Nicotine Pouch Poisonings in Toddlers Rose 760% in 3 Years, AAP Says

Little hands stay busy those first few years and while parents may keep cleaning cabinets locked, electric outlets covered and detergent pods hidden away, there’s a new danger to kids on the rise.

A new report reveals a staggering 760% rise in nicotine pouch poisonings among toddlers between 2020 and 2023. The study, published in the American Academy of Pediatrics’ (AAP) Pediatrics journal, examined reports of nicotine ingestions in young children made to US poison control centers between 2010 and 2023.

While the rate of many types of nicotine ingestion has gone down over the past decade, the rate of nicotine pouch poisonings has spiked. In 2020, there was approximately 1 report of nicotine pouch poisoning for every 100,000 children. By 2023, that number had climbed to nearly 5 cases per 100,000. That may not sound like a lot, but it adds up to more than 1,800 reports of children ingesting nicotine pouches between 2020 (when tracking began) and 2023.

Perhaps most concerning is the majority of these ingestions occurred in kids under the age of 2, with 98% happening at home. And while nicotine pouch ingestions represent a relatively small portion of all nicotine exposures, they are more likely to result in serious medical complications. Although most exposures led to minor or no effects, there were 36 cases with serious medical outcomes. Nicotine is highly toxic, especially to smaller bodies, and can lead to vomiting, increased heart rate, confusion, drowsiness or more severe issues.

“Nicotine pouches are a serious and growing toxic ingestion hazard among young children,” said Hannah Hays, MD, co-author of the study 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. This is why we need to continue ongoing surveillance and increase our efforts to prevent nicotine ingestions among young children.”

The AAP and other experts are calling for stronger federal regulation of nicotine pouches and other nicotine products, whether through childproof packaging or a ban on flavored options that may appeal to kids. In the meantime, parents can help protect their children by following a few key safety tips:

• Store nicotine products safely. Keep them up high, out of sight and locked away—ideally in a cabinet, drawer or box.
• Talk to caregivers, family and visitors about safe storage. If you keep pouches in a purse or backpack, be sure to store bags out of reach.
• Avoid using nicotine products in front of children.
• Opt for child-resistant packaging when available.
• Save the national Poison Help Line (1-800-222-1222) in your phone and post it somewhere visible at home.

Take these simple steps to keep household hazards out of reach and stay up to date on the latest in baby proofing options to keep your child safe.