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The Food and Drug Administration (FDA) is warning clinicians and parents about the potential health risks of nicotine pouches, especially those that do not have child-resistant packaging. Reports of accidental exposures to nicotine pouches have increased with some cases leading to nicotine poisoning, and according to FDA, children can experience toxic effects after exposure to as little as 1-4 milligrams of nicotine. Symptoms can include confusion, vomiting, and loss of consciousness. In a statement, the agency called on manufacturers to adopt child-resistant packaging and says it has authorized 20 nicotine pouch products with child-resistant packaging so far.
Pouches pose the most risk: An August 2025 article in Pediatrics notes that 134,663 overall nicotine ingestions among children younger than age 6 years were reported to poison control centers from 2010–2023. Most were among children younger than age 2 years (76.2%). However, only 15.9% of ingestions were medically evaluated, and just 0.5% were medically admitted. Nicotine pouches were more likely to be associated with a serious medical outcome (odds ratio [OR]: 1.53, 95% confidence interval [CI]: 1.10–2.13) or medical admission (OR: 2.03, 95% CI: 1.31–3.15) than other product formulations combined. Nicotine-containing products found in households may include items that could be attractive to young children such as gum, lozenges, e-liquids, pouches, and powder, as well as tablets/capsules/caplets and traditional cigarettes.