Study: Nicotine Pouches Linked to Rising Poisonings in Young Children

A new study highlights growing concerns over nicotine pouches and their impact on young children. According to research from Nationwide Children’s Hospital in Ohio, nicotine pouches are now among the fastest-growing sources of nicotine poisoning in children under six years old.

The study, published in the journal Pediatrics, analyzed over 134,000 pediatric nicotine ingestion cases reported from 2010 through 2023. While exposures from vapes, gums, and lozenges have declined since 2016, incidents involving nicotine pouches rose more than 760% between 2020 and 2023.

“These pouches are high-concentration nicotine products, and they taste good,” said Dr. Natalie Rine, director of the Central Ohio Poison Center and study co-author. “There’s nothing telling the kid, ‘this is bad, you should spit it out.’”

Nicotine pouches, like the popular Zyn brand, don’t contain tobacco but do include synthetic or naturally derived nicotine, flavorings, and sweeteners. While marketed to adults as a tobacco alternative, they’ve gained popularity among teens and young adults, becoming the second most-used nicotine product among young people according to CDC data.

Despite that, nicotine pouch use remains relatively low among the overall U.S. population — just 0.5% of Americans use them, compared with 9% who smoke cigarettes.

The study found that nicotine pouches carry a 150% greater risk of serious medical effects in children compared to other smokeless nicotine products. Ingesting even 1 to 2 milligrams of nicotine — less than what's in a single pouch — can cause nausea, vomiting, tremors, and more serious symptoms in small children.

Over 1,600 cases in the study resulted in serious medical outcomes, and two deaths were linked to liquid nicotine ingestion.

Philip Morris International, which owns the Zyn brand, stated Monday that all packaging includes child-resistant features and clear warnings.

Experts recommend keeping all nicotine products out of children’s reach and talking with babysitters or relatives about doing the same.

If a child is suspected of ingesting a nicotine pouch, caregivers should call Poison Control immediately at 1-800-222-1222.

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