Dear Alice,

I am a 17-year-old female who hasn’t been feeling well at all. It started a couple nights ago when I was stressed and chain-smoked a lot of cigarettes that night. Two mornings later, I woke up feeling nauseous and dizzy with chest pain, sore throat, a headache, a stiff neck, and swollen nasal passages. I am having a hard time thinking, remembering directions, and doing a few other things. I assumed it was all because I am allergic to second hand smoke, which my doctor predicted for me when I was very young. I read an article about smoking and nausea and found that I have a lot of similar symptoms to nicotine poisoning. I’m really worried about it and don’t know much about the condition. I’m very curious about how long it will last and how much damage there will be to my body if there is any. Please help me Alice!

Sincerely,

Worried Smoker

Dear Worried Smoker,

Take a big breath of fresh air and try to relax. The amount of nicotine inhaled during regular cigarette smoking is usually not enough to cause nicotine poisoning. However, if you don't smoke regularly or smoke more cigarettes than usual, then dizziness and nausea can occur. Most adult cases of nicotine poisoning occur due to prolonged exposure with nicotine-containing pesticides or constant skin-to-nicotine contact, such as with tobacco leaves or in very rare cases, improper use of nicotine replacement therapy (NRT) products, such as the nicotine patch. However, simply put, nicotine poisoning results from too much nicotine whether it's inhaled or absorbed through the skin or stomach. 

It’s great that you took stock in the symptoms you’re experiencing and have thought about what might have caused them. Typically, symptoms of nicotine poisoning usually begin within 15 minutes of exposure and may include:

  • Agitation/restlessness
  • Weakness
  • Burning sensation in mouth
  • Muscle twitching
  • Vomiting
  • Abdominal cramps
  • Heart palpitations
  • Depression
  • Seizures
  • Fainting or coma
  • Breathing that may be difficult, rapid, or even stopped

List adapted from MedlinePlus

Currently, there's no single cure for nicotine poisoning, but a health care provider may treat the symptoms as appropriate. If a person develops minor symptoms, recovery can be relatively quick and long-term effects from nicotine overdose are uncommon. However, if you're still worried, Poison Control can be reached by phone or online. By providing them with your age, weight, symptoms, what was consumed, if it was swallowed or inhaled, and roughly how much, they may better direct you with how to proceed and whether you need to see a medical professional.  

Additionally, you mentioned that you may be allergic to secondhand smoke, which refers to the smoke that's released in the air when a smoker exhales as well as the smoke released from a burning cigarette, cigar, or pipe. Secondhand smoke contains thousands of chemicals, including poisonous ones such as formaldehyde and arsenic, among others. Along that train of thought, there's another type of smoke called thirdhand, which is the residue from tobacco smoke. For example, when a cigarette is smoked, chemicals in the smoke stick to surfaces and can mix with dust particles. This allows the chemicals to last for months after the smoke is gone and continue to mix and react with other pollutants in the air.

Now for what to make of all this: the available information on nicotine poisoning is as hazy as the smoke it produces. Perhaps the chain-smoking made your allergies worse or triggered another illness that your body is now trying to fight. On the other hand, whatever you may be experiencing may be completely unrelated to smoking, and it could just be a coincidence that it arose right after you smoked. If you're allergic to secondhand smoke or have inhaled thirdhand smoke, you may be reacting to that, rather than experiencing nicotine poisoning. With all these different possibilities, you may want to talk with a health care provider who can assess your condition and give you more specifics about how long these symptoms might last, the long- and short-term effects on your body, and how you can make yourself feel better.

Although smoking cigarettes may provide a temporary feeling of relaxation and relief, the worry it can cause afterwards may not be worth it. Other ways to deal with stress include getting some physical activity, talking to a friend, reading a book for fun, cooking up a new recipe, or even watching a little bit of television. You may want to consider giving some of these methods a shot the next time you're having a stressful night. For more information on how to avoid smoking when under stress, check out the Q&A Smoking for stress relief.

If nothing else, this information most likely won't make you feel worse in the morning!

Alice!

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