Tobacco and cigarette butt consumption in humans and animals

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  1. Thomas E Novotny1,
  2. Sarah Northward Hardin1,
  3. Lynn R Hovda2,
  4. Dale J Novotny3,
  5. Mary Kay McLean4,
  6. Safdar Khan4
  1. 1Graduate School of Public Wellness, San Diego State University, San Diego, California, USA
  2. 2SafetyCall International, PLLC and Pet Poison Helpline, Bloomington, Minnesota, Usa
  3. 3San Diego State University Research Foundation, San Diego, California, USA
  4. 4ASPCA Brute Poison Command Eye, Urbana, Illinois, U.s.a.
  1. Correspondence to Professor Thomas E Novotny, Graduate Schoolhouse of Public Wellness, San Diego Land Academy, Hardy Tower 119, 5500 Campanile Drive, San Diego, CA 92186, USA; tnovotny{at}mail.sdsu.edu

Abstract

Discarded cigarette butts may nowadays health risks to homo infants and animals because of indiscriminate eating behaviours. Nicotine institute in cigarette butts may cause vomiting and neurological toxicity; leachates of cigarette butts in aquatic environments may cause exposure to additional toxic chemicals including heavy metals, ethyl phenol and pesticide residues. This written report reviews published and grey literature regarding cigarette butt waste consumption by children, pets and wild fauna. Although reports of human being and creature exposures number in the tens of thousands, severe toxic outcomes due to butt consumption are rare. Nonetheless, the ubiquity of cigarette butt waste and its potential for adverse effects on human and beast health warrants boosted research and policy interventions to reduce the stream of these pollutants in the environment.

  • Toxicology
  • environment
  • public policy

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  • Toxicology
  • environs
  • public policy

Introduction

Cigarette butt waste material is not just unsightly, just when ingested may be chancy to the health of humans and animals. Cigarette butts are commonly discarded onto beaches, sidewalks, streets, parks and many other public places where children, domestic animals and wild fauna may be exposed to run a risk of ingestion; they may also be accessed by children from ashtrays at habitation, in cars or in public places. When carelessly discarded by smokers, they are carried from storm sewers and beaches to streams and waterways leading directly to the aquatic environment.1 Infants, as well as many sea creatures, birds and pets are indiscriminate eaters, and ingested plastic trash, including cigarette butts, tin choke an animal or poison information technology with toxins. Animals may not be able to regurgitate such items, with some acquiring gastrointestinal bezoars that tin can lead to a imitation sense of satiation and subsequent under-nutrition.ii However, canines often self-decontaminate through vomiting.

Cigarettes contain at least 4000 chemicals, with almost l of these being carcinogenic.3 Many of these chemicals are derived from agricultural use in tobacco growing, including herbicides, insecticides, fungicides and rodenticides; humectants may be added to go on tobacco moist. Many are additives used in flavouring and adjusting the burn rate of cigarettes, and the tobacco industry has reported many of these as being 'generally regarded as safe'—when consumed equally food, merely not necessarily when combusted and so consumed.4 Cigarette butts have been shown to leach out numerous chemicals such as heavy metals, nicotine and ethylphenol in water and may be a continual bespeak source for contagion of aquatic environments after discarding.five One laboratory-based study has shown that cigarette barrel leachates tin can kill water fleas (Daphnia species) in relatively low concentrations.6 Slaughter et al demonstrated that the median lethal dose is approximately one cigarette butt per litre of water for both freshwater and saltwater test fish species.vii

Approximately 0.half-dozen–3.0% of tobacco (by dry out weight) is composed of nicotine, a constitute pesticide,viii although it is no longer used equally such in the United states of america. Nicotine is the nigh commonly reported toxic substance causing symptoms among children who have consumed cigarettes or butts. Although a typical cigarette contains from nine mg to 30 mg of nicotine, inhalation through smoking is but virtually 0.5–2 mg per cigarette. The estimated toxic dose of nicotine in non-addicted adults is 4–8 mg, and the lethal dose after i-fourth dimension ingestion amid children is reported as xl–60 mg.nine Nicotine in tobacco products is quickly absorbed by oral and intestinal mucosa, and alkalinisation enhances absorption; nicotine-related symptoms develop speedily (<4 hours) subsequently ingestion.10 These may represent a wide diverseness of symptoms including nausea, airsickness, salivation and diaphoresis; with severe poisoning, there may exist convulsions, bradycardia with hypotension, cardiac arrhythmias and respiratory depression.

Cigarette butts have a bitter sense of taste, and thus this may limit the amount of nicotine that is accidentally ingested. Nonetheless, children often explore their surround through oral contact or through mimicry of developed behaviours.xi In young children, one–2 mg may exist toxic, causing nausea and vomiting in low doses, and more all-encompassing neurological symptoms with higher doses.12

In pets, an oral minimum lethal dose of nicotine in dogs is reported to be 9.two mg/kg; however, clinical signs have been reported at doses as depression equally one mg/kg. In small dogs, signs tin be seen later on the ingestion of one cigarette.13 With large ingestions, dogs may take a very poor prognosis every bit a result of nicotine toxicity.14 Pet birds are specially sensitive to many chemicals owing to their modest size and very efficient metabolism. Curious birds have been reported to ingest cigarette butts left in household ashtrays and have died as a result.15

In order to evaluate the potential extent of cigarette and barrel ingestion among animals and humans, we present a brief summary of ingestion reports from published and gray literature, every bit well as results of a brief online survey of the Cigarette Butt Pollution Projection (CBPP) contacts who might be involved in wild animate being rescue and monitoring. We also report data from ii national veterinary poison command resources centres.

Methods

First, nosotros searched published material using the PubMed database to identify reports on cigarette butt ingestion past humans or animals. Second, boolean searches were conducted using http://google.com for "cigarette butt ingestion", "my canis familiaris ate a cigarette", "animals that eat cigarette butts", "kid poisoning" and "child cigarette ingestion". Published fabric found on the web search was retrieved from the San Diego State University library databases. Next, nosotros posted a request on the CBPP website (http://www.cigwaste.org) seeking information from website visitors regarding cigarette butt ingestion by wild animals or pets. We then used SurveyMonkey,xvi a free online market enquiry tool, to seek information by email from CBPP voluntary contacts regarding cigarette butt ingestion by marine animals including birds, mammals, turtles and fish. This survey consisted of ten questions asking whether the volunteers had worked with marine animals and had observed ingested cigarette butts; if they had whatsoever specific knowledge of reports on animals ingesting cigarette butts; and if they knew of cigarette butts found on necropsies of recovered animals. The survey allowed open-concluded responses to refer to other individuals, organisations or reports. In add-on, specific information was sought from the San Diego Zoo pathology database involving recovered wildlife and zoo animals' necropsy reports. Finally, co-authors (MKMcL and LRH) provided data from the ASPCA Brute Toxicant Control Centre (AAPC), Urbana, Illinois, and the Pet Poison Assist Line (PPH), Bloomington, Minnesota, on reported cigarette and cigarette butt ingestion from 2005 to 2010.

Results

Cigarette barrel consumption past humans

Reports of adventitious ingestion of cigarettes (and butts) are not uncommon among children, specially those <half dozen years old. Nigh reports and reviews of cigarette and barrel ingestion have described few significant toxic responses or sequelae among children to cigarette or butt consumption (table 1), but some accept shown severe toxicity with as few equally two cigarettes consumed.17

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Tabular array ane

Reports of cigarette and butt ingestion among children, 1983–2009

Some business organization was raised22 well-nigh the possible differences betwixt European and American tobacco's nicotine content because the ii studies reporting more than severe observed toxicity were European (in Greece and Italian republic). Malizia et al9 described four children who ingested ii cigarettes each and developed salivation, vomiting, diarrhoea, tachypnoea, tachycardia and hypotension within xxx minutes, and depressed respiration and cardiac arrhythmias within forty minutes. Convulsions occurred within lx minutes of ingestion. All recovered after gastric lavage with activated charcoal, intermittent positive pressure level ventilation and intravenous diazepam for convulsions. In addition, one older prospective study17 as well reported toxicity amongst four of five children (aged 20 months-nine years) consuming from half to four pieces of nicotine gum.

In a review of 20 cases of 'cigarette tobacco' ingestion past children ≤ii years of age in Wisconsin,19 13 children were treated with emetics and activated charcoal, and but 1 child was symptomatic plenty to require hospitalisation. In Philadelphia, the Albert Einstein Hospital Emergency Department described 700 children <6 years former who ingested cigarettes or cigarette butts and reported to the Poison Command Centre in 1988-91.18 Of these, 143 (twenty.4%) were symptomatic, and vomiting was the only symptom in 138 (98.6%), occurring in <twenty minutes in 104 (74.3%). In 1997, the Rhode Isle Department of Health reported 146 cases of cigarette barrel ingestion among children <half dozen years old; of these, approximately one-third displayed transient nicotine toxicity.21 During 2001 to 2006, 276 children presented at the Japan Red Cross Infirmary with cigarette ingestion.23 The majority of these were <i year old, and 83% were asymptomatic and thus treated with only observation.

Based on the population-representative National Electronic Injury Surveillance Arrangement of the US Consumer Production Safety Commission, Quirk24 reported approximately 12 000 total cigarette injuries in 2002–vii. Of these, virtually 4400 (i-third) were listed as 'ingestion' or 'poisoning'. The other almost common diagnoses were burns (43%) and bruises or abrasions (12%). From 2006 to 2008, the American Association of Poison Control Centers (AAPCC) reported nearly 14 000 injuries acquired by tobacco products among children, 70% of whom were <6 years old. Most of these exposures (ninety%) were due to the ingestion of cigarettes or cigarette butts.25 The vast majority of these incidents were not-toxic and the children were not hospitalised.

A contempo study of new, flavoured, dissolvable, processed-like smokeless tobacco products26 provided further data regarding accidental consumption. Connolly et al analysed 13 705 tobacco product ingestion cases reported to the National Poison Data Arrangement for 2006–viii, most (70%) of which were amidst infants <one year of age. Smokeless tobacco products were the 2d nearly common tobacco products ingested by children, later on cigarettes and used filter tips, and increased in proportion with increasing age. Further regulatory review of these new products was recommended.

Cigarette barrel consumption by pets and wildlife

Reports of nicotine ingestion in domestic animals are rare; however, this ingestion tin cause excessive salivation, excitement, tremors, vomiting, lack of coordination, weakness, convulsions, respiratory failure and even decease.27 28 There are merely anecdotal reports of wild animals (bounding main turtles) ingesting cigarettes butts.29 No reports of cigarette butt ingestion were found on a review of the San Diego Zoo Necropsy Database (C Witte, personal communication i Dec 2010).

Over the menstruum 2005–x, the PPH and the APCC received calls on 801 cases of cigarette or butt ingestion amid dogs, on 41 among cats and on half-dozen among other brute species (table 2). Animals ingesting multiple items other than cigarettes or butts or those in multi-beast households were excluded from the PPH database analysis. Follow-up data were unavailable on some of the ingestions from PPH, only most symptomatic cases involved gastrointestinal signs (primarily retching and vomiting) and neurological signs such irritability, sluggishness or ataxia. Ingestion ranged from one cigarette or butt to an ashtray full of butts and a pack of cigarettes.

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Table 2

Reported cigarette and cigarette butt ingestions by domestic animals, USA, 2005–ten*

According to the APCC, in canine cases that were assessed by APCC staff every bit highly likely to be due to tobacco ingestion (time, clinical finding, history are sufficient and characteristic of a toxicosis from the amanuensis) or medium likely (findings are characteristic, only historical and/or clinical data not completely bachelor), 55% of patients had airsickness and 25% of patients were ataxic after ingestion. Other common signs included lethargy, tremors, hypersalivation and bradycardia. Ingestion ranged from one to xxx cigarette butts.

But xiv responses were received from the SurveyMonkey process. Of these, none reported finding cigarette butt ingestion in a sick or dying brute. When asked "Do you see cigarette barrel waste matter as a major environmental concern, and if so, why or why not," only four responded affirmatively. Selected open-concluded responses included: "I see so much of it in our environment", "(concern) due to quantities and harm" and "During a two mile cardio walk I usually pick upward over 100 of them, just I practice not know the affect on wild fauna".

Discussion

This review suggests that cigarette barrel consumption by pocket-sized children and animals is a frequent source of business and attention for poison control centres, parents and pet owners. The ubiquity of this waste should thus be a business organization for policymakers who would seek to reduce the costs of dealing with tobacco ingestions for both parents and providers. We found that severe poisoning by cigarette butts among young children was rare but possible and that poisonous substance centres already emphasise the demand to reduce the gamble of poisoning by tobacco products.30 It is articulate that smokers must treat cigarette butts as toxic waste products and accept more care in discarding them; children will mimic parental behaviour by putting these items into their mouths and sometime eat them in quantities sufficient to be toxic. Information technology is likewise clear that new, flavoured tobacco products are a source of concern for poisoning amidst small children because these products, unlike cigarette butts, are not foul tasting.

Veterinary reports of nicotine poisoning are uncommon, but domestic animals may swallow them and show serious gastrointestinal, central nervous system and cardiovascular signs. Veterinarian poisonous substance centre information may be further studied with regard to follow-up on reported exposures and outcomes of these exposures.

We have not yet been able to identify well-documented reports of cigarette butt consumption by wild fauna. However, this does non mean that such consumption does non occur. On the other hand, cigarette and barrel consumption among domestic animals is adequately common and of concern to pet owners. It would logically follow that wild animals might likewise exist at chance of butt consumption in natural environments. Our brief email survey and web-based entreatment for data were very limited by lack of structure, response and a non-representative sampling design.

Future survey research on knowledge, attitudes and practices involving cigarette butt waste product should be conducted systematically, possibly through key informant surveys or even population-based surveys of smokers and non-smokers. There is substantial and growing evidence near the toxicity of cigarette butt leachates in aquatic environments, but more enquiry is needed to ascertain specific toxic substances in cigarette butt leachates, their bioaccumulation potential and chemic markers of cigarette barrel waste product in natural settings.

Given the precautionary principle for environmental hazards,31 the potential impairment to children, pets and wildlife acquired by cigarette barrel waste matter in the surroundings should be recognised. This concern might be addressed by belongings accountable tobacco producers for costs incurred for medical care expenditures caused past barrel consumption by children and animals and for mitigation of cigarette butt waste in the environment.32

Acknowledgments

The authors are grateful to the Pet Poison Help Line, the ASPCA Animal Poisonous substance Control Center and the San Diego Zoo for providing access to their information on fauna consumption of tobacco products.

References

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    U.Southward. Section of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, GA, United states: United states Section of Wellness and Human Services, Centers for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Office on Smoking and Wellness, 2004.

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    CDC. Ingestion of cigarettes and cigarette butts past children—Rhode Isle, Jan 1994–July 1996. Morb Mortal Wkly Rep 1997;46:125–eight.

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