Nicotine Ingestions Among Young Children: 2010-2023

The objective of this study is to investigate the characteristics and trends of nicotine ingestions among young children reported to US poison centers.

We analyzed unintentional, single-substance nicotine ingestions among children younger than age 6 years reported to the National Poison Data System from 2010-2023.

There were 134 663 nicotine ingestions among children younger than age 6 years reported to US poison centers, and most were among children younger than age 2 years (76.2%), boys (55.5%), or occurred at a residence (98.5%). 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). This rate trend was primarily determined by the ingestion rate for liquid nicotine, which increased by 450.0% from 2010 to 2015 (P < .001) and then decreased by 45.2% from 2015 to 2023 (P < .05). Most nicotine ingestions were associated with no effect (36.8%) or minor effect (19.6%), and 81.3% did not receive treatment at a health care facility. Moderate effects were observed among 1.2% of ingestions, and there were 39 ingestions with major effects and 2 fatalities. A minority of ingestions (15.9%) were treated/evaluated and released, and 0.5% were medically admitted. The rate of nicotine pouch ingestions increased by 763.1% from 2020 to 2023. Nicotine pouches were more likely to be associated with a serious medical outcome (odds ratio [OR]: 1.53, 95% CI: 1.10-2.13) or medical admission (OR: 2.03, 95% CI: 1.31-3.15) than other product formulations combined.

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.