Childhood Nicotine Poisoning and Public Policy | The American Spectator

A recent piece published in Pediatrics, titled “Nicotine Ingestions Among Young Children: 2010–2023,” has received significant media attention. The study reports that between 2010 and 2023, 134,663 children under the age of six ingested nicotine. Tragically, two children died as a result.

The deaths of two children from nicotine poisoning — like the death of any child — are tragedies. That these deaths were likely accidental is of no comfort to the grieving parents. One can only imagine the lifelong guilt they will carry. And we can reasonably assume the other 134,661 ingestions were also accidental. No parent is perfect. Even the most vigilant among us has at some point held a hand in front of a toddler’s mouth and pleaded, “Spit it out!”

Calls for further education are important. But a child raised by adults who are unaware that nicotine products must be kept out of reach is likely to face other serious challenges in life. There are probably dozens of other household products that pose equal or greater danger. Parenting is the most important responsibility anyone can assume — yet it is the only one that requires no license, no formal training, and no verifiable qualification.

While the Pediatrics article presents a large number of cases, some context is needed. Only 1.2 percent of reported ingestions had even a moderate effect. In fact, 79.1 percent were classified as either “no effect” (36.8 percent) or “minimal clinical effect possible” (42.3 percent).

These figures aren’t surprising.

Parents are a cautious group. It’s our natural instinct to protect our children. That 42.3 percent of ingestions were deemed to have minimal clinical effect reflects the fact that many parents seek medical attention out of an abundance of caution. Even if we believe the exposure was brief and unlikely to cause harm, we will call a healthcare provider to confirm what our instincts tell us. Many of the reported ingestions likely fall into this category, which helps explain why so many cases resulted in “no effect” or “minimal effect possible.”

The article also highlights a rise in nicotine ingestions with the introduction of nicotine liquids for vaping and newer nicotine pouches. What most media coverage missed is that the rate of ingestion per 100,000 children actually peaked in 2015 and has declined by 43 percent since then. Specifically, the rate increased from 198 in 2010 to 316 in 2015, then fell to 208 in 2023 — representing only a 5 percent net increase over the 13-year study period.

The real question for parents is: Do newer nicotine products significantly increase the risk of poisoning for my child? The answer requires perspective. There are hundreds of products in the average household that need to be kept away from children — prescription medications, cleaning products, cosmetics, paints, pesticides, and more. The National Poison Data System identifies 58 major substance categories. Tobacco and nicotine account for just one of them.

The 134,663 nicotine ingestions reported from 2010-2023 represent about 1 percent of the more than 11.4 million poison exposures among children under six from 2012-2023 (data from 2010-2011 was unavailable). Of these, exposures to nicotine liquids and pouches make up only 0.3 percent of the total — pouch exposures are nearly negligible. So yes, newer nicotine products do present a risk — but an extraordinarily small one in the broader context of household poisonings.

At the same time, the potential benefit of these reduced-risk nicotine products is enormous. Cigarettes, the original nicotine delivery device, contain over 70 known carcinogens.

Newer products — like e-cigarettes and nicotine pouches — are designed to deliver nicotine without the cancer-causing chemicals found in cigarettes. E-cigarettes alone have helped an estimated 20 million Americans dramatically reduce or eliminate their exposure to cigarette smoke. Yet nearly 30 million Americans still smoke. That means these newer products have the potential to reduce harm for as many as 50 million people. That is a significant public health opportunity.

Societal outcomes are never perfect. Life involves tradeoffs. Just as there are no perfect parents, there are no perfect public policies. The Child Nicotine Poisoning Prevention Act of 2015 already mandates child-resistant packaging for nicotine liquids. And the U.S. Food and Drug Administration has noted that ZYN — the only FDA-authorized nicotine pouch — features child-resistant packaging as well.

Given the vast potential for harm reduction that newer nicotine products offer, it would be unfortunate if public policy were further changed in ways that reduce adult access.

READ MORE:

The Dangers of Public Health Zealotry

Progressives’ Deadly Hypocrisy on ‘Harm Reduction’

David M. Ozgo is the president of Advocacy Analytics LLC and a senior fellow at the Parkview Institute. He can be reached at [email protected].