What is nicotine pouch poisoning? Why are experts warning parents to be careful about it?

This one comes with the classic twist – a bad news along with good one.

Smoking rates have generally declined since the 1960s, in 2022, approximately 11.6% of US adults were current cigarette smokers, according to the CDC. While this is a significant drop from 42.6% in 1965, and by 2025, the US has seen a significant decline, reaching an 80-year low – another crisis is at large.

Nicotine pouches are a fast-growing source of nicotine poisoning in young children, according to a new study.

In recent years, nicotine pouches – small, flavored sachets resembling candy – have surged in popularity among adults and teens. But hidden beneath their innocuous packaging is a serious health hazard, especially to children.

Alarming new research shows a 763% increase in nicotine pouch poisonings among children under six between 2020 and 2023. Experts are now warning parents: these seemingly harmless products pose a real danger.

Read on to find out more about the poisonous habit that’s raising great concerns.


What is Nicotine Pouch Poisoning?

A nicotine pouch is a small, pre-portioned sachet containing nicotine, typically placed between the lip and gum. They are designed to be smokeless and spitless, offering a discreet way to consume nicotine. While often marketed as a tobacco-free alternative, they still contain nicotine, which is addictive.


Now, nicotine pouch poisoning occurs when an individual – frequently a child – ingests a nicotine pouch or its contents. These pouches, placed between the lip and gum, contain nicotine (typically 3–15 mg per pouch), flavorings, and fillers.


Why is it poisonous for children

Nicotine is a potent stimulant and toxin. While adults may tolerate higher doses, in young children, ingestion of just 1–2 mg can cause symptoms like nausea, vomiting, tremors, and a racing heart. Unlike earlier forms (gum, e-liquids), pouches present a new, stealthy threat. Severe cases progress to seizures, respiratory failure, coma, and even death.


What does the study say?

Researchers at Nationwide Children’s Hospital in Ohio examined over a decade of data involving more than 134,000 cases of young kids (under 6) accidentally ingesting nicotine from products like vapes, gums, and lozenges.

From 2010 to 2023, there were over 134,000 calls to poison control in the US about kids under six who accidentally consumed nicotine. A striking 763% increase in these cases was tied to nicotine pouches between 2020 and 2023! While most types of nicotine ingestions decreased after 2016, nicotine pouches saw a massive surge, with their numbers skyrocketing over 760% in just a few years.


According to Dr. Natalie Rine, director of the Central Ohio Poison Center at Nationwide Children’s Hospital and a co-author of the study published in the journal Pediatrics, “It’s a high-concentration nicotine product, and it tastes good. There’s nothing telling the kid, ‘this is bad, you should spit it out’ … and that’s where you get into trouble.”

The study also revealed that nicotine pouches pose a 150% greater risk of serious medical effects and are twice as likely to result in hospitalization compared to other smokeless nicotine products, such as gums, lozenges, e-liquids, tablets, and powders. While most pediatric nicotine ingestions resulted in little to no harm, more than 1,600 kids faced serious health issues, and tragically, two children died after ingesting liquid nicotine.


Why parents need to be cautious

The miniature white packets that users tuck between their lip and gum hit US shelves in 2014. They don’t contain tobacco but are instead filled with nicotine, either synthetically or naturally derived, along with flavorings and sweeteners.

They’ve become the second most-used nicotine product among young people, according to the US Centers for Disease Control and Prevention. The National Youth Tobacco Survey found that nicotine pouch use among teens doubled between 2021 and 2024.

Here’s why parents must stay more vigilant.

High nicotine concentration: Levels of nicotine in pouches can vary from 3 to 12 milligrams per pouch. At their lowest doses, they deliver more of the stimulant than a cigarette, and even small amounts of nicotine can be dangerous for small children. Many nicotine pouches carry 6 mg of nicotine per pouch – some even double that. A full tin (around 15 pouches) can exceed 90 mg, more than double the nicotine content in an entire cigarette pack.

Candy‑like flavor and packaging: Flavors like citrus, mint, and berry, often in clean, brightly colored tins, make pouches attractive to children. Their non‑toxic-looking design gives no visual warning to toddlers.

Stealthy household storage: These packets are small, discreet, and frequently kept in accessible spots – purse pockets, bedside tables, or unlocked cabinets – making accidental ingestion more likely.

Higher risk of severe outcomes: Ingesting just 1 to 2 milligrams – less than what’s inside a single regular-strength pouch – can cause nausea, vomiting, and tremors, among other serious symptoms, according to the National Library of Medicine. Data shows pouch ingestion is 1.5 times more likely than other nicotine products to cause serious medical outcomes and twice as likely to result in hospitalization.



Early symptoms of nicotine poisoning

Early signs of nicotine pouch poisoning in children include vomiting, nausea, salivation, abdominal pain, rapid heartbeat, high blood pressure, sweating, and dizziness. If the poisoning progresses, they might experience tremors, confusion, seizures, slow breathing or heart rate, or even coma.

Emergency response: If ingestion is suspected, consulting with professional healthcare procide without delay is recommended


Advice for parents and caregivers

Prevention is always better than treatment.

Rine recommends that parents avoid using nicotine pouches in front of children to keep them from imitating potentially risky adult behaviors. She also suggests keeping nicotine products physically out of kids’ reach and having conversations with other caretakers, like babysitters and extended family, about doing the same.

Here are a few tips that could help:

Secure storage: Keep nicotine pouches locked away, out of reach and sight, away from everyday storage areas like purses or kitchen drawers.

Avoid using around kids: Pouch use in front of children can encourage mimicry, increasing the risk.

Educate loved ones: Teach older children and caregivers about the dangers. Emphasize that these products are not candy or snacks.

Use child‑resistant packaging: Only trust pouches with verified, child‑proof containers, instead of relying on them as the sole safeguard.

Consider removing them from home: The most effective prevention is to eliminate the hazard entirely.


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