O2083: Nic Picks: Analyzing Age Verification Procedures for Nicotine Toothpicks Vendors

Background: Nicotine toothpicks, such as Pixotine, are a popular nicotine product amongst teenagers. Disguised inconspicuously as ordinary toothpicks, they contain 2-3 mg of nicotine compared to 1.1-1.8 mg inhaled per cigarette. Additionally, nicotine toothpicks are attractive to youth because of cheap prices and appealing flavors. Consuming nicotine increases the risk of stroke, diabetes, and heart disease, raising concern regarding access to these fast acting and addictive nicotine products. To examine the marketplace and accessibility of nicotine toothpicks to identify risks to pediatric populations.

Methods: Two nicotine toothpicks’ accessibility paths were assessed: in-person stores and online vendors. In-person stores on pixotine.com within a 10 mile radius of the most populated city in each state were called and asked if they required ID for purchase. Stores that did not answer or no longer sold Pixotine were excluded. Websites selling nicotine toothpicks were identified and assessed. The following data were collected: 1) vendor (name, URL); 2) age verification/restriction; 3) product characteristics (e.g., flavor, nicotine content); 4) payment methods; 5) price/discounts; 6) disclaimers; 7) marketing terminology. Descriptive analysis was conducted in R.

Results: 404 in-person stores were called; 77 met inclusion criteria. 1.3% (n=1) of locations were willing to sell Pixotine to minors. 16 nicotine toothpicks’ vendor sites that shipped to the US were analyzed. See Figure 1 for nicotine toothpicks’ brand images. 69% of sites (n=11) prompted users to confirm they were 21+ to enter the site or place orders; 75% (n=12) required no formal method of verification. 69% of sites (n=11) provided warnings/disclaimers (e.g., “nicotine is an addictive chemical”). Products ranged in price from $2.63 to $6.99 per pack, with discounts available on 44% of sites. Sites offered a total of 32 flavors (e.g., cherry, mocha). See Table 1 for nicotine toothpicks’ vendor site characteristics. Marketing statements included: “discreet”; “cost-effective.” Reviews claimed that nicotine toothpicks were “convenient” and “rich in flavor.”

Conclusion: While nicotine toothpicks seem to be regulated for in-person sales, nicotine toothpicks’ online vendor sites lack strict age verification procedures, potentially putting minors at significant risk. Marketing tactics such as “appealing flavors,” “low prices,” and “discounts” make nicotine toothpicks attractive to internet savvy youth. Although nicotine toothpicks were originally marketed as a smoking cessation tool/smoking alternative, their ability to be discreetly consumed allows for teen nicotine use in any environment. Our findings reveal the need for enforceable legislation that regulates nicotine toothpicks’ vendors to protect pediatric populations from the dangers of nicotine.