Nicotine pouch

Last updated

A box of nicotine pouches Nicotine pouches (52263232478).jpg
A box of nicotine pouches
A single 3 cm nicotine pouch Size of nicotine pouch (cropped).png
A single 3 cm nicotine pouch

Nicotine pouches are small rectangles containing nicotine, flavorings and other ingredients. [1] Unlike snus, they do not include tobacco leaf, dust, or stem. [2] [3] The nicotine may either be derived from tobacco plants or may be synthetic. [2] [4] [5]

Contents

Like with snus or dipping tobacco the user puts a pouch between their lip and gum, and leaves it there while the nicotine and taste is being released. [6] The nicotine enters the bloodstream via mucous membranes in the gums. [7] When finished, the pouch is disposed of. [6] 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. [8]

There is limited independent testing of the constituents, exposure, or biomarkers of effects for nicotine pouches, [2] although independent research is now emerging. [9] Global sales of nicotine pouches expanded rapidly between 2018 and 2023, increasing from an estimated 292 million units to 20.1 billion units, with approximately 85 percent of purchases occurring in the United States, and on brand, Zyn, accounting for more than 70 percent of the global market share. [10] [11] Since 2021, sales of nicotine pouches have grown with Zyn as the global leader. [12] This popularity has led 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. [2] Retail prices for nicotine pouches vary across countries and sales channels. In the United States, convenience store data from 2018 to 2022 indicate that inflation-adjusted prices for modern oral nicotine products, including nicotine pouches, ranged from approximately US$4.22 to $4.57, compared to about $5.73 to $8.55 per pack of cigarettes over the same period. [15] Recent analyses of the U.S. retail market indicate that oral nicotine pouches are often priced lower than cigarettes, in part because many states do not tax them in the same way as other tobacco products, a factor that may contribute to their uptake among price-sensitive users. [16] Unlike vaping products, they require no batteries and no accessory device. [2]

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. [2]

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. [17] [18] 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. [19] [20]

Contents

The contents of a nicotine pouch are mostly plant fiber Obsah nikotinoveho sacku.png
The contents of a nicotine pouch are mostly plant fiber
Nicotine pouches advertisement on Kyle Busch's NASCAR Cup Series show car, Nashville Superspeedway, 2025. Zone nicotine pouches advertisement, Showcar Nashville 2025 (cropped).jpg
Nicotine pouches advertisement on Kyle Busch's NASCAR Cup Series show car, Nashville Superspeedway, 2025.

In addition to nicotine, the pouches typically contain food-grade fillers, sweeteners, and flavorings. [2] 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. [21]

Nicotine pouches are sold in a wide array of flavors, such as peppermint, black cherry, coffee or citrus. [2] The nicotine content among nicotine pouch brands typically varies from 1 mg/pouch to 10 mg/pouch [22] although some have much more. Nicotine pouches usually have a longer shelf-life than traditional snus. [23]

Health risks

Nicotine pouches contain the addictive chemical nicotine. [8] Major public health authorities in the United States emphasise that these products should not be used by youth, young adults, or pregnant individuals who are classed as vulnerable to the effects of nicotine exposure. [24] [25]

There is limited independent testing of the constituents, exposure, or biomarkers of effects for nicotine pouches, [26] although independent research is now emerging. [27] Nicotine itself is currently classified as non-carcinogenic according to the International Agency for Research on Cancer, and according to the Royal College of Physicians, nicotine in itself is not a hazardous drug. [28] [29] In turn, it is hypothesized that if nicotine can be delivered without tobacco and smoke inhalation, most, if not all of the harm of smoking can be avoided. [30] [31] [32] [29] However, if not carcinogenic, nicotine is still moderately harmful to cardiovascular health, therefore long-term use of non-tobacco nicotine pouches very likely causes higher risks for cardiovascular diseases, stroke, and reproductive harms. [33] [34] [35] [ better source needed ]

Several recent clinical studies and reviews have further evaluated the health effects and nicotine delivery profile of nicotine pouches. A 2025 study from Japan Tobacco International showed that nicotine uptake from pouches increased proportionally with dose, showing plasma nicotine levels comparable to Swedish snus and faster than nicotine gum. No major safety concerns were observed after single use. [36]

An independent 2024 clinical trial evaluating high-nicotine pouches found that 30-mg pouches delivered plasma nicotine levels twice as high as cigarettes. These pouches caused significant increases in heart rate and arterial stiffness, raising concerns about cardiovascular effects and addiction potential. The authors recommended setting upper limits on nicotine content. [37]

Additionally, a 2024 scoping review summarized existing research and noted that nicotine pouches likely pose fewer toxicant exposures compared to cigarettes, but highlighted concerns regarding youth uptake and the lack of long-term independent studies assessing public health impact. [38]

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. [39] The Kenya Tobacco Control Alliance alleged that given the higher levels of some toxic chemicals, and what the US 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. [39]

Major health and cancer organisations in the United States, including MD Anderson Cancer Center, the Cleveland Clinic, and the America Cancer Society recognise that nicotine pouches generally expose users to fewer toxic substances than combustible cigarettes because they contain no tobacco lead and involve no combustion. [40] [41] [42]

As leading scientific bodies such as the Royal College of Physicians and National Academies of Sciences have emphasized, it is the products of burning tobacco, not nicotine itself, that cause the majority of cardiovascular disease and respiratory illness. [43] [44] [45]

Accidental ingestion in children

Reports of accidental ingestion of nicotine pouches by young children have increased in recent years. A 2025 analysis of U.S. poison-control center data found that reported pouch ingestions among children under six rose by approximately 763 percent between 2020 and 2023, with most cases involving toddlers under the age of three, [46] highlighting the importance of safe storage practices in households where nicotine products are present.

Classification

Garant nicotine pouches Garant nicotine pouches.jpg
Garant nicotine pouches

Nicotine pouches are regulated differently around the world.

Although nicotine pouches are not heavily regulated in the European Union, some regulatory characteristics fall under the European Union CLP-Regulation (EC) 1272/2008. [47] [48]

Canada

In Canada, 4 mg nicotine pouches are available for sale in pharmacies as a form of nicotine replacement therapy under the Zonnic brand. [49] [50] 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. [51] 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. [52] [53]

Finland

In Finland, until April 2023, nicotine pouches were classified for medicinal use. [54] 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. [54]

France

Nicotine pouches, gums and pearls are due to be banned in France from 1 April 2026. [55] The proposed ban followed earlier warnings from the French Agency for Food, Environment and Occupational Health and Safety (ANSES), which expressed concerns about potential toxicity risks and the possibility that certain product presentations could appeal to adolescents. A government decree published in September 2025 cited an increase in calls to French poison-control related to nicotine pouch exposures, rising from three cases in 2020 to eighty-six cases in 2022. These reports contributed to ongoing policy discussions on product safety standards and appropriate regulatory pathways for emerging nicotine products. [56] [57]

Germany

As of 2023, nicotine pouches are classified as a food product in Germany, with some being withdrawn from sale in shops under that authority due to their high nicotine content. [58] They can be purchased online. [59]

Norway

In Norway, their sale in general stores are banned because they are classified as a new nicotine product.[ citation needed ]

Tobacco-free nicotine pouches were for sale in Norway from 2014 to 2018, under the name Epok. [60] 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. [61] 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. [62] As of July 2025, Epok is still sold by Norwegian grocery stores. [63] [64]

Sweden

Sweden regulated tobacco-free nicotine products, including nicotine pouches, under the Act (2022:1257) on Tobacco- Free Nicotine Products, which entered into force on 1 August 2022. The law establishes requirements for product composition, health warnings, packaging and labelling, bans sales to persons under 18 years of age, and restricts the marketing of such products in line with the country’s broader tobacco control framework. [65]

Switzerland

In the second half of the 2010s, nicotine pouches arrived on the Swiss market. [66] The revised Tobacco Products Law (Tabakproduktegesetz, TPL) and Tobacco Products Ordinance (TPO) entered into force in Switzerland on 1 October 2024. Under this framework, nicotine-containing products for oral use, including nicotine pouches and other tobacco-free nicotine products, fall within federal tobacco regulation. The legislation establishes national minimum-age requirements for purchase, introduces advertising and sponsorship restrictions, and provides for the regulation of similar products that may be introduced in the future. [67]

United Arab Emirates

From 29 July 2025, tobacco-free nicotine pouches became legally available for sale in the United Arab Emirates following the adoption of a new cabinet resolution establishing technical standards for these products. The regulation includes requirements on quality, labelling, and packaging, sets a minimum purchase age of 18 years, and positions nicotine pouches as part of a harm-reduction strategy intended to support smokers seeking alternatives to cigarettes. [68] [69]

United Kingdom

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. [70]

United States

In 2021, the American College of Chest Physicians (CHEST) and other health organizations urged the US Food and Drug Administration (FDA) to address regulatory gaps related to synthetic nicotine products, including nicotine pouches, citing concerns about youth usage and public health impact. [71] The US Food and Drug Administration (FDA) has extended its oversight to nicotine pouches under the Family Smoking Prevention and Tobacco Control Act, requiring manufacturers to submit Premarket Tobacco Product Applications (PMTAs) for approval. [72]

In January 2025, the FDA granted the first U.S. marketing authorizations for 20 ZYN nicotine pouch products through the PMTA pathway, concluding that the products exposed users to substantially lower levels of certain harmful chemicals than cigarettes and some traditional smokeless tobacco, while emphasizing that they still carry health risks and are intended for use only by adults. [73] [74] [75]

References

  1. ↑ CDC (31 January 2025). "Nicotine Pouches". Smoking and Tobacco Use. Retrieved 27 February 2025.
  2. 1 2 3 4 5 6 7 8 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.
  3. ↑ Hartmann-Boyce, Jamie; Travis, Nargiz (17 June 2024). "Oral nicotine pouches deliver lower levels of toxic substances than smoking – but that doesn't mean they're safe". The Conversation. Retrieved 27 February 2025.
  4. ↑ Klausen, Marte (25 July 2018). "Bråstans for snus uten tobakk". Dagbladet.no (in Norwegian). Retrieved 2 February 2020.
  5. ↑ "LYFT | Vitt utan Tobak! | Nettotobak!". Nettotobak.com. Retrieved 3 February 2020. LYFT är det senaste inom helvitt snus
  6. 1 2 How to Use Nicotine Pouches
  7. ↑ "Nicotine Gum". myhealth.alberta.ca. Retrieved 28 April 2024.
  8. 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.
  9. ↑ 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.
  10. ↑ Alexandrou, Georgia; Moodie, Crawford (2 December 2024). "Keeping pace with nicotine pouch market developments". Tobacco Control. doi:10.1136/tc-2024-059017. ISSN   0964-4563. PMID   39622640.
  11. ↑ "Other | Keeping pace with nicotine pouch market developments | University of Stirling".{{cite journal}}: Cite journal requires |journal= (help)
  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. ↑ "National Trends in Sales and Price for Commercial Tobacco and Nicotine Products, 2018-2022" . Retrieved 12 December 2025.
  16. ↑ He, Yanun; Zhang, Zezhong; Keller-Hamilton, Brittney; Mays, Darren; Wagener, Theodore L.; Berman, Micah L.; Shang, Ce (12 June 2025). "Trends of oral nicotine pouch prices and sales by product characteristics in the USA, 2021–2024". Tobacco Control. doi:10.1136/tc-2024-059222. ISSN   0964-4563. PMID   40506226.
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  18. ↑ "Røykeslutt - legemidler - helsenorge.no". helsenorge.no. 19 June 2018. Archived from the original on 3 February 2020. Retrieved 3 February 2020.
  19. ↑ "Zonnic, flavoured nicotine pouch approved by Health Canada, targets teens, health experts say". The Globe and Mail. 14 November 2023. Retrieved 26 January 2024.
  20. ↑ "Product information". health-products.canada.ca. Retrieved 26 January 2024.
  21. ↑ "What are Nicotine Pouches? Complete Guide - Swenico". 9 February 2023. Retrieved 16 February 2023.
  22. ↑ 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.
  23. ↑ Difference between Nicotine Pouches and Snus SnusDirect February 2021
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  25. ↑ Products, Center for Tobacco (24 July 2025). "Other Tobacco Products". FDA.
  26. ↑ 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.
  27. ↑ 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.
  28. ↑ "IARC Monographs on the Identification of Carcinogenic Hazards to Humans". International Agency for Research on Cancer. World Health Organization.
  29. 1 2 "Nicotine without smoke: Tobacco harm reduction". Royal College of Physicians.
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  31. ↑ Avenue, 677 Huntington; Boston; Ma 02115 (16 April 2024). "Zyn pouches safer than smoking, but still pose risks". News. Retrieved 15 July 2024.{{cite web}}: CS1 maint: numeric names: authors list (link)
  32. ↑ Blum, Dani (25 January 2024). "Can Nicotine Pouches Like Zyn Harm Your Health?". The New York Times. ISSN   0362-4331 . Retrieved 15 July 2024.
  33. ↑ Avenue, 677 Huntington; Boston; Ma 02115 (16 April 2024). "Zyn pouches safer than smoking, but still pose risks". News. Retrieved 4 July 2024.{{cite web}}: CS1 maint: numeric names: authors list (link)
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  47. ↑ "EUR-Lex - 02008R1272-20211001 - EN - EUR-Lex". eur-lex.europa.eu. Retrieved 6 April 2022.
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  50. ↑ "Product information". health-products.canada.ca. Retrieved 26 January 2024.
  51. ↑ "Consolidated federal laws of Canada, Natural Health Products Regulations". 24 November 2023.
  52. ↑ "Notice: Prescription Drug List (PDL): Nicotine Qualifier Clarification | Canada.ca". www.canada.ca. 23 August 2018. Retrieved 15 December 2020.
  53. ↑ "Food and Drug Regulations | laws-lois.justice.gc.ca". www.laws-lois.justice.gc.ca. 19 December 2013. Retrieved 15 December 2020.
  54. 1 2 "Fimea supports legislative reform concerning nicotine pouches". Fimea. Retrieved 16 August 2023.
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  59. ↑ Galvin, Gabriela (28 February 2025). "France bans nicotine pouch sales. Where does the rest of Europe stand?". euronews.
  60. ↑ "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.
  61. ↑ Journalist, Lene Skogstrøm (25 July 2018). "Denne snusen blir nå trukket tilbake fra hyllene. Årsak: Den inneholder ikke tobakk" . Aftenposten. Retrieved 3 February 2020.
  62. ↑ Klausen, Marte (26 July 2018). "Disse snusboksene forsvinner fra butikkene". Dagbladet.no (in Norwegian). Retrieved 3 February 2020.
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  73. ↑ Commissioner, Office of the (16 January 2025). "FDA Authorizes Marketing of 20 ZYN Nicotine Pouch Products after Extensive Scientific Review". FDA. Retrieved 12 December 2025.
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