Nicotine pouch ingestions among children have surged, new study finds
The study, published Monday in the journal Pediatrics, found reports of children under 6 years old ingesting nicotine pouches increased from less than 1 per 100,000 in 2020 to more than 4 per 100,000 in 2023 — a 763% increase.
Unlike smoking and vaping, nicotine pouches — like popular brand Zyn — are smoke- and tobacco-free, but the pouches still contain nicotine, an addictive chemical that can be fatally toxic to young children.
Researchers analyzed calls to U.S. poison centers from 2020, which is when these pouches were first tracked in national poison center data, to 2023, the most recent available data.
"Nicotine pouches are a serious and growing toxic ingestion hazard among young children," said Dr. Hannah Hays, co-author of the study and medical director of the Central Ohio Poison Center, said in a news release.
The study also looked at ingestions of other nicotine products and formulations, including cigarettes, chewing tobacco, e-cigarettes and liquids.
Overall, researchers examined nearly 135,000 cases of nicotine ingestions among young children in the U.S. from 2010 to 2023, finding most cases occurred at home and involved children under 2 years old.
From 2010 to 2015, the overall rate of all nicotine ingestions increased 59%, but then decreased 34% from 2015 to 2023, researchers found, making the sharp rise in pouch ingestions a concerning contrast.
While pouch ingestions only made up 1.4% of the cases examined in the study, they were more likely to be associated with serious medical outcomes or hospital admissions than ingestions of other products, according to the study.
"Many nicotine products are flavored and sold in colorful packaging that may be attractive to a young child," Dr. Gary Smith, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children's, said in the release. "Banning flavors in all nicotine products helps reduce unintentional ingestions by young children as well as discourage use among teens."
Earlier this year, the Food and Drug Administration authorized the parent company of Zyn's manufacturer to sell the product to help adult smokers cut back or quit cigarettes. The authorization included 10 Zyn flavors, including coffee, mint and menthol.
It was the first time regulators have authorized sales of nicotine pouches, which are the fastest-growing segment of the U.S. tobacco market, and prompted health advocates to criticize the FDA's decision.
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Aitana Bonmati interview: ‘I found myself in a situation of suffering. You feel alone'
It was 7am on Thursday, June 26 when Aitana Bonmati began to feel unwell. She had been in Madrid for four days with the Spanish national team preparing for a match against Japan and the European Championship to follow. Like the other players, she was up and getting ready for an earlier-than-usual training session in an attempt to avoid the intense heat. 'That's when I started to feel very ill,' Bonmati says, speaking to The Athletic in Lausanne, Switzerland, two days before Spain's Euro 2025 quarter-final against the hosts. 'I had a bad headache, which surprised me because it was constant and wouldn't go away. 'I was like that until Friday at noon, when the doctor told me to go to the hospital because something was wrong. He wanted to rule out anything more serious than a simple cold or a mild illness. There, they did a CT scan and everything came back fine. Then they did a blood test and everything came back fine. Then they did a lumbar puncture, which is where they found I had viral meningitis.' Bonmati, the reigning two-time Ballon d'Or winner, was lying on her hospital bed when the doctor delivered the news. Fortunately, it was not bacterial meningitis, which takes much longer to recover from. That evening, her Spain team-mates were in action against Japan in their final game before departing, three days later, for the Euros. During the match, the midfielder posted a picture from her hospital bed, with the game on the television in front of her and an emoji of an arm flexing its biceps, as if to say she felt strong. 'She is a very important player for us, we are going to wait for her until the end,' Spain head coach Montse Tome said after the match. At the hospital, the 27-year-old continued to talk with doctors. 'They explained what meningitis meant. I also started looking it up on the internet because meningitis is something you may have heard of but don't really know what it is.' Everything pointed to the player missing the first matches of the Euros. Alarm bells rang. 'The diagnosis was that I might be unwell for five to 10 days, and then I might have some symptoms,' she adds. 'At that point, I didn't get too worked up. I was coming to terms with the fact that I had something that I didn't even know what it was. I accepted it and carried on. 'I was away from my home environment because I was with the national team and at that precise moment I was alone. Then a lifelong friend of mine, Maria, came. She came on Saturday and stayed until Sunday. She slept in my room with me. I didn't have any other visitors because I didn't want to bring people over if I didn't know when I was going to be discharged. 'I found myself in a situation of suffering, because when something happens to you that you don't understand where it comes from, you feel a little alone because you're not in your close environment. But I'm very grateful to Maria for always supporting me. It's good to have people like that around. 'At that moment, I wasn't thinking about whether I would be able to come back or not because I was confident I would get through it. At no point did I think I was out of the Euros. 'I took it easy and I didn't get carried away. All the work I do every day to take care of myself: to eat well, to be healthy, not to smoke, not to drink alcohol, basic things like that, to play sport, obviously… I think your body remembers how you treat it. I'm not a doctor, but I think that helped me.' Three days after being admitted to the hospital, Bonmati was discharged. The next day, she travelled to Lausanne, Spain's base camp, to rejoin her team-mates. 'Fortunately, I was only really unwell for two or three days, but then I made a radical change for the better,' she says. 'I didn't have a gradual progression; I went from feeling very bad to feeling fine.' At a press conference prior to Spain's opening match against Portugal, Tome said the player's progress was positive, that she had shown a very good attitude but that 'Aitana had to be slowed down'. 'From then on, I wanted to speed things up because I felt fine and had no symptoms whatsoever,' Bonmati says. 'I wanted to start training, even if it was gradually. I wanted to get my body working. 'It's part of who I am. I don't want to waste a single day. If I'm 100 per cent fit to be there, I'll be there. I don't like wasting days. Here, a day lost is a day less. On the Sunday when I was discharged, I trained in Las Rozas (Madrid). I went to the gym and moved around a bit. I had been lying down for three or four days without doing anything. 'On Monday morning, I trained again at the gym a little harder, starting to try some jumps to see how the pressure in my head felt. Everything went well. I arrived in Lausanne and started training the next day. The group was already training, and I trained separately. 'Obviously, I would like the progress to have been faster. I suppose everyone here is aware and takes some responsibility because it's not just any illness. I understand that. But I felt fine, I wanted to start feeling part of the group. I had already felt out of the group for a few days. If I felt fine, why couldn't I come back sooner? That was the frustration I felt. Looking at it in perspective, I suppose you have to understand everyone's opinion. 'I don't consider myself a player who finds it difficult to get into shape; I had a lot of confidence in my body and my physical condition. It has been a learning process. Life sometimes throws you these setbacks that make you deal with certain situations you're not used to. 'I wanted to be on the pitch, I wanted to feel good. I wanted to enjoy and I haven't enjoyed what's happened to me very much because I've had to deal with this frustration.' Remarkably, six days after the diagnosis, Bonmati came off the bench with nine minutes remaining of the 5-0 win over Portugal. She had spent the entire match standing in the technical area or by the bench, waving her arms as she always does when she plays to communicate with her team-mates. Like a police officer, as her father always jokes. 'On the one hand, I felt proud to have been part of the match and to have been able to play for a few minutes,' she says. 'On the other, I felt frustrated… But obviously, with what had happened to me, I had to be more grateful than frustrated.' Against Belgium, all eyes were on whether she would return to the starting XI or not. Tome decided to go with Vicky Lopez again. 'It was something that was discussed internally,' Bonmati says. 'We wanted to take good care of my physical condition so I would be in the best possible shape for the most important part, which is now (the knockout stages). Having been in the hospital, I had to respect the timeframe; they treated it as if it were an injury. When a player is injured, they're not going to exploit her. 'Sometimes you have to reach agreements or understand the other person's point of view. As a player, I was frustrated to see the process taking so long, but I know it was done with my best interests in their minds.' She made her first start of the Euros against Italy in the final group match — a 3-1 win — and is now able to think again about adding the one title that is missing from her collection. 'What we have done so far is very good and it's a good platform to face what's coming,' she says. 'But now we have decisive, do-or-die matches against tough opponents. Next up is Switzerland, the host nation. We're back in the quarter-finals against the host nation — in 2022, it was England. Now it's Switzerland. 'They've had a great tournament and, as the hosts, there are things that work in their favour. The crowd will be behind them. But it's also cool as a player to experience these moments.' Which other teams has she been impressed by? 'I really like France and Germany,' she says. 'France are a different team from what we've seen in recent years. They're very young with a lot of talent and versatility. They have a rich bench to change things up and energise the games. They have some very good players, such as Delphine Cascarino. 'Then there is Germany. The other day, they conceded four goals and had a player sent off, but they started the game (against Sweden) with a brutal level of intensity. In fact, we commented with some players that they were flying. I'm really liking (Klara) Buhl, I think she's at a very good level. (Jule) Brand too.' Spain are based in Lausanne, on the shores of Lake Geneva, and the team are making the most of what Switzerland has to offer. 'It's one of my favourite countries,' she says. 'I came here years ago on a trip, in winter. It's a country that transports you to tranquillity. It seems that everywhere you go is like a postcard landscape. Everywhere. 'Being in a city like Lausanne, with the hotel in the centre, gives us freedom to visit places. The other day we had a day off and we all did what we wanted. We went on an excursion I organised to some mountains nearby, on a rack railway, with spectacular views. It's all about breathing fresh air and tranquillity all the time. 'It's something that's sometimes lacking in Catalonia, which also has stunning landscapes, but in the area where I live, it's not the same. Switzerland is an amazing country.' But now, with the quarter-finals under way, it is time for business. 'I'm approaching this final stretch with a lot of energy, enthusiasm and excitement, eager to play three good matches,' Bonmati adds. 'Let's hope it's three, because that would be good news. And I'm feeling very well.' This article originally appeared in The Athletic. Barcelona, Spain, Premier League, La Liga, Women's Soccer, Women's Euros 2025 The Athletic Media Company
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Gastrointestinal cancers rising dramatically in people under 50
Gastrointestinal cancers, which include colorectal, stomach and pancreatic cancer, are rising dramatically in younger adults, though doctors aren't fully sure why. Even some of the possible causes require more research, they say. According to a review published Thursday in JAMA, gastrointestinal cancers have become the fastest-growing type of cancers diagnosed in adults younger than 50 in the U.S.. The review, one of the most comprehensive looks at gastrointestinal cancer trends, summarized the findings of major international and U.S. cancer databases, plus 115 papers on gastrointestinal cancers published from January 2014 to March 2025. The authors underscore the need for people to follow the screening guidelines for colorectal cancer, which suggest that people with an average risk start screening — usually a colonoscopy or stool test — at age 45. Since doctors don't routinely screen for pancreatic, stomach and esophageal cancers in the U.S., the authors also call for new ways to screen more people for these cancers. 'This really points to the importance of trying to improve screening and early detection,' said Dr. Kimmie Ng, the review's co-author and director of the Young-Onset Colorectal Cancer Center at Dana-Farber Cancer Institute. According to the review, colorectal cancer is by far the most common early-onset gastrointestinal cancer, with nearly 185,000 cases reported worldwide in 2022 and nearly 21,000 cases reported that same year in the U.S. Diagnoses in the U.S. have risen 2% annually in people younger than 50 since 2011, according to the American Cancer Society. 'It never used to happen in this age group, and now a very significant rise in 20, 30 and 40-year-olds are getting colon cancer,' said Dr. John Marshall, chief medical consultant at the nonprofit Colorectal Cancer Alliance, who was not involved in the research. In one of the most high-profile examples, actor Chadwick Boseman was diagnosed with colon cancer in 2016 and passed away of the disease four years later at age 43. Early-onset cases of pancreatic, stomach and esophageal cancers are also rising, according to the new study. Previous research has shown a disproportionate share of those gastrointestinal cancer diagnoses were among Black and Hispanic people. Pancreatic cancer is among the deadliest forms of cancer, with just 13% of patients surviving five years after their diagnosis. Because colorectal cancer is the most common, doctors said they have a better grasp of what might be contributing to these early-onset cases compared to others. 'If we can understand what's going on in colorectal [cancer], I think it would really provide a lot of guidance to help us understand the other GI tract cancers,' said Dr. Scott Kopetz, a professor of gastrointestinal medical oncology at the University of Texas MD Anderson Cancer Center. Kopetz said there are likely multiple factors driving the increase in early-onset cases. 'The leading theory is that there is no single leading theory,' he said. Ng's new review in JAMA suggests that most gastrointestinal cancers in people under 50 are associated with lifestyle factors such as obesity, lack of exercise, poor diet, cigarette smoking or alcohol consumption. One study included in the review found that women who consumed more sugar-sweetened beverages during adolescence had a higher risk of developing early onset colorectal cancer. 'It's really what people were doing or exposed to when they were infants, children, adolescents that is probably contributing to their risk of developing cancer as a young adult,' Ng said. Health and Human Services Secretary Robert F. Kennedy Jr. has been vocal about the association between sugary beverages and health issues, including cancer. On Wednesday, President Donald Trump said Coca-Cola will start being made with cane sugar rather than corn syrup in the U.S., but the company did not commit to the change when asked about it by NBC News. Marshall said he suspects the rise in early-onset colorectal cancer could have something to do with changes in people's gut microbiomes — the bacteria that live in our gastrointestinal tracts. Diet, antibiotic use, microplastics and exposure to environmental chemicals likely all influence a person's gut bacteria, but scientists still don't have a clear understanding of what a healthy microbiome looks like nor how it affects our health. That is a booming area of research. Ng's review also found that 15% to 30% of people with early-onset gastrointestinal cancer carry hereditary genetic mutations that may have predisposed them to getting cancer at a young age. Because of that, she said, 'we do recommend that all young patients diagnosed under the age of 50 undergo testing for hereditary conditions.' Overall survival rates for gastrointestinal cancers have gotten better over time, due to improvements in treatment and screening. But Ng's review found that younger patients often have worse outcomes, despite typically receiving more treatments, including more surgery, radiation and aggressive combinations of chemotherapy, she said. One reason could be that primary care doctors may overlook symptoms such as abdominal pain, constipation, heartburn or reflux in younger patients, thereby delaying their diagnoses. 'My personal feeling is that it's because we're finding them at a more advanced stage, because people don't really think of colon or other GI cancers when they see a young person with these non-specific complaints,' said Dr. Howard Hochster, director of gastrointestinal oncology at Rutgers Cancer Institute and RWJBarnabas Health in New Jersey. But Ng said that even after controlling for the stage at which patients are diagnosed, young people still seem to have worse survival rates. 'This makes us wonder as researchers whether that means that the cancers that develop in younger people may be biologically different and more aggressive, or maybe less responsive to treatment,' she said. This article was originally published on Solve the daily Crossword
