Chewing tobacco is a form of smokeless tobacco designed for nicotine absorption through the mouth lining, not the stomach. It contains highly concentrated nicotine and numerous other toxic chemicals. Swallowing chewing tobacco, or the juices produced while using it, is never safe and immediately exposes the body to a toxic dose of these substances.
Nicotine Toxicity and Systemic Effects
Swallowing chewing tobacco causes acute nicotine poisoning, as the drug is rapidly absorbed through the stomach and intestinal walls into the bloodstream. Nicotine acts quickly on the central and autonomic nervous systems, causing symptoms that follow a two-phase pattern. The initial phase is stimulatory, often resulting in a rapid heart rate, a temporary spike in blood pressure, tremors, and a headache.
This stimulation is followed by a depressant phase, which can occur within minutes to a few hours of ingestion. During this stage, the heart rate slows (bradycardia), blood pressure drops significantly (hypotension), and the person may experience muscular weakness, confusion, and dizziness. In severe cases, the respiratory system can become depressed, leading to shallow breathing, respiratory failure, or a coma. The highly concentrated saliva, or “spit,” produced while chewing poses a similar risk of nicotine overdose if swallowed.
Immediate Gastrointestinal Distress
Beyond the systemic effects of nicotine, ingesting the tobacco product causes distress to the digestive system. The caustic nature of the tobacco and its chemicals immediately irritate the stomach lining, or gastric mucosa. This commonly leads to severe nausea, vomiting, and intense abdominal cramping.
Vomiting is a common early symptom of nicotine poisoning from ingestion, occurring in over 50% of cases. The chemicals in the tobacco can also trigger an influx of stomach acid production. This further contributes to the burning sensation and discomfort in the abdomen.
Non-Nicotine Carcinogens and Additives
Swallowing chewing tobacco exposes the esophagus and stomach to a high concentration of harmful, non-nicotine components. Smokeless tobacco contains over 4,000 chemicals, with at least 30 linked to cancer. The most dangerous compounds are Tobacco-Specific Nitrosamines (TSNAs), which are potent carcinogens.
If ingested, these carcinogens and other toxic materials, such as heavy metals like arsenic, lead, and cadmium, travel directly through the digestive tract. These compounds increase the risk of cancers in the esophagus and pancreas, and they contribute to the irritation and damage of the stomach lining. While nicotine presents the acute poisoning threat, these non-nicotine ingredients pose a severe chemical hazard to the digestive organs.
When to Seek Emergency Medical Care
Ingesting any amount of chewing tobacco requires immediate attention, as symptoms of nicotine poisoning can progress quickly. Contact Poison Control or emergency services immediately if severe symptoms develop, particularly in children or individuals with no tolerance. Specific signs requiring medical attention include seizures, difficulty breathing, a change in consciousness, or persistent, severe vomiting.
Medical professionals focus on stabilizing the patient and preventing further absorption of the nicotine. Treatment often involves administering activated charcoal to bind the nicotine remaining in the stomach and intestines. Supportive care may include intravenous fluids for low blood pressure, medications (like benzodiazepines) to control seizures, and mechanical ventilation if respiratory function is compromised.