Add candy-like nicotine "orbs" to the list of hazardous products that look enticing to little ones. The size of a Tic-Tac, the flavored pellets pack a nicotine punch that could be fatal to children, according to a report published today in the journal Pediatrics.

Advertised in mainstream magazines, the Camel nicotine pellets are promoted as an alternative to cigarettes to use in places where smoking is banned. Although the advertising is careful to say it is "not a safe alternative."

Indeed, according to Gregory N. Connolly, lead author of the study and director of the Tobacco Control Research Program at the Harvard School of Public Health, the potential public health effect could be disastrous, particularly for infants and adolescents. “This product is called a ‘tobacco’ product, but in the eyes of a 4-year-old, the pellets look more like candy than a regular cigarette. Nicotine is a highly addictive drug and to make it look like a piece of candy is recklessly playing with the health of children,” said Connolly.

Ingestion of tobacco products by infants and children is a major reason for calls to poison control centers nationwide, according to the report. In 2007, 6,724 tobacco-related poisoning cases were reported among children five years of age and under. Small children can experience nausea and vomiting from as little as 1 mg of nicotine, which is how much an orb contains. The smokeless products are also sold as sticks and strips, which contain even more nicotine. All are being test marketed by R.J. Reynolds Tobacco.

Based on median body weight, researchers determined how much nicotine ingestion would lead to symptoms of poisoning in children: A one-year-old infant could suffer mild to moderate symptoms of nicotine poisoning by ingesting 8 to 14 Orbs; ingesting 10 to 17 Orbs could result in severe toxicity or death. A four-year-old child could have moderate symptoms by ingesting 13 to 21 Orbs and could suffer severe toxicity or death by consuming 16 to 27 Orbs, the HSPH reported. The researchers report that a poison control center in Portland, Oregon, a test market for Orbs, reported a case in which a three-year old ingested an Orbs pellet.

David Howard, a spokesman for Reynolds told The New York Times that the Orbs packages were child-resistant and denied that they looked like Tic-Tac mints: "Those packages don't look at all alike to me."

Read the full report, “Unintentional Childhood Poisonings Through Ingestion of Conventional and Novel Tobacco Products,” on the Pediatrics Web site.

Image courtesy of Andrew Seidenberg, Harvard School of Public Health