E-cigarettes, vapes, Juuls, cigarettes and cigars. And now there's something else to worry about.

Public health officials are warning parents and educators about a new tobacco product that teens may be abusing — nicotine toothpicks.

The toothpicks look just like regular toothpicks, but the often fruit or cinnamon-flavored sticks under brand names like NicoPix, ZipPik and Pixotine are packed with more nicotine than traditional cigarettes.

The toothpicks are often infused or coated with nicotine and can have as much as 3 mg of nicotine, compared to the about 1.5 mg of nicotine most smokers inhale from a cigarette.

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Nicotine toothpicks come in fruity, mint and cinnamon flavors. Brands include NicoPix, ZipPik, Pixotine, Smart Toothpicks and more. Nicotine toothpicks can contain as much as a traditional cigarette. Public health officials warn of the use of any product containing nicotine by children and young adults. Contributed Photo/Times Free Press

Nicotine is a dangerously addictive substance, and youth are especially vulnerable, Chattanooga-Hamilton County Health Department officials said.

"Nicotine is highly addictive and a lot of youth don't think that's going to be [them], but what might seem as a toothpick here or there can be harmful," said Paula Collier, tobacco prevention coordinator and public health educator for the department. "Our main message is to just encourage parents and teachers and other people who work with youth to be constantly vigilant, because there are a lot of products that youth might not understand."

Nicotine can be one of the hardest addictions to beat, said Dr. John Heise, director of adolescent medicine at Erlanger Children's Hospital.

"We do know that you can get addicted pretty quickly to it," he said. "There are some people who say it's easier to get off cocaine or heroin than nicotine."

It is also especially dangerous to children and teens because their brains are still developing, experts said. Nicotine can have even more harmful effects on a developing brain than an adult's, they said.

Though traditional smoking is down among today's teens, the use of e-cigarettes has increased and teens are experimenting with other substances that might be concealed in candies, gummies or lollipops.

Collier warns that fruit-flavored and candy-type substances are especially attractive to teens.

"Gummy bears may be candy or may not be candy same as lollipops and other things, that traditionally were what they were at face value," she said. Collier encourages parents and educators to be vigilant and pay attention to new habits an adolescent may have developed.

Heise said the use of these products may seem "cool" to teenagers, who are already prone to experimentation and exploration.

"People might think it's cool, but they really are toying with something that can be very damaging to their health long term, can cost a lot of money and can make them less attractive to the opposite sex," Heise said.

Hamilton County Schools officials say they have not been made aware of nicotine toothpicks being a trend or problem in local schools, but most tobacco-related or non-illegal-substance infractions are handled at the school level.

Bradley Jackson, campus discipline specialist for the district, said they asked principals across the district about nicotine toothpicks and did not hear about any discipline-related incidents.

The school district instituted a tobacco-free policy last year, and the use or possession of illegal drugs on a school campus is considered a zero-tolerance offense by the Hamilton County Board of Education.

"As of right now, each school administrator or principal has the jurisdiction to handle tobacco use as they see fit," Jackson said. "Here at [the] central office, we only hear of discipline situations that warrant a suspension that is more than 10 days or involves a a controlled substance."

For parents and educators concerned a young person is struggling with nicotine or tobacco use, there are a variety of resources available, officials say. Motivational interviewing, similar to counseling, can be very successful, Heise said. But teenagers need to be motivated to quit, he added.

Erlanger's Division of Adolescent Medicine is developing resources for families with teens struggling with addiction and plans to launch clinics addressing the topic in coming months.

Heise also advises parents speak with their own medical providers.

Contact staff writer Meghan Mangrum at or 423-757-6592. Follow her on Twitter @memangrum.