
In the US, Nicorette lozenges come in 2 and 4 mg strengths, and are often mistaken for gum by small children due to their packaging. NiQuitin mints release their nicotine faster into the bloodstream, and in some cases of accidental overdose, can lead to serious health complications such as irregular heartbeat, difficulty breathing, and death. NiQuitin is a product sold in the UK, and US pharmacies must do their part to ensure that Nicorette products are safely stored by adult customers which are purchasing them. Nicorette is packaged in similar foil pop-out trays to gum, and if left unattended, can quickly be opened by children.
Adults who use Nicorette gum or another nicotine supplying product must be educated on proper storage of these items. Having these items on a counter or in a purse is tempting to a child, which can easily access them to ingest or share with friends. Keeping these products out of the reach of children can be accomplished by securing purses and diaper bags, and keeping a close eye on visitors’ belongings. Unattended bags can be a point of curiosity for children, who may find Nicorette gum or a nicotine containing medication in a bag which is left out in the open.
Referring to any medication as “candy” is strongly cautioned against. Avoiding taking medication in front of young children can also help to curb curiosity. Parents and caregivers can instruct children to not take any medication unless an adult administers it, and to always ask an adult before eating any candy or food given to them by another child. Keep your local poison control center telephone number in a place that is easy to access, and save it to cell phone contacts for on-the-go emergency attention.
Pharmacists can do their part to educate parents and children about the dangers of accidental nicotine lozenge ingestion by offering a workshop or distributing pamphlets, so that children understand and recognize that these medications are not candy or treats. Parents can be advised on proper storage techniques, and how to best continue their efforts to stop smoking while ensuring that their child does not ingest any harmful medication. Quitting smoking can cause anxiety in parents, which in some cases can lead to forgetfulness caused by stress. Ensuring that nicotine medications are kept in a secure place away from children is crucial to helping parents make the transition from smoker to non-smoker. Young children can be educated on how to refuse food and drinks from their peers politely, and to never accept strange candy like objects that they do not recognize from other children.