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E-Cigarette Overdose: How Much Liquid Nicotine Would It Take To Kill You?

Photo by Lindsay Fox/Flickr

Above: Liquid nicotine comes in different shapes, sizes, and concentrations.

Nicotine is a poison. And not just a long-term poison in the sense that smoking can put you on the slow but steady road to cancer.

It's a poison like arsenic or cyanide is a poison. Enough of it can kill you dead, in minutes flat. Just ask Gustave Fougnies, the wealthy brother-in-law of the greedy Belgian Count Hippolyte Visart de Bocarmé. Oh wait, you can't, because he's dead — murdered by nicotine poisoning.

Nicotine's poisonous properties were highlighted in a recent article in The New York Times that raised concerns about e-cigarettes and the bottles of liquid nicotine used to refill them. The director of California Poison Control's San Diego division, Lee Cantrell, told reporter Matt Richtel:

It’s not a matter of if a child will be seriously poisoned or killed. It’s a matter of when.

E-cigarettes must be accustomed to public scrutiny by now, especially in San Diego County. Carlsbad, Vista, Solana Beach and Poway have all banned e-cigarettes wherever tobacco is already prohibited. The city of San Diego is considering a similar ordinance.

Cantrell's quote about nicotine's potential deadliness got me wondering... how much liquid nicotine would it take to kill you? The answer to that question turned out to be more complicated than I expected.

The Centers for Disease Control and Prevention says 60 milligrams of nicotine is enough to kill a 150-pound adult. That's alarming! Because some e-cigarette "juice" formulas pack as much as 72 milligrams per refill. Even if nicotine isn't absorbed fully when inhaled as a vapor, that's getting scary close to lethal territory. If you plan to suck this stuff down quickly (pushing through the nausea signaling you've had enough), you might want to prepare your last will and testament.

Or maybe not.

A closer look at the history behind nicotine's stated lethal dose suggests 60 milligrams probably isn't anywhere near enough to kill. German toxicologist Bernd Mayer wanted to know where this number came from, so he traced it back to a dubious 19th century experiment carried out by two brave researchers... on themselves.

After consuming a reported dose of just 4 milligrams of nicotine, the men known only as Dworzack and Heinrich...

...became agitated, suffered from headache, dizziness, numbness, cloudy vision and hearing, light sensitivity, anxiety, dryness of the throat, coldness of the limbs, ructus [belch], flatulence, nausea, vomiting and rectal tenesmus ... After 45 minutes the experimenters lost consciousness. One of them suffered clonic seizures for 2 hours, particularly of the respiratory muscles, also tremors of the limbs and shivering over the whole body.

If these symptoms seem drastic for the amount of nicotine consumed, they are. Two cigarettes alone can pack 4 milligrams of nicotine, and plenty of chain-smokers go through multiple cigarettes without puking, passing out or having seizures. But 50 years later, another German scientist uncritically took Dworzack and Heinrich's results, did some arbitrary math and produced the 60 milligram figure still cited today.

Mayer suggests the true lethal dose of nicotine may be 10 times higher than the CDC's estimates. Meaning you'd have to hastily refill your e-cigarette at least 10 times with the strongest juice on the market before vaping got you anywhere near the grim reaper. Even then, you still might live. One case study documents a person who ingested 1,500 milligrams of liquid nicotine and survived, suffering no worse than "abdominal pain and voluminous vomiting."

But for Cantrell and other toxicologists worried about liquid nicotine, vaping isn't the problem. The refill bottles are the problem. The larger containers of the more concentrated stuff pack enough nicotine to endanger small children, who might mistake the brightly labelled and sweetly flavored products as candy. Liquid nicotine has already killed a cute bull terrier in England and been the agent for at least one suicide.

Put simply, the question "How Much Liquid Nicotine Would It Take To Kill You?" leads to two answers. "A Lot!" and "Actually, Not That Much." Smoking a single refill of strong 72 milligram juice won't kill you, as CDC information seems to suggest. Most people vape much lower concentrations, anyway. But drinking a whole bottle of that juice could easily turn deadly. For instance, that bottle I linked to earlier contains 3,600 milligrams of nicotine total. We may not know the exact lethal dose of nicotine, but I'm not about to chug 3,600 milligrams in hopes of finding out.

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