INDIANA – A new study reveals that nicotine pouches are a rapidly growing source of nicotine poisoning in young children, with cases soaring by over 760% between 2020 and 2023. The research, conducted by Nationwide Children’s Hospital and published in the journal Pediatrics, analyzed over 134,000 cases of accidental nicotine ingestion in children under six over the past decade.
While most other nicotine product exposures in young children decreased after 2016, nicotine pouches emerged as a significant and escalating threat. Dr. Natalie Rine, co-author of the study and director of the Central Ohio Poison Center, highlighted that these products are “high-concentration nicotine products” that “taste good,” lacking any deterrent for children who ingest them.
Nicotine pouches, small white packets placed between the lip and gum, entered the U.S. market in 2014. They contain nicotine (synthetic or natural), flavorings, and sweeteners, but no tobacco. Their discreet, sweet, and smokeless nature has fueled their rising popularity among teens and young adults, making them the second most-used nicotine product among youth, according to the CDC. Nicotine pouch use among teenagers doubled between 2021 and 2024.
Despite their growing use among younger demographics, only 0.5% of Americans currently use nicotine pouches, compared to 9% who smoke cigarettes and 3% who vape.
The nicotine content in pouches varies from 3 to 12 milligrams. Even at their lowest doses, they deliver more nicotine than a single cigarette. Ingesting as little as 1 to 2 milligrams can cause severe symptoms in small children, including nausea, vomiting, and tremors.
The study found that nicotine pouch ingestions were associated with a 150% greater risk of serious medical effects and were twice as likely to lead to hospitalization compared to other swallowed smokeless nicotine products like gums, lozenges, and e-liquids. While most pediatric nicotine ingestions resulted in minor or no harm, over 1,600 children experienced serious medical outcomes, and two children died after ingesting liquid nicotine.
Dr. Rine advises parents to avoid using nicotine pouches in front of children, keep all nicotine products out of children’s reach, and communicate these precautions to other caregivers. In case of suspected nicotine pouch ingestion, parents should immediately call Poison Control at 1-800-222-1222 for guidance.
