Nicotine pouches linked to spike in child poisonings, U.S. study warns

Accidental poisonings among young children in the U.S. are rising sharply due to nicotine pouches and vaping, with a study warning of serious health risks and calling for stronger regulation and public awareness.

A new study published Monday in the journal Pediatrics has found that the growing use of nicotine pouches and vaping products in the United States has led to a significant rise in accidental poisonings among children under six.

Between 2010 and 2023, U.S. poison control centres received over 134,000 reports of nicotine ingestion in toddlers and infants. These cases involved products such as nicotine pouches, chewing tobacco, traditional cigarettes, e-cigarette liquids, and vapes.

While poisonings linked to most nicotine products began declining after 2016, the study found that cases involving nicotine pouches surged by more than 760% between 2020 and 2023. Researchers attributed this rise to the high nicotine concentration and rapid release from these pouches.

Although the majority of children experienced only mild symptoms—such as vomiting and nausea—1.2% of cases involved severe outcomes like seizures or respiratory failure. Two children under the age of two died after ingesting liquid nicotine.

Nicotine pouches are tobacco-free packets containing nicotine, sweeteners, and flavourings. Public health experts warn their discreet design and appeal to teenagers raise serious concerns, especially as they are not approved by the U.S. Food and Drug Administration (FDA) for smoking cessation.

The researchers urged stronger federal oversight of nicotine pouch marketing and flavourings and called on healthcare providers to remain alert and advocate for child safety. They also recommended building on existing laws such as the 2015 Child Nicotine Poisoning Prevention Act.

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