National Programme for Substance Abuse Deaths (np-SAD), International Centre for Drug Policy, St George's, University of London, Cranmer Terrace, London SW17 0RE, United Kingdom.
Forensic Sci Int. 2010 Jun 15;199(1-3):e9-13. doi: 10.1016/j.forsciint.2010.02.004. Epub 2010 Mar 3.
Tobacco is one of the most easily accessible and commonly abused drugs world-wide. Nicotine, one of its principal constituents, can cause serious or fatal overdoses. Whilst the deliberate ingestion of this substance appears to be relatively rare, often the important signs of its consumption are not recognised, sometimes with fatal results. Here we describe two cases of intentional fatal ingestion of nicotine. The nicotine was extracted from tobacco using instructions available on the Internet. The first case involved a male aged 19 who died in 2008. The post-mortem blood and urine levels of nicotine were 5.5mg/l and >80 mg/l respectively; the blood level is in line with the generally recognised fatal level of >5mg/l. The levels of nicotine's main metabolite, cotinine, for this case were 2.5mg/l and 7.9 mg/l for blood and urine respectively. A comparative case in 1999 involved a 32 year-old male. The level of post-mortem nicotine in his blood was 1.0mg/l. These are believed to be the first UK suicides by nicotine using instructions from the Internet reported in the literature. Information that nicotine was the agent responsible only became apparent some time after death. There may be more deaths due to this cause that go unrecognised because quantification of nicotine and cotinine levels is not often conducted, due to the wide prevalence of smoking. It is important that all evidence at the scene of a sudden and unexplained death is carefully evaluated, including potential clues on PCs and lap-tops.
烟草是全球范围内最容易获取和滥用最广泛的毒品之一。尼古丁是其主要成分之一，可导致严重或致命的中毒。虽然故意摄入这种物质的情况似乎相对较少，但往往没有识别出其消费的重要迹象，有时会导致致命后果。在这里，我们描述了两起因故意摄入尼古丁而导致的致命案例。尼古丁是根据互联网上的说明从烟草中提取的。第一个案例涉及一名 19 岁的男性，他于 2008 年死亡。尸检时血液和尿液中的尼古丁含量分别为 5.5mg/L 和>80mg/L；血液中的尼古丁含量符合公认的致命水平>5mg/L。该病例中尼古丁的主要代谢物可替宁的血药浓度和尿液浓度分别为 2.5mg/L 和 7.9mg/L。1999 年的一个类似病例涉及一名 32 岁的男性。他血液中的死后尼古丁含量为 1.0mg/L。这些据信是英国首例因互联网上的说明而自杀的尼古丁中毒案例。直到死后一段时间，有关尼古丁是导致死亡的原因的信息才变得明显。由于吸烟的广泛流行，可能还有更多因这种原因而未被识别的死亡。因此，在突然且无法解释的死亡现场，仔细评估所有证据非常重要，包括个人电脑和笔记本电脑上的潜在线索。
