Accidental nicotine poisonings in very young children have risen sharply in the United States, according to a peer-reviewed study published 14 July in the journal Pediatrics. Researchers analysed calls logged by the National Poison Data System and identified 134,663 ingestions among children younger than six between 2010 and 2023. While overall nicotine exposures fell after 2015, reports linked specifically to nicotine pouches climbed from 0.48 to 4.14 per 100,000 children between 2020 and 2023—a 763 percent increase that the authors associate with the rapid growth of brands such as Zyn. Pouches accounted for just 1.4 percent of total incidents but were 1.5 times more likely than other nicotine forms to result in serious outcomes or hospital admission. Infants and toddlers remain most vulnerable: 76 percent of all cases involved children under two, and 98 percent occurred in the home. Although most exposures caused mild or no symptoms, the study recorded 39 severe cases, including seizures and respiratory failure, and two deaths after ingestion of liquid nicotine used in e-cigarettes. The findings add to regulatory scrutiny of the fast-growing pouch segment, which the Food and Drug Administration authorised for U.S. sale earlier this year. The authors call for stronger child-resistant packaging and flavour restrictions across all nicotine products, along with continued public-health messaging urging caregivers to store them securely.