Nicotine Pouch Poisonings in Young Children Surge: Study Finds

Oral nicotine pouches are a rapidly growing cause of nicotine poisoning in young children, according to a new study published in the journal Pediatrics. Researchers from Nationwide Children’s Hospital in Ohio analyzed over a decade of data on more than 134,000 cases of accidental nicotine ingestion by children under six, finding that while most exposure types fell after 2016, incidents involving nicotine pouches surged by over 760% between 2020 and 2023.

These small, tobacco-free white packets, which users place between their lip and gum, deliver nicotine along with flavorings and sweeteners. Dr. Natalie Rine, director of the Central Ohio Poison Center and a co-author of the study, highlighted the danger they pose to children. “It’s a high-concentration nicotine product, and it tastes good,” she said. “There’s nothing telling the kid, ‘this is bad, you should spit it out’ … and that’s where you get into trouble.”

The study found that nicotine pouches were associated with a 150% greater risk of serious medical effects and were twice as likely to lead to hospitalization compared to other smokeless nicotine products like gums or lozenges when swallowed by children. Nicotine levels in pouches can range from 3 to 12 milligrams, and ingesting even small amounts (1-2 mg) can cause serious symptoms like nausea, vomiting, and tremors in young children, according to the National Library of Medicine. Although most pediatric nicotine ingestions resulted in little harm, the study documented over 1,600 serious medical outcomes and two deaths from liquid nicotine ingestion over the analyzed period.

This trend is particularly concerning as the popularity of nicotine pouches rises among teens and young adults, where they are now the second most-used nicotine product, according to the CDC. Dr. Rine recommends that parents avoid using nicotine pouches in front of children and keep all nicotine products physically out of their reach. She advises anyone who suspects a child may have ingested a nicotine pouch to immediately call Poison Control at 1-800-222-1222 for expert guidance.