Snus is a moist, ground tobacco product, typically sold in small pouches, intended for oral use. Users place the pouch under the upper lip, allowing nicotine to absorb through the mouth’s mucous membranes. Swallowing snus is strongly discouraged because it bypasses this intended absorption method, introducing a high concentration of nicotine and other components directly into the digestive tract. This accidental ingestion poses a significant risk of acute nicotine toxicity and severe gastrointestinal distress.
Understanding Snus Composition and Intended Use
Snus is composed primarily of ground tobacco, water, salt, flavorings, and alkali compounds like sodium carbonate or sodium bicarbonate. These alkali compounds, known as pH adjusters, are deliberately added to increase the product’s alkalinity. A higher pH converts a larger proportion of the nicotine into its free-base form, which is uncharged and can pass more easily across biological membranes.
The intended use involves placing the pouch against the gum, where the nicotine is absorbed through the thin lining of the mouth, known as the oral mucosa. This method is designed for controlled nicotine delivery directly into the bloodstream, bypassing the harsh environment of the stomach. When snus is swallowed, the high concentration of free-base nicotine, combined with the caustic nature of the alkali compounds, is introduced to the sensitive tissues of the esophagus and stomach.
Acute Effects of Swallowing Snus
When snus is swallowed, the gastrointestinal tract becomes a rapid absorption site for the nicotine, leading to a much higher risk of acute toxicity, or nicotine poisoning. Nicotine is a known gastrointestinal irritant, and its presence in the stomach can cause immediate and severe symptoms. The high pH of the snus itself can also irritate the lining of the digestive tract, contributing to the initial discomfort.
Common initial symptoms include acute gastrointestinal distress, such as severe nausea, vomiting, and abdominal pain. Although stomach acid may break down some of the nicotine, the initial rapid absorption that occurs can still deliver a high, concentrated dose to the body. This rapid systemic exposure leads to effects beyond the digestive system.
Systemic symptoms can include dizziness, headache, sweating, and an increased heart rate. In more severe cases of acute nicotine poisoning, individuals may experience confusion, tremors, or seizures. These effects are particularly pronounced in children or individuals with no prior tolerance to nicotine, as their smaller body mass makes even a small amount of ingested nicotine potentially dangerous.
Emergency Steps Following Accidental Ingestion
If snus is accidentally swallowed, immediately remove any remaining product from the mouth. The mouth should be thoroughly rinsed with water to remove any lingering tobacco residue. Drinking a small amount of water may help to dilute the stomach contents and ease mild irritation.
It is important to avoid attempting to induce vomiting unless a medical professional specifically instructs it. Vomiting can increase the risk of aspiration and re-expose the esophagus to the irritants and concentrated nicotine. The most important action is to contact Poison Control or emergency medical services right away.
When seeking professional advice, be prepared to state the person’s age and weight, the specific product name, the estimated amount swallowed, and the time of ingestion. Even if the symptoms appear mild, seeking guidance is necessary, especially if the person is a child, as they are at a significantly higher risk for severe nicotine poisoning. Monitoring the person for any worsening symptoms, such as severe vomiting, rapid heartbeat, or confusion, is necessary.