New research shows that nicotine pouches are the fastest growing source of nicotine addiction in young children.
Researchers at the National Children’s Hospital in Ohio have analyzed data over a decade, examining over 134,000 children under the age of six, and mistakenly intaken nicotine on products such as steam, gums and lozenges. Most types of exposure have decreased since 2016. However, one delivery method (nicotine pouch) shot, rising over 760% between 2020 and 2023.
“It’s a high concentration of nicotine product and it tastes better,” said Dr. Natalie Rine, director of the Central Ohio Poison Center at the National Children’s Hospital and co-author of the study published Monday in Journal Pediatrics. “There’s nothing to say to a child, ‘This is a bad thing, you should spit it out’…it gets you into trouble. ”
A miniature white packet that users tuck between their lips and gum hit a US shelf in 2014. They do not contain tobacco, but instead are filled with synthetic or naturally derived nicotine along with aromas and sweeteners.
The modest, sweet, smokeless nature of nicotine pouches has sparked concern among public health advocates who have meticulously watched the growing popularity among teens and young adults. According to the US Centers for Disease Control and Prevention, they have become the second most used nicotine product among young people. The National Youth Tobacco Survey has discovered that nicotine pouch use among teenagers doubled between 2021 and 2024.
Still, the overall user base remains small. According to data from the US Census Bureau, only 0.5% of Americans use nicotine pouches, while 9% smoke and 3% use vape or e-cigarettes.
In January, the US Food and Drug Administration gave marketing permission for certain nicotine pouches for the first time, allowing sales of 10 flavors from popular brand Zyn to help adult smokers stop or reduce cigarette use. The agency said Zyn products contain fewer harmful ingredients than tobacco and some types of chewing cigarettes.
At the time, the FDA noted that overall youth use of nicotine pouches was low, with only 1.8% of middle and high school students.
The level of nicotine in the pouch is from 3 to 12 milligrams per pouch. At the lowest dose, it supplies more stimulants than tobacco, and even small amounts of nicotine are dangerous to small children. Among other serious symptoms, ingestion of 1-2 milligrams more than that found in one rule strength pouch can cause nausea, vomiting and trembling, according to the National Library of Medicine.
This study found that nicotine pouches are associated with a 150% higher risk of serious medical effects, and are twice as likely to lead to hospitalization than other smokeless nicotine products that children swallow, such as gums, lozenges, e-liquids, tablets, and powders.
While the majority of pediatric nicotine intake caused little harm, more than 1,600 children had serious medical consequences, the study found. Two children died after taking liquid nicotine.
Philip Morris International, who owns Zyn through Swedish Match, said in a statement Monday that each can of the nicotine pouch includes warnings about keeping the product out of reach of children, and packaging includes child-bearing.
Rine recommends parents use nicotine pouches in front of their children to avoid imitating potentially dangerous adult behavior. She also suggests keeping nicotine products out of reach of children and having conversations with other caregivers, such as babysitters and extended families.
If your child may have taken a nicotine pouch, the best first step is to control the poison at 1-800-222-1222. Trained staff will guide caregivers based on their child’s symptoms and help them determine whether emergency care is needed.
