Nicotine pouches are becoming more common, especially among young adults. According to a study published in Pediatrics, a journal of the American Academy of Paediatrics, US poison centres reported over one lakh cases of nicotine poisonings among children under age 6. These cases included exposures to several nicotine sources, including nicotine pouches. Nicotine pouches are small, easy to use, and often sold in sweet flavours with colourful packaging. But while they may seem harmless, these pouches can be very dangerous for children.
Speaking with the OnlyMyHealth team, Dr Shehla Kazi, Consultant - Paediatrics, Jaslok Hospital & Research Centre, Mumbai, shared detailed insights on what nicotine pouch poisoning is, what causes it, and why cases are soaring among kids and young adults.
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What Is Nicotine Pouch Poisoning?
Nicotine pouch poisoning occurs when an individual, especially a child, consumes excessive nicotine from smokeless products called nicotine pouches. These small pouches, placed under the lip, release nicotine into the bloodstream through the mouth’s lining. While they are marketed as ‘tobacco-free’, they can still contain dangerous levels of nicotine enough to cause toxic effects or even death in children.
Why Cases Of Nicotine Pouch Poisoning Are Increasing In Children
The recent study published in Pediatrics looked at cases of young children under age 6 who accidentally ingested nicotine, based on reports to US poison centres between 2010 and 2023.
Over 134,000 cases were recorded, with most involving boys under age two and happening at home. Nicotine ingestions rose sharply from 2010 to 2015, mainly due to liquid nicotine, but then dropped after 2015. However, nicotine pouch ingestions surged by over 760% from 2020 to 2023 and were more likely to cause serious health effects or require hospital admission than other forms of nicotine.
According to Dr Kazi, several factors contribute to the rise of accidental nicotine pouch ingestion among children:
Appealing packaging and flavours: Bright tins and sweet flavours like berry or fruit punch resemble candy.
Increased accessibility: These pouches are sold online, in local shops, and often without strict age restrictions.
Unaware adults: Parents and caregivers may underestimate the danger, especially when the product is labelled “tobacco-free”.
Improper disposal: Used pouches discarded in open bins or within reach still contain enough nicotine to harm a child.
Rising popularity among teens: Their increasing use at home boosts exposure for younger siblings.
Health Risks Associated With Nicotine Pouch Poisoning
Nicotine pouches are often flavoured and come in bright, candy-like packaging, which makes them highly appealing to children. With no tobacco leaf and minimal odour or smoke, they don’t trigger the same visual or sensory alarms as cigarettes or vaping products.
Dr Kazi shares that nicotine is a powerful stimulant and neurotoxin, and therefore, children, due to their lower body weight and developing nervous systems, are particularly vulnerable. Just one strong pouch, containing up to 12 mg of nicotine, may be enough to poison a toddler weighing 10 kg.
Risks include:
- Vomiting and seizures within minutes
- Respiratory difficulty
- Coma or death in severe cases
Symptoms Of Nicotine Pouch Poisoning To Watch Out For
Early symptoms (within 15–60 minutes):
- Nausea, vomiting, and stomach cramps
- Excessive drooling or pale/flushed skin
- Sweating, dizziness, and headache
- Fast heart rate and muscle twitching
Severe or late symptoms (1–4 hours post-exposure):
- Slow heart rate, low blood pressure
- Confusion, extreme drowsiness
- Seizures, bluish lips or skin
- Difficulty breathing or unresponsiveness
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Action To Take Right Away
If you suspect a child has ingested a nicotine pouch:
- Stay calm but act fast.
- Remove the pouch from the child’s mouth if it is still present.
- Do NOT induce vomiting; it may do more harm than good.
- Call emergency services.
- Keep the packaging to help medical staff identify the nicotine dose.
- Monitor for symptoms, especially breathing issues, drowsiness, or seizures.
- Avoid giving food or drink, which could interfere with treatment.
Conclusion
Nicotine pouches may look harmless, but they pose a serious risk to children. With symptoms appearing rapidly and sometimes fatally, awareness and prevention are key. By staying vigilant, spreading awareness, and advocating for regulation, we can protect children from this growing hazard.