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New Study Finds Sharp Increase in Nicotine Pouch Ingestions Among Young Children

New Study Finds Sharp Increase in Nicotine Pouch Ingestions Among Young Children 1024 683 Laura Dattner
Close-up of nicotine pouches in a plastic container on a dark background, illustrating smokeless tobacco alternatives and nicotine addiction and poisoning risks.

Experts urge stronger regulations, a ban on flavors for all nicotine products and secure at-home storage to help prevent nicotine ingestions.

A new study reveals that ingestions of nicotine pouches by young children in the United States have surged in recent years.

Researchers at the Center for Injury Research and Policy at Nationwide Children’s Hospital and the Central Ohio Poison Center analyzed calls to U.S. poison centers and found an alarming 763% increase in the rate of reported nicotine pouch ingestions among children younger than 6 years old from 2020 to 2023. Children who ingested nicotine pouches were more likely to experience serious medical outcomes or hospital admissions than those exposed to other nicotine products such as gum/lozenges, e-liquids, powder/granules and tablets/capsules/caplets.

Nicotine pouches, which contain nicotine powder and are placed in the mouth, were not tracked in national poison center data until 2020. However, between 2020 and 2023 (the most recent year of data from the study), the rate of unintentional ingestion of nicotine pouches by young children increased at a fast rate — even as ingestion rates for other formulations of nicotine declined.

“Nicotine pouches are a serious and growing toxic ingestion hazard among young children,” says Hannah Hays, MD, co-author of the study, chief of Toxicology at Nationwide Children’s and medical director of the Central Ohio Poison Center.

“The rapid increase in the number and comparative severity of nicotine pouch ingestions is a reminder of the public health challenges of the changing nicotine product market,” Dr. Hays says. “This is why we need to continue ongoing surveillance and increase our efforts to prevent nicotine ingestions among young children.”

The study, published in Pediatrics, also investigated other nicotine products and formulations. Researchers examined nearly 135,000 cases of nicotine ingestions among children younger than 6 years old that were reported to U.S. poison centers from 2010 through 2023. Most ingestions occurred at home and involved children under the age of 2 years. While most exposures resulted in minor or no effects, there were 39 cases with major medical outcomes and two deaths.

The overall rate of all nicotine ingestions increased 59% from 2010-2015 before decreasing 34% from 2015 to 2023. This rate was primarily driven by the ingestion rate for liquid nicotine and nicotine solid formulations such as tablets, capsules and caplets. The ingestion rate for liquid nicotine increased by 450% from 2010 to 2015 and then decreased by 45% from 2015 to 2023.

“This abrupt change in the rate trend for liquid nicotine ingestions corresponded with the passage of both state and federal legislation, including the Child Nicotine Poisoning Prevention Act of 2015, which required child-resistant packaging of liquid nicotine,” says Gary Smith, MD, DrPH, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children’s. “This suggests that legislation can make a difference. However, despite this improvement, the ingestion rate for liquid nicotine remained higher than the rates for any other nicotine product, which clearly indicates that there are opportunities for further improvement.”

This article appeared in the 2025 Fall/Winter print issue. Download the issue here.

 

Reference:

Olivas M, Hays HL, Kistamgari S, Rine NI, Zhu M, Yang J, Smith GA. Nicotine ingestions among young children: 2010-2023. Pediatrics. 2025 Aug 1;156(2):e2024070522.

Image credit: Adobe Stock

About the author

Laura Dattner

Laura Dattner, MA, is a research writer in the Center for Injury Research and Policy of the Abigail Wexner Research Institute at Nationwide Children’s Hospital. With both a health communications and public health background, she works to translate pediatric injury research into meaningful, accurate messages which motivate readers to make positive behavior changes.

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