Nicotine pouch

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A single 3cm nicotine pouch Size of nicotine pouch (cropped).png
A single 3cm nicotine pouch
A tin of Lyft brand nicotine pouches Lyft nicotine pouches.jpg
A tin of Lyft brand nicotine pouches

Nicotine pouches are white pouches usually made from plant fibers containing nicotine among other ingredients. They do not include tobacco leaf, dust, or stem. [1] The nicotine may either be derived from tobacco plants or may be synthetic. Nicotine pouches are described as either similar to or a tobacco-free version of snus. [1] [2] [3]

Contents

To use a nicotine pouch, the user puts a pouch between their lip and gum, and leaves it there while the nicotine and taste is being released. [4] The nicotine enters the bloodstream via mucous membranes in the gums. [5] When finished, the pouch is disposed of. [4] Many brands have a storage area in the top case (a catch lid) where used pouches can be kept if no trash can is readily available. The small pouches differ from chewing tobacco in that the user does not need to spit, since the contents of the pouches stay inside the pouches during use. [6] [1] No combustion is involved during use. [1]

There is limited independent testing of the constituents, exposure, or biomarkers of effects for nicotine pouches, [1] although independent research is now emerging. [7] The pouches are sold in an array of flavors. [1] Many of the brands of nicotine pouches are made by major tobacco companies (e.g., Swedish Match makes Zyn and Volt, British American Tobacco makes Lyft and Velo, Imperial Tobacco makes Skruf and ZoneX, Japan Tobacco International makes Nordic Spirit, Philip Morris International makes Shiro, and Altria owns 100% of On!). [8] In December 2020 and April 2021, Altria subsidiaries closed transactions to acquire the remaining 20% of the global On! business for a total of approximately $250 million. [9] [10] [11] Since 2021, sales of nicotine pouches have grown exponentially with Zyn as the global leader. [12] This popularity has lead to controversy among government regulators who view the product's appeal to youth as concerning. [13]

Usage

While relatively new, nicotine pouches share similarities with Swedish snus. The first pouch product was developed in the beginning of the 2000s by a small start up company Niconovum. This company registered the product in 2008 as a medicinal nicotine replacement product (Zonnic) with 2 mg of nicotine. In 2009, RJ Reynolds (now British American Tobacco) bought Niconovum. Thereafter tobacco companies, particularly Swedish Match, became active in the pouch category. Many of Sweden’s leading snus manufacturers, such as Swedish Match, Skruf and AG Snus created their nicotine pouch brands as a direct response to demand for a nicotine option with less conspicuous, smokeless usage. While discreet and tobacco-free, nicotine pouches can still, potentially, cause some side effects like: hiccups, gum irritation, nausea and headaches. [14]

It is unclear whether smokers might switch to nicotine pouches or if they would continue to smoke and use nicotine pouches, resulting in dual use. [1] Nicotine pouches typically cost about as much as a pack of regular cigarettes. [1] Unlike vaping products, they require no batteries and no accessory device. [1]

Nicotine pouches may entice youth as well as young adult never-smokers because they are available in an array of flavors and may be used unobtrusively. [1]

In pharmacies in Norway, Finland, Denmark, and Sweden, nicotine pouches are also sold as a delivery mechanism for nicotine replacement therapy. In Norway, the brand Zonnic is approved by the Norwegian Medicines Agency for smoking cessation. [15] [16] In Canada, 4 mg nicotine pouches became available for sale in gas stations and convenience stores in 2023 as a form of nicotine replacement therapy under the brand Zonnic. [17] [18]

Contents

The contents of a nicotine pouch Obsah nikotinoveho sacku.png
The contents of a nicotine pouch

In addition to nicotine, the pouches typically contain food-grade fillers, sweeteners, and flavorings. [1] The main ingredient in nicotine pouches in terms of volume is plant fiber. Plant fibers are used to fill the pouch and give it the desired shape, fit, and properties. Different brands use different fibers, but some of the most common derive from eucalyptus and pine. [19] Nicotine pouches are sold in an array of flavors, such as peppermint, black cherry, coffee, citrus, and many others. [1] The nicotine content among nicotine pouch brands typically varies from 1 mg/pouch to 10 mg/pouch [20] although some have much more. Nicotine pouches usually have a longer shelf-life than traditional snus. [21]

Research

Nicotine pouches contain the addictive chemical nicotine. [6]

While nicotine is not a carcinogen according to the International Agency for Research on Cancer, [22] a meta-analysis paper by members of Tata Memorial Hospital in Mumbai, India, state that nicotine may be carcinogenic and has widespread adverse effects on many systems of the body. [23] According to the Royal College of Physicians nicotine in itself is not a highly hazardous drug. RCP also states that it is unlikely that nicotine itself contributes significantly to the mortality or morbidity caused by smoking, and that if nicotine could be delivered to smokers without smoke, most, if not all of the harm of smoking can probably be avoided. [24]

Opposition

Advocacy groups opposed to the introduction of nicotine pouches in Kenya have protested that they may raise the risk of cancer, heart disease, and reproductive or developmental harms. [25] The Kenya Tobacco Control Alliance alleged that given the higher levels of some toxic chemicals, and what the U.S. Food and Drug Administration said was a lack of medical data showing the pouches are safer than cigarettes (as claimed by manufacturer British American Tobacco), the government should not license the product. [25]

Classification

Nicotine pouches are regulated differently around the world. In some countries, like Norway, their sale in general stores are banned because they are classified as a new nicotine product. In other countries, they are sold freely, because they do not classify as a tobacco product due to their lack of tobacco. [26] They are banned in Germany, but are available in Sweden. Although nicotine pouches are not heavily regulated in the European Union, some regulatory characteristics fall under the European Union CLP-Regulation (EC) 1272/2008. [27] [28]

It is assumed nicotine pouches are classified as tobacco products in the US because they contain nicotine obtained from tobacco. [1]

Tobacco-free nicotine pouches were for sale in Norway from 2014 to 2018, under the name Epok. [29] In June 2018 the Norwegian Directorate of Health forced British American Tobacco Norway to remove Epok from sale. The Norwegian Directorate of Health argued that since Epok didn't contain any tobacco, it was a new form of nicotine product, distinct from the other forms of snus approved in Norway. Approval for the nicotine pouch brand ZYN had already been rejected twice for a very similar product. [30] Within days of the ban, Epok was re-introduced to the Norwegian market, with a minute amount of bleached tobacco added, to qualify as snus, an already approved form of nicotine product. [31] As of July 2022, Epok is still sold by Norwegian grocery stores. [32] [33]

In Canada, 4 mg nicotine pouches are widely available for sale in gas stations and convenience stores as a form of nicotine replacement therapy under the Zonnic brand. [34] [35] Nicotine products in Canada with a standard dosage exceeding 4 mg are considered a prescription drug, therefore personal imports of nicotine pouches containing over 4 mg of nicotine per pouch are prohibited. [36] Exceptions exist for those who are a health practitioner or medical practitioner, a drug manufacturer, a wholesale druggist, a pharmacist, or a resident of a foreign country while a visitor in Canada. [37] [38]

In Finland, until April 2023, nicotine pouches were classified for medicinal use. [39] The Finnish Medicines Agency (FIMEA) stated that nicotine pouches cannot be classified as medicinal products unless they are specifically marketed for a medicinal purpose or it can be demonstrated in some other way that they are typically used as medicinal products. [39]

The pouches are sold in supermarkets in the United Kingdom, and are not covered by tobacco or medical laws there. In 2022, the Action on Smoking and Health group called for a regulatory framework covering all nicotine products. [40]

Related Research Articles

<span class="mw-page-title-main">Nicotine</span> Chemical stimulant produced by some plants

Nicotine is a naturally produced alkaloid in the nightshade family of plants and is widely used recreationally as a stimulant and anxiolytic. As a pharmaceutical drug, it is used for smoking cessation to relieve withdrawal symptoms. Nicotine acts as a receptor agonist at most nicotinic acetylcholine receptors (nAChRs), except at two nicotinic receptor subunits where it acts as a receptor antagonist.

<span class="mw-page-title-main">Altria</span> American tobacco corporation

Altria Group, Inc. is an American corporation and one of the world's largest producers and marketers of tobacco, cigarettes, and related products. It operates worldwide and is headquartered in Henrico County, Virginia, just outside the city of Richmond.

<span class="mw-page-title-main">Imperial Brands</span> British tobacco company

Imperial Brands plc is a British multinational tobacco company headquartered in London and Bristol, England. It is the world's fourth-largest international cigarette company measured by market share after Philip Morris International, British American Tobacco and Japan Tobacco and the world's largest producer of fine-cut tobacco and tobacco papers.

<span class="mw-page-title-main">Snus</span> Moist tobacco product placed under the upper lip

Snus is a tobacco product, originating from a variant of dry snuff in early 18th-century Sweden. It is placed between the upper lip and gum for extended periods, as a form of sublabial administration. Snus is not fermented. Although used similarly to American dipping tobacco, snus does not typically result in the need for spitting, and, unlike naswar, snus is steam-pasteurized.

<span class="mw-page-title-main">Swedish Match</span> Swedish multinational tobacco company

Swedish Match AB is a Swedish multinational tobacco company headquartered in Stockholm. The company manufactures snus, nicotine pouches, moist snuff, tobacco- and nicotine-free pouch products, chewing tobacco, chew bags, tobacco bits, cigars, matches, lighters, and other fire products with operations in Sweden, Denmark, the United States, the Dominican Republic, Brazil, the Netherlands, and the Philippines. The company's origins can be traced back to 1868, and Ivar Kreuger. Swedish Match has played an important part in Sweden's industrial development.

<span class="mw-page-title-main">Nicotine replacement therapy</span> Treatment for tobacco use disorder

Nicotine replacement therapy (NRT) is a medically approved way to treat people with tobacco use disorder by taking nicotine through means other than tobacco. It is used to help with quitting smoking or stopping chewing tobacco. It increases the chance of quitting tobacco smoking by about 55%. Often it is used along with other behavioral techniques. NRT has also been used to treat ulcerative colitis. Types of NRT include the adhesive patch, chewing gum, lozenges, nose spray, and inhaler. The use of multiple types of NRT at a time may increase effectiveness.

<span class="mw-page-title-main">Skoal (tobacco)</span> Brand of smokeless tobacco

Skoal is an American brand of smokeless tobacco. First produced by the U.S. Smokeless Tobacco Company (USSTC) in 1934 as the first wintergreen flavored dipping tobacco, Skoal is considered a high-priced product within the dipping tobacco market. "Skoal" is an Anglicization of skål, a term used often in Scandinavia to announce a toast of friendship, with connotations of well-wishing.

Nicorette is the brand name of a number of products for nicotine replacement therapy (NRT) that contain nicotine polacrilex. Developed in the late 1970s in Sweden by AB Leo in the form of a chewing gum, Nicorette was the first nicotine replacement product on the market.

<span class="mw-page-title-main">Dipping tobacco</span> Finely ground smokeless tobacco product

Dipping tobacco is a type of finely ground or shredded, moistened smokeless tobacco product. It is commonly and idiomatically known as dip. Dipping tobacco is used by placing a pinch, or "dip", of tobacco between the lip and the gum. The act of using it is called dipping. Dipping tobacco is colloquially called chaw, snuff, rub, or fresh leaf among other terms; because of this, it is sometimes confused with other tobacco products—namely dry snuff.

<span class="mw-page-title-main">Philip Morris International</span> Multinational tobacco company

Philip Morris International Inc. (PMI) is an American multinational tobacco company, with products sold in over 180 countries. The most recognized and best selling product of the company is Marlboro. Philip Morris International is often referred to as one of the companies comprising Big Tobacco.

<span class="mw-page-title-main">U.S. Smokeless Tobacco Company</span> American company responsible for making smokeless tobacco

U.S. Smokeless Tobacco Company is an American company that manufactures smokeless tobacco products, notably dipping tobacco, as well as chewing tobacco, snus, and dry snuff. The company is a subsidiary of Altria.

Kodiak is a brand of dipping tobacco manufactured by American Snuff Company, a U.S. smokeless tobacco manufacturer which also produces the Grizzly tobacco and Levi Garrett brands. Introduced in 1980, Kodiak is currently available in three flavors: Wintergreen, Mint , and Straight, each featuring a picture of a Kodiak bear on the top label. Kodiak recently introduced pouches, which hold the moist snuff in a tea-bag like pouch, preventing it from spreading around the mouth and keeping it out of the teeth.

<span class="mw-page-title-main">Smoking in Finland</span>

In Finland, the smoking figures are among the lowest in Europe. There are several factors that have influenced the decrease in the smoking prevalence, such as legislative actions, health promotion and national monitoring systems, policies aimed at reducing tobacco consumption through public awareness campaigns, advertising bans and increased taxation. Ministry of Social Affairs and Health has the leading role in tobacco control in Finland, and one of their main aims is have a more effective ban on sale of tobacco products to children and young people and to prevent sale of illegal tobacco products. Among the key elements in the successful tobacco policy is the traditional collaboration between the health authorities and non-governmental organisations, and intensive health promotion.

<span class="mw-page-title-main">Regulation of electronic cigarettes</span>

Regulation of electronic cigarettes varies across countries and states, ranging from no regulation to banning them entirely. As of 2015, around two thirds of major nations have regulated e-cigarettes in some way. A 2023 report by the World Health Organization (WHO) found that 34 countries had banned the sale of e-cigarettes.

<span class="mw-page-title-main">Modified risk tobacco product</span> United States legal designation

A modified risk tobacco product (MRTP) is a legal designation in the United States for a tobacco product that poses lower health risks to individual users and the population as a whole when compared to existing products on the market such as cigarettes. The Family Smoking Prevention and Tobacco Control Act of 2009 gives the US Food and Drug Administration (FDA) broad authority to regulate tobacco products; the FDA's power extends to approving or rejecting MRTP applications.

<span class="mw-page-title-main">Juul</span> American electronic cigarette manufacturer

Juul Labs, Inc. is an American electronic cigarette company that spun off from Pax Labs in 2017. Juul Labs makes the Juul electronic cigarette, which atomizes nicotine salts derived from tobacco supplied by one-time use cartridges.

<span class="mw-page-title-main">Zyn (nicotine pouches)</span> Nicotine pouch brand

Zyn is a brand of nicotine pouches originating in Sweden. Zyn pouches are designed to be placed between the gum and upper lip and are available in several variants with different nicotine strengths and flavors. Unlike snus, these pouches contain no tobacco.

<span class="mw-page-title-main">Veev</span> Electronic cigarette brand

Veev is a brand of electronic cigarettes manufactured by Philip Morris International (PMI).

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 Robichaud, Meagan O.; Seidenberg, Andrew B.; Byron, M. Justin (21 November 2019). "Tobacco companies introduce 'tobacco-free' nicotine pouches". Tobacco Control. 29 (e1): e145–e146. doi:10.1136/tobaccocontrol-2019-055321. PMC   7239723 . PMID   31753961.
  2. ↑ Klausen, Marte (25 July 2018). "Bråstans for snus uten tobakk". Dagbladet.no (in Norwegian). Retrieved 2 February 2020.
  3. ↑ "LYFT | Vitt utan Tobak! | Nettotobak!". Nettotobak.com. Retrieved 3 February 2020. LYFT är det senaste inom helvitt snus
  4. 1 2 How to Use Nicotine Pouches
  5. ↑ "Nicotine Gum". myhealth.alberta.ca. Retrieved 28 April 2024.
  6. 1 2 Buehler, Hannah (16 October 2019). "Concern over nicotine pouches targeting teens". WKBW-TV. Archived from the original on 18 October 2019. Retrieved 25 November 2019.
  7. ↑ Stanfill, Stephen; Tran, Hang; Tyx, Robert; Fernandez, Carolina; Zhu, Wanzhe; Marynak, Kristy; King, Brian; Valentín-Blasini, Liza; Blount, Benjamin C.; Watson, Clifford (18 August 2021). "Characterization of Total and Unprotonated (Free) Nicotine Content of Nicotine Pouch Products". Nicotine & Tobacco Research. 23 (9): 1590–1596. doi: 10.1093/ntr/ntab030 . ISSN   1469-994X. PMID   34233354.
  8. ↑ "Nicotine Pouches". TobaccoTactics. Retrieved 11 October 2022.
  9. ↑ "Nachrichten – Weitere Nachrichten". Wallstreet Online (in German). Retrieved 6 May 2023.
  10. ↑ "Altria Reports 2021 First-Quarter Results; Reaffirms 2021 Earnings Guidance; Acquires Remaining 20% of Global on! Business". Wallstreet Online. Archived from the original on 14 June 2021. Retrieved 6 May 2023.
  11. ↑ "Altria Reports 2022 Fourth-Quarter and Full-Year Results; Provides 2023 Full-Year Earnings Guidance; Announces New $1 Billion Share Repurchase Program". Wallstreet Online. 1 February 2023. Retrieved 6 May 2023.
  12. ↑ Rodenburg, Malissa (8 March 2024). "Nicotine pouches are growing in popularity. Are they safe?". The Hub. Retrieved 28 April 2024.
  13. ↑ "What to know about Zyn, the tiny nicotine pouch that's sparked a big health debate". AP News. 26 April 2024. Retrieved 28 April 2024.
  14. ↑ Nicotine Pouch Side Effects Prilla.com January 2023
  15. ↑ "Zonnic Niconovum munnpulver i porsjonspose - Felleskatalogen Pasientutgave". www.felleskatalogen.no. Archived from the original on 3 February 2020. Retrieved 3 February 2020.
  16. ↑ "Røykeslutt - legemidler - helsenorge.no". helsenorge.no. 19 June 2018. Archived from the original on 3 February 2020. Retrieved 3 February 2020.
  17. ↑ "Zonnic, flavoured nicotine pouch approved by Health Canada, targets teens, health experts say". The Globe and Mail. 14 November 2023. Retrieved 26 January 2024.
  18. ↑ "Product information". health-products.canada.ca. Retrieved 26 January 2024.
  19. ↑ "What are Nicotine Pouches? Complete Guide - Swenico". 9 February 2023. Retrieved 16 February 2023.
  20. ↑ Stanfill, S.; Tran, H.; Tyx, R.; Fernandez, C.; Zhu, W.; Marynak, K.; King, B.; Valentín-Blasini, L.; Blount, B. C.; Watson, C. (September 2021). "Characterization of Total and Unprotonated (Free) Nicotine Content of Nicotine Pouch Products". Nicotine & Tobacco Research. 23 (9): 1590–1596. doi: 10.1093/ntr/ntab030 . PMID   34233354.
  21. ↑ Difference between Nicotine Pouches and Snus SnusDirect February 2021
  22. ↑ "IARC Monographs on the Identification of Carcinogenic Hazards to Humans". International Agency for Research on Cancer. World Health Organization.
  23. ↑ Mishra, Aseem; Chaturvedi, Pankaj; Datta, Sourav; Sinukumar, Snita; Joshi, Poonam; Garg, Apurva (2015). "Harmful effects of nicotine". Indian Journal of Medical and Paediatric Oncology. 36 (1): 24–31. doi: 10.4103/0971-5851.151771 . PMC   4363846 . PMID   25810571.
  24. ↑ "Nicotine without smoke: Tobacco harm reduction". Royal College of Physicians.
  25. 1 2 Kabale, Nasibo (8 June 2019). "Lobby alleged the introduction of pouches could result in increased risk for cancer". Daily Nation . Archived from the original on 2 December 2019. Retrieved 24 November 2019.
  26. ↑ Vitásek, Petr (30 September 2020). "Zrádné nikotinové sáčky nepodléhají zákonné regulaci a mohou vést k závislosti". Deník.cz (in Czech). Retrieved 29 June 2021.
  27. ↑ "EUR-Lex - 02008R1272-20211001 - EN - EUR-Lex". eur-lex.europa.eu. Retrieved 6 April 2022.
  28. ↑ "Nikotiinipussien etämyynti Suomessa - Snuush - vahvat nikotiinipussit reseptillä" (in Finnish). 20 March 2022. Retrieved 6 April 2022.
  29. ↑ "Why did BAT kill the EPOK brand for LYFT?". SnusCENTRAL. 18 March 2019. Archived from the original on 3 February 2020. Retrieved 3 February 2020.
  30. ↑ Journalist, Lene Skogstrøm (25 July 2018). "Denne snusen blir nå trukket tilbake fra hyllene. Årsak: Den inneholder ikke tobakk" . Aftenposten. Retrieved 3 February 2020.
  31. ↑ Klausen, Marte (26 July 2018). "Disse snusboksene forsvinner fra butikkene". Dagbladet.no (in Norwegian). Retrieved 3 February 2020.
  32. ↑ "Epok | Meny.no". www.meny.no (in Norwegian). Retrieved 3 February 2020.
  33. ↑ "Epok - Kolonial.no". Kolonial.no (in Norwegian Bokmål). Retrieved 3 February 2020.
  34. ↑ "Local public health experts warn about nicotine pouches | CityNews Kitchener". kitchener.citynews.ca. Retrieved 26 January 2024.
  35. ↑ "Product information". health-products.canada.ca. Retrieved 26 January 2024.
  36. ↑ "Consolidated federal laws of Canada, Natural Health Products Regulations". 24 November 2023.
  37. ↑ "Notice: Prescription Drug List (PDL): Nicotine Qualifier Clarification | Canada.ca". www.canada.ca. 23 August 2018. Retrieved 15 December 2020.
  38. ↑ "Food and Drug Regulations | laws-lois.justice.gc.ca". www.laws-lois.justice.gc.ca. 19 December 2013. Retrieved 15 December 2020.
  39. 1 2 "Fimea supports legislative reform concerning nicotine pouches - fimea englanti". Uutinen. Retrieved 16 August 2023.
  40. ↑ "Call to ban nicotine pouch sale to under-18s". BBC News. 31 October 2022. Retrieved 9 March 2024.
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