As no-smoking rules make it more difficult to smoke cigarettes at work, in public spaces and even in your home, smokeless alternatives have become more popular. E-cigarettes, chewing tobacco, nicotine gum and nicotine pouches all provide a nicotine buzz without any smoke.
Smokeless nicotine options like nicotine pouches aren’t necessarily a healthier option for anyone, says Adnan Sabic, M.D., an emergency medicine physician at Henry Ford Health. And when they fall into the wrong hands (especially those of a small child), they can be downright dangerous.
What Are Nicotine Pouches?
Nicotine pouches are small rectangular pouches about the size of a small piece of gum. They contain powdered nicotine (sometimes a synthetic version) mixed with flavorings like mint, cinnamon or citrus.
A user tucks the pouch between their teeth and cheek. Unlike chewing tobacco, the tiny pouches are discreet and require no spitting.
While it’s in place, the nicotine powder in the pouch dissolves and is absorbed through the gums. When you’re done using it, you remove the pouch and throw it away.
What Are the Health Risks of Using Nicotine Pouches?
“Nicotine is extremely addictive, and these pouches contain highly concentrated amounts of the chemical,” says Dr. Sabic. “Some people may use them while trying to quit smoking, but there’s no evidence so far that they’re effective for that.”
In addition to being addictive, using nicotine in any form can have negative health effects. The chemicals in smokeless products—including nicotine pouches—have been linked to increased risk of heart disease, cancer and gum disease.
Dangers Nicotine Pouches Pose for Toddlers
Anyone who’s ever been around toddlers and young children knows that the way they explore the world is with their hands and their mouths. “If they see nicotine pouches lying around, their natural instinct is going to be to grab it and put it in their mouth,” says Dr. Sabic.
These concentrated hits of nicotine can be very dangerous when ingested by a tiny human. “We’re seeing more and more of these kids show up in the emergency department,” says Dr. Sabic. “Most cases aren’t serious, but if kids ingest higher doses, it can be.”
A recent study found that the rate of nicotine pouch ingestion in young children increased by more than 760% from 2020 to 2023. The same study also noted that pouches were nearly twice as likely to be associated with medical issues in young children compared to other types of nicotine products.
Signs of Nicotine Poisoning
In a toddler or young child, it can be easy to miss symptoms of nicotine poisoning. And the severity of a child’s symptoms can vary depending on their size and how much nicotine they consumed.
Nicotine is a stimulant, and in high doses it can cause symptoms such as:
- Increased heart rate
- Irritability
- Nausea
- Vomiting
If you know or suspect your child has ingested nicotine pouches, Dr. Sabic recommends calling their pediatrician or poison control. If symptoms are severe, take them to the nearest emergency department.
There is no medication to reverse nicotine poisoning. “Most cases resolve on their own in six to eight hours,” says Dr. Sabic. “But sometimes a child may need to stay in the hospital longer for observation.”
How to Keep Your Kids Safe From Nicotine Pouches
“Kids are curious by nature,” says Dr. Sabic. “So if they find pouches that are easily accessible, they will explore them.”
Sometimes these products come in child-resistant containers, but not always. And their bright colors and flavors can make children mistake them for mints, gum or candy.
Because they can pose a danger to children, they need to be stored securely and out of reach of young hands. “Be as careful with them as you would with medications or other substances that are dangerous to children,” says Dr. Sabic.
If you decide to use nicotine pouches, be sure to also do your part to keep the kids in your life safe from them.
Reviewed by Adnan Sabic, M.D., an emergency medicine physician at Henry Ford Medical Center - New Baltimore.
