For smokers looking to cut out tobacco, it’s become possible to enjoy a nicotine fix in the form of tobacco-free pouches. These pouches are sold in a variety of strengths, flavors, and purchase locations, and are being marketed as an alternative to traditional cigarettes and vape pens. However, these nicotine pouches aren’t free of risk. They can still deliver dangerous chemicals to the gums and lungs, and some even contain tobacco-specific carcinogens like benzo(a)pyrenes and nitrosamines. In addition, long term exposure to these chemicals can damage DNA and potentially lead to cancer.
Pouch brands like ZYN, Rogue, On!, and Velo are selling these tobacco-free nicotine products. These small, pouch-shaped packages look like tea bags and are placed between the lip and gum, just as snus is parked under one’s upper lip to absorb nicotine in a hands-free way. They also offer a variety of different flavours to appeal to users, including fruit, confectionery, and drinks.
While they do not contain tobacco, pouches hands-free tobacco pouches do contain nicotine that has been extracted from tobacco leaves or made synthetically, as well as plant fibres (which function similarly to snus’s shredded tobacco), water, microcrystalline cellulose, sweeteners, and other flavourings. The tobacco-free versions of these products are typically called oral nicotine delivery systems (ONPs), and they have become a very popular product in the US and UK since they launched in 2014 (see image below).
Nicotine pouches are being marketed as a smoking or vaping cessation aid, and they are widely available in places where it’s not possible to smoke or use a vape pen. However, there’s little evidence that they are an effective quitting aid and the long-term health impact is unknown. They do not qualify as smokeless tobacco products and are not regulated by the FDA in the same way that smoked or vaped tobacco products are, but they may still contain carcinogens.
Using these pouches may be appealing to smokers who want to quit because they do not require the same level of inhalation as a cigarette or vape pen. But this does not mean they are safe to use, and Kecia Christensen, a University of Nebraska Medical Center nurse practitioner in pulmonary disease and thoracic surgery, and Nebraska Medicine certified tobacco treatment specialist, warns that nicotine pouches are addictive and can cause mouth, throat, and lung irritation, nausea, vomiting, and gum damage. High doses of nicotine can also be harmful to developing adolescent brains.
The marketing of these products can be deceptive, and the variety of flavours on offer could attract young people. Nicotine pouches are not marketed as medicinal products, so they do not come under the jurisdiction of the Medicines and Healthcare Regulatory Agency in the UK. The companies behind these brands are using catchy one-syllable names that resemble gum brand names and are advertising their products in places where teenagers congregate. This means that if adolescents start using these products, their parents and teachers will be less likely to recognize the dangers they pose to health.