The pre-workshop survey that we ask older students to complete always makes interesting reading, and it has put a new product firmly on our radar: nicotine pouches.
If you haven’t heard of them, you aren’t alone. A 2022 ASH survey of over 13,000 adults found that nearly half weren’t aware of them, and most who did know about them weren’t users. In fact, under 4 per cent said that they had ever tried nicotine pouches, with less than 1 per cent saying they were current users. But awareness and use was significantly higher in under 35s, and it seems to be something that is creeping into the public consciousness: there was a 10 per cent rise in those who had heard of nicotine pouches between 2020 and 2022.
So what are they? Well, they are small parcels that fit under the lip and dissolve, releasing nicotine into the saliva from where it gets absorbed into the bloodstream and makes its way to the brain. They are often considered similar to snus, an oral smokeless tobacco product popular in Sweden (but illegal in the UK), but nicotine pouches are tobacco-free. On the face of it, they also appear to have much in common nicotine replacement therapy products such as nicotine gums and lozenges, but those are licensed medicines supported by a body of evidence for their effectiveness in helping people quit smoking, which nicotine pouches do not have.
There are some big brands of nicotine pouches out there – Lyft, Skruf, Nordic Spirit, Velo, Zyn – available in a range of flavours such as mint, citrus, fruit and cola. They also come in different strengths, from 0 to 20mg nicotine, and the packaging is compact and attractive. Many make claims about not staining teeth – to the point that they are sometimes referred to as “white snus” – as well as their cost-effectiveness compared to other nicotine and tobacco products, and how discreet they are to use with an absence of second-hand smoke; they are sometimes called “nicopods”.
Research is meagre and there appears to be no long-term data supporting the use of nicotine pouches to stop smoking. There is some evidence of potential harms, however, with one study into the ingredients finding that 26 of 46 products contained cancer-causing chemicals known as tobacco-specific nitrosamines, and raising concerns about poor labelling to the point of it being impossible to tell how much nicotine was in many of the nicotine pouches involved in the research.
This last is due to nicotine pouches being subject to scant regulation, particularly compared to medicines, tobacco products or even vapes (which in the UK are subject to stricter laws than many other places in the world). While some brands have introduced their own restrictions on age of sale, and warnings on packaging, this is all voluntary. And these are products that contain nicotine, which is a psychoactive substance, and a highly addictive one at that, particularly for young people who have brains like sponges during adolescence.
So we will be keeping nicotine pouches firmly in our sights, keeping track of what seems to be happening with them – and particularly awareness and use of them among young people – to get a sense of whether this is a flash in the pan or the start of something more.