As the U.S. Food and Drug Administration considers allowing more flavors of e-cigarettes to be sold in the U.S., a new report sheds light on risks associated with another nicotine product becoming more popular: nicotine pouches.
These small pouches contain a high concentration of nicotine and are placed underneath the lip, along the gums Nicotine from them is absorbed through the gums and lining of the mouth.
“In partnership with The Independent, Leslie Liang reports for The Examination, a nonprofit newsroom that investigates global health threats, on how the colorful packaging and fruity flavors that make nicotine pouches appealing to adults also make them tempting – and dangerous – for kids,” said the report.
Zyn and on! PLUS pouches have been approved for sale in the U.S. by the FDA. Most legal are mint flavored, per the CDC Foundation, but Audacy reported last year on FDA authorization for other Zyn flavors like cinnamon and citrus.
“Nicotine pouch sales in the United States are rapidly increasing, particularly since 2023,” according to the CDC Foundation. From January of that year through last August, sales jumped up by 250.8%.
According to The Examination’s report, a health department in Multnomah County, Oregon, a network of poison control centers in Florida, and the North Texas Poison Center have all issued warnings about nicotine pouche. The Texas center said “we’re seeing a sharp rise in young children accidentally swallowing nicotine pouches – and even a small amount can cause serious harm.”
Last September, America’s Poison Centers reported that there had been a 91.7% increase in nicotine-pouch related exposures compared to the previous year. That came after a 202% spike from 2022 to 2024.
“While case counts increased across all age ranges, children under 6 years old accounted for the majority of exposures (73.1%),” said the centers’ press release. Doctors cited in The Examination report said that it isn’t surprising that children are getting sick from the pouches, since they can look similar to food or candy.
It also noted that nicotine can harm brain development in adolescents and lead to nicotine addiction. Even more concerning, America’s Poison Centers said “accidental exposure of nicotine in young children can lead to life-threatening poisoning.”
In an effort to protect children from accidental exposure to the pouches, the FDA called on pouch manufacturers to use child resistant packaging last September. It also mentioned the spike in pouch exposure cases. However, The Examination report said that the administration hasn’t required that the packages be child-proofed.
While the legally available nicotine pouches in the U.S. can only be purchased by people age 21 and over, The Examination report noted that black market pouches “with extremely high concentrations of nicotine (up to 50 mg) are becoming more popular.” That’s around five times more potent than the higher end of the legal pouches at 9 mg of nicotine.
“Part of the problem, researchers said, is that the FDA lacks the staff to keep tabs on a booming market,” said The Examination report.
Why is the market booming? Well, as health officials in New York found last October, tobacco use among high school students had fallen to a record low. That even included vapes, but it didn’t include nicotine pouches. Researchers at the University of Southern California also found a similar trend nationally around nicotine pouch use.
Pouches appeal to young people because they can be used discretely, unlike cigarettes and vapes, The Examination explained. They can use them at home or at school without being easily detected, as the pouches can’t be seen and they don’t have an odor.
Researchers think poisoning from the pouches may also be trending among teens, but those poisonings are harder to measure, The Examination said. For that cohort, nausea, headaches and trouble sleeping – symptoms of poisoning – can be easy to hide if they don’t want their use of the products to be discovered.
Nicotine pouches poisoning is also becoming an issue in other countries, The Examination said. Velo, a brand of nicotine pouches that a British American Tobacco subsidiary has applied for authorization for in the U.S., is shown in a colorful marketing display in a photo shared by The Independent.
“It’s easier to grab shoppers’ attention with pouches,” said The Examination report. “Anti-tobacco laws often require cigarettes to be packaged discreetly and placed behind a counter or out of sight. Colorfully packaged nicotine pouch products are often displayed alongside snacks and candies on the counter.”
Social media influences on TikTok and Instagram are also known to promote the pouches, often framing them as less harmful than other nicotine products. However, the CDC Foundation warned that no nicotine products are safe.
Support for the pouches has even entered the political sphere in Canada. There, the National Post reported this week that conservative politicians have been carrying packages of Zyn (not available for sale in Canada) as an “accessory of choice” and some have even urged Prime Minister Mark Carney to loosen federal restrictions around nicotine products.
Meanwhile, The New York Times reported this week that the FDA is looking into allowing mint, coffee, spice and tea flavored vapes to be sold in the U.S. to appeal to adults. This comes as illicit candy-flavored vapes still flood the market, the outlet noted.