406 - Trends in Pediatric Nicotine Exposures Reported to US Poison Centers from 2016 to 2023

Publication Number: 406.6702

Perry E. Rosen, New Jersey Poison Control Center, New York, NY, United States; Danielle R. Bartsche, Rutgers New Jersey Medical School, Spring Lake Hts, NJ, United States; Howard Greller, Rutgers New Jersey Medical School, Newark, NJ, United States; James B. Leonard, Washington Poison Center, Seattle, WA, United States; Bruce Ruck, Rutgers New Jersey Medical School, Newark, NJ, United States; Diane P. Calello, New Jersey Poison Information & Education System, Rutgers New Jersey Medical School, Newark, NJ, United States

Background: Nicotine is a highly addictive legal drug available to US individuals aged 21 and older. Less than 2 mg of nicotine poses serious risk to young children. The rising popularity of electronic cigarettes (e-Cigarettes) has been associated with increased pediatric exposures.

Objective: We aim to describe trends in pediatric nicotine exposures reported to poison centers. We analyzed changes in exposure types and outcome severity.

Design/Methods: This retrospective study utilized NPDS data on children aged one month to five years with acute exposure to a tobacco or nicotine product. Descriptive statistics, including median and interquartile range for continuous variables, and frequencies for categorical variables, were calculated. Trends over time were analyzed using linear regression, with statistical significance set at p< 0.05.

Results: A total of 92,973 pediatric exposures to nicotine were reported from 2016 to 2023. Most exposures (91.22%) involved children aged two years or younger, with a median age of 1.25 years (IQR: 1.08). Exposure occurred most frequently at the child’s own residence (n=88,328, 95.00%). The predominant route of exposure was ingestion (94.68%), followed by inhalation (3.22%). Exposures to e-cigarettes increased from 16.95% (n=2,044) of total exposures in 2016 to 54.56% (n=7,009) in 2023, while traditional tobacco decreased from 75.63% (n=9,122) to 40.51% (n=5,204), and non-tobacco nicotine products decreased from 7.42% (n=895) to 4.94% (n=634). The most frequent effects reported were nausea/vomiting (n=15,867, 17.1%), cough/choking (n=9,264, 10.0%), signs of CNS depression (drowsiness/lethargy, coma, major, moderate, and minor) (n=1,313, 1.4%).

Conclusion(s): This study highlights a significant changing trend in pediatric nicotine exposures reported to poison centers, particularly the rise of e-cigarette exposure. While the overall incidence of exposures remained stable from 2016 to 2023, the increase in e-cigarette-related incidents is concerning, reflecting a shift in the types of nicotine products impacting young children, despite newer regulations on their sale. These findings underscore the urgent need for targeted public health interventions and educational campaigns aimed at reducing pediatric exposure to nicotine products, especially e-cigarettes, to safeguard vulnerable populations.

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