Are Nicotine Pouch Poisonings Out of Control?

Listen to the screeching headlines, and you might think that carelessly handled nicotine pouches are taking out every second kid. Significant percentage increases and urgent nouns like “surge” are being thrown around to frame the latest peril, but let’s try to separate the correct from the clickbait.

How big a problem are nicotine poisonings?

First off, let’s look at the numbers. Some news outlets highlight a “763% increase in calls to poison control centers for nicotine pouch ingestions,” which certainly grabs one’s attention. Often, you can find the real truth in what is being deliberately omitted. Well, get into that below.

The figures come from the American Academy of Pediatrics’ (AAP) paper, “Nicotine Ingestions Among Young Children: 2010–2023,” which was published this summer.

The paper is illuminating for anyone who wants to get a sense of the scale of the problem. As the title suggests, the data runs from 2010 to 2023, during which time there were 134,663 cases of nicotine poisoning among children under six years old. That works out to approximately 10,000 per year.

Again, we’ll draw from the AAP paper to present the data on what type of nicotine-related poisonings affected those under six. Here is a rough breakdown.

• Cigarettes: 53%
• Chewing tobacco: 12%
• E-cigarettes: 18% (Split as 11.8% vaping hardware, 6.1% eliquids)
• Nicotine gum, lozenges, tablets: 8.6%
• Nicotine pouches: 1.4%

When we look at it like this, the gargantuan 763% increase in nicotine pouch poisonings is actually a rise of 20 annual cases in 2020 to 260 in 2023.

Reasons to be cautious about nicotine pouches in particular

Novel products will naturally have spikes of growth when it comes to usage and other associated statistics, such as poisonings. While media alarmism is fun to poke fun at, there are some reasons why nicotine pouches present a slightly unique case.

As shown in the AAP report, pouches are twice as likely to result in hospital admission compared to the average products. What’s more, they’re 1.5 times as likely to result in serious medical complications.

The obvious reason for this is their compact nature. The parcels are small and easy to swallow, whereas a revolting taste would act as a barrier to fully eating a cigarette or drinking vape juice.

Interestingly, liquid nicotine poisonings spiked by 450% between 2010 and 2015, but then dropped by almost half after the U.S. Child Nicotine Poisoning Prevention Act of 2015 required child-resistant packaging for e-liquids. This dynamic might hold some clues as to how to address this “problem”.

Do all pouches have child safety features?

In the US, FDA-approved pouches have child-safe mechanisms. In fact, many non-approved pouches also do so because there is a general trend in the market towards self-regulation. However, rogue operators are not constrained by the same ethics. As such, they’re the most likely source of the nightmare scenario where a 50mg per pouch container is opened and then consumed by a toddler.

For all the wailing about targeting kids, ZYN and Velo have child-resistant lids. Other brands like Nordic Spirit and on! feature twist-lids or flip-top lids that could prove more accessible.

What might the future look like?

UK-based Origin Pharma Packaging has a solution called ClicCan. You can see it in action below, and it seems like a good option for more secure pouches.

Some UK brands are using this tech, but this is an innovative space, so there are plenty of other ideas floating around, such as twist-lock or press-latch cans that are similar to medicine bottles or other multi-step solutions.

In conclusion

Even though rates have gone up with product adoption, nicotine pouch poisonings are not out of control. Most of these events (75%) affect children under two and almost exclusively happen at home (98.5%).

It’s great to see various brands take the initiative themselves to ensure their products do not cause harm. However, considering the place where these events happen, personal responsibility is paramount. In other words, we should not be waiting for regulations or innovation to keep kids safe; we need to take personal responsibility. That might not be a popular message in our modern society, but it’s fundamentally correct.