Ingestion of Nicotine caused a dramatic spike in poisonings of children under 6 between 2020 and 2023 in the U.S. Really!

Bad news! How is this possible?

Notice that the ingestion rate actually peaked in 2015 (see chart below)

The good news is that about 56% of these ingestions had no or only minor effects. Only "39 ingestions with major effects and 2 fatalities".

There seems to be a very strange inconsistency in this study: There were about 135,000 ingestions between 2010-2023, but the tables show data for only about 77,000 children. This seems to suggest that some children suffered multiple poisonings, but the study

For the usual sensationalism, the media picked up on nicotine pouches with the phenomenal "763%" increase. However, actual share of these kind of ingestions are minuscule.

"Candy-like nicotine pouches caused a 763% spike in child poisonings between 2020 and 2023 in the U.S.—even as ingestion rates for other nicotine products fell, per a study in Pediatrics that underscores the need for stronger regulations, a ban on flavored nicotine products, and secure storage practices. ..."

From the abstract:

"OBJECTIVE

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

STUDY DESIGN

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

RESULTS

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.

CONCLUSIONS

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."

From the study:

"... Nicotine pouches are oral nicotine products containing nicotine powder and are a serious and growing toxic ingestion hazard among young children. Although nicotine pouches accounted for only 1.4% of ingestions in this study, they were 1.5 times more likely to be associated with a serious medical outcome and twice as likely to be associated with a medical admission than other product formulations combined. ..."

Global Health NOW: Danish Study Finds Aluminum in Vaccines Safe; Abortion Access in Sicily; and Missed Flood Warnings in Texas and North Carolina

Deadly disguise: How candy-like nicotine pouches caused a 763% spike in child poisonings

Nicotine Ingestions Among Young Children: 2010–2023 (open access)

Fig. 1 Annual rate of nicotine ingestions among children younger than age 6 years per 100,000 US population reported to the National Poison Data System by age, 2010 to 2023.