The number of young children falling ill after getting their little hands on nicotine products such as pouches and vape e-liquids has skyrocketed in recent years in the US.

From 2010 to 2023, US poison centres reported 134,663 cases of nicotine poisonings among kids younger than age 6, according to a study published in Pediatrics, a journal of the American Academy of Pediatrics.

Nearly all occurred at home.

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The cases included exposures to nicotine pouches, chewing tobacco, regular cigarettes, vapes and nicotine replacement products such as gum and lozenges.

But it is nicotine pouches, like the wildly popular Zyn, that are behind the most significant rise in accidental nicotine poisonings among young kids.

The new research found the rate of poisonings involving nicotine pouches among kids younger than 6 rose from 0.48 per 100,000 children in 2020 to 4.14 per 100,000 in 2023.

That is an increase of 763 per cent in just three years — a startling finding that correlates with a surge in sales of nicotine pouches.

Nicotine pouches — which users tuck between their lip and gum and later discard — can contain as much as 6mg of nicotine, a stimulant, and have been promoted as tobacco-free, spit-free and hands-free alternatives to cigarettes and chewing tobacco.

They are not, however, approved by the Food and Drug Administration as nicotine replacement products used to help quit smoking.

Philip Morris, which owns Zyn, said: “Zyn’s packaging is designed to be child-resistant.”

A 2021 study from the Centres for Disease Control and Prevention’s Office on Smoking and Health (one of several public health groups dismantled under the Trump administration) found that sales of nicotine pouches rose dramatically in the past decade, from $709,000 in 2016 to $216 million by mid-2020.

“It was just a matter of time before they fell into the hands of younger kids,” American Academy of Paediatrics spokesperson Dr Molly O’Shea said.

“It’s unfortunate but not shocking.”

Why is nicotine toxic to little kids?

Nicotine is a chemical that is highly toxic and could easily exceed a fatal dose in small children, according to a 2013 study.

The chemical increases heart rate and blood pressure and could lead to nausea, vomiting or even coma, the study authors wrote.

Most cases included in the new research were not serious enough to warrant medical attention.

But 39 children had significant side effects, such as trouble breathing and seizures, Central Ohio Poison Centre and study co-author Natalie Rine said.

Most nicotine poisoning cases, 76 per cent, were babies and toddlers younger than age 2.

Two children, a one-year-old boy and an 18-month-old boy, died after ingesting liquid nicotine used in vapes.

“It’s good that the majority of kids in the study actually did pretty well,” Rine said.

“Most kids had either minor symptoms or no symptoms and didn’t require any medical management.

“But two deaths is a lot, especially for something considered a preventable death.”

The study “adds to concerns about the health risks that nicotine pouches pose to kids,” Campaign for Tobacco-Free Kids president Yolonda Richardson, said. She was not involved in the new research.

“It’s critical that we educate parents, childcare providers and healthcare providers about the health risks of these products, including poisoning.”

How to reduce nicotine poisonings in kids

Kids are curious by nature. Babies and toddlers in particular explore their worlds by putting things in their mouth.

And they’re masters at breaking into drawers and cabinets to find new “toys”.

Many canisters of nicotine pouches are not equipped with child-resistant packaging. They taste good, too. Mint and fruit flavours are almost always added.

O’Shea said it’s critical that all nicotine products are placed far out of reach of children.

“That doesn’t mean in your purse, in your back pocket or on the counter,” she said. “It means locked away.”

It’s not just parents and other adult caregivers who must be mindful of their nicotine products.

An April study from the Keck School of Medicine of the University of Southern California found the use of nicotine pouches among high school students nearly doubled between 2023 and 2024.

“It’s easy for a teenager to be using this product and have parents be unaware,” O’Shea said.

“It’s important for parents to be talking with their teenagers about products like this and having open dialogue in a non-judgmental way in order to ascertain any risk.”