Nicotine Pouch Ingestions in Children Under Age 6 Soared Between 2020 and 2023

U.S. Poison Centers reported nearly 135,000 nicotine ingestions by children under age 6 between 2010 and 2023, with the rate of nicotine pouch ingestions increasing by more than 760% between 2020 and 2023, according to a study published in the August 2025 Pediatrics. The study, “Nicotine Ingestions Among Young Children: 2010-2023” (published online July 14), found that children under age 2 accounted for 76% of the nicotine ingestions. Nearly all ingestions occurred at a residence, and 55% of them were among boys. While nicotine is highly toxic, most ingestions were associated with no effect (36.8%) or minor effect (19.6%), and 81.3% of children did not receive treatment at a healthcare facility. However, two children died and 39 experienced major health effects. Among nicotine products, chewing tobacco (1.8%) had the highest proportion of serious medical outcomes, followed by e-cigarette liquids (1.4%) and e-cigarette devices (1.3%). When comparing product formulations, pouches were associated with the highest proportion of serious medical outcomes (2.0%), followed by liquids (1.9%) and gum/lozenges (1.3%). Nicotine pouches were 1.5 times and 2 times more likely to be associated with a serious medical outcome or medical admission, respectively, than other nicotine product formulations. The rate of nicotine pouch ingestions per 100,000 US children <6 years old was 0.48 in 2020 and 4.14 in 2023. The authors note the health challenges of the evolving oral nicotine product market and suggest ongoing surveillance and increased public policy and other efforts to prevent nicotine ingestions among young children. 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.