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TOPLINE:

Researchers analyzed 134,663 nicotine ingestions among children younger than 6 years, finding that nicotine pouch ingestions increased by more than 760% from 2020 to 2023. Nicotine pouches were 1.5 times more likely to cause serious medical outcomes and twice as likely to require medical admission than other nicotine formulations.

METHODOLOGY:

• Analysis included unintentional, single-substance nicotine ingestions among children younger than 6 years reported to the National Poison Data System (NPDS) from 2010 to 2023.
• Data collection encompassed 134,663 cases, with most occurring among children younger than 2 years (76.2%), boys (55.5%), and at residences (98.5%).
• Researchers examined various nicotine product formulations, including gum/lozenges, liquids, pouches, powder/granules, and tablets/capsules/caplets, and tracked medical outcomes ranging from no effect to death.

TAKEAWAY:

• The rate of nicotine ingestions increased by 59.4% from 2010 to 2015 (P < .001) before decreasing by 34.1% from 2015 to 2023 (P < .001), primarily driven by liquid nicotine ingestion rates.
• Nicotine pouches were associated with higher odds for serious medical outcomes (odds ratio [OR], 1.53; 95% CI, 1.10-2.13) and medical admission (OR, 2.03; 95% CI, 1.31-3.15) than other formulations.
• Most ingestions resulted in no effect (36.8%) or minor effect (19.6%), while 1.2% had moderate effects, with 39 cases of major effects and two fatalities reported.
• The rate of nicotine pouch ingestions increased by 763.1% from 2020 to 2023 (P < .001), contrasting with declining rates for other nicotine formulations during this period.

IN PRACTICE:

“Study findings, including the emergence and comparative severity of nicotine pouch ingestions, support the need for ongoing surveillance and increased efforts to prevent nicotine ingestions among young children,” the authors of the study wrote.

SOURCE:

This study was led by Madelyn Olivas, MHA, Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio. It was published online in Pediatrics.

LIMITATIONS:

According to the authors, the NPDS is a passive surveillance system that underestimates the true number of nicotine ingestions among children younger than 6 years. The data were self-reported and cannot be completely verified by Poison Centers or America’s Poison Centers. The increase in nicotine pouch ingestions may be partially attributable to the increased use of new NPDS product codes for these products.

DISCLOSURES:

Olivas reported receiving a student research scholarship from the Child Injury Prevention Alliance. The funding organization did not have any involvement in study design, data collection, analysis, interpretation, manuscript writing, or publication decisions.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.