Reports of US children under six ingesting nicotine pouches – the small rectangles containing flavored nicotine that have exploded in popularity – jumped 763% in just three years, according to a study published on Monday.
Several of the children ended up in intensive care after ingesting the pouches, the report said.
The uptick in poisonings comes as the country has seen a recent surge in sales of nicotine pouches.
“If there is more access or increased popularity of an item in the community, it’s not surprising for us to see increased exposures to products like that,” said Natalie Rine, director of the Central Ohio Poison Center at Nationwide Children’s hospital and an author of the study in Pediatrics, a journal of the American Academy of Pediatrics.
Zyn, a brand of nicotine pouches produced by the Stockholm-based Swedish Match which is owned by the cigarette manufacturer Philip Morris International, has become particularly popular, with the hashtag #Zyn accumulating more than 700m views on TikTok and rightwing commentators such as Tucker Carlson promoting it.
The Zyn pouches come in flavors such as citrus and mint, which public health experts say makes them more attractive to children and teens.
“As a result of it not being in an oil like in a vape pen, or in a leaf like tobacco, there really isn’t as much negative taste associated with it for a young child to spit it out, and it’s therefore more appealing if you were to discover it as a young kid,” said Dr Molly O’Shea, a Michigan pediatrician and spokesperson for the American Academy of Pediatrics.
While the product can elevate a person’s mood and their focus, “if you’re a teeny tiny person, it can poison you. It can increase your heart rate and blood pressure so much that it causes your heart to fail, and that’s why it’s such a big problem,” said O’Shea.
A spokesperson for Zyn said in a statement: “The latest data from the US Food and Drug Administration (FDA) and the Centers for Disease Control show that youth use remains low. Zyn is the only nicotine pouch authorized by the FDA as appropriate to protect public health. In making that conclusion the agency noted that Zyn’s packaging is designed to be child resistant. We welcome the chance to meet with these researchers and educate them on the robust actions Swedish Match takes to guard against underage use.”
The study found that most exposures among children resulted in minor or no effects, but there were 39 cases with major medical outcomes.
Health providers say adults should store the product in a locked area of the home or cabinet so children cannot access them, and to avoid using the products in front of children, who are likely to mimic such behavior.
“Kids are incredibly curious. They’re very resourceful, and they want to do what adults do,” O’Shea said.
If you suspect that a child may have ingested a pouch in the US you can call the Poison Help line at 1-800-222-1222 where nurses and pharmacists are available at all hours to advise.
This article was amended on 15 July 2025. An earlier version said that two children died from ingesting nicotine pouches; however, they ingested liquid nicotine. This reference has been removed. Also, Zyn is not specifically a Swedish brand but is owned by a Swedish company, and its pouches come in citrus flavor, not “fruit”. A statement from Zyn has been added.