What are nicotine pouches, and are they actually better for you than cigarettes?
For months, lawmakers in the US have been bickering over Zyn, a popular brand of nicotine pouches.
At a press conference at the end of January, Chuck Schumer, the Senate majority leader, warned of children becoming hooked on the pouches. He also called on the Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) to investigate the products’ health effects and marketing tactics.
Schumer’s remarks sparked outrage among Republicans. “Big Brother Schumer doesn’t want us to chew or smoke. Now he’s against an alternative that’s helped many quit,” tweeted the New York representative Richard Hudson, along with a picture of himself in full camo, holding up a tin of Zyn.
According to the CDC, in 2021, 2.1% of adults reported current use of smokeless tobacco products. In 2023, the agency found that 1.5% of high school students reported that they had used smokeless tobacco in the past 30 days.
While those numbers are low, the popularity of nicotine pouches has risen. Sales of Zyn alone rose in the US by 58.8% between 2019 and 2022, according to one report, and then climbed a further 66% in the third quarter of 2023.
We looked at the health risks associated with nicotine pouches and whether they can help people quit smoking, as some proponents claim.
What are nicotine pouches?
Nicotine pouches are small, porous, teabag-like products that users place in the mouth, between the upper lips and gums. They contain nicotine, flavorings and other fillers, but they don’t contain tobacco. The nicotine is absorbed through the gums and saliva.
Pouches are sold in small tins, each of which contains about 15 to 20 units, depending on the brand.
Most brands recommend using their pouches for up to an hour. The pouches come in a variety of flavors and strengths, generally varying in strength between 3mg and 12mg; a typical cigarette contains 10 to 14mg of nicotine.
Unlike dipping tobacco, which users also tuck into the corners of their mouths, nicotine pouches are often advertised as being “spit-free”.
Is nicotine harmful?
When US customers visit the websites of nicotine pouch brands, a large banner at the top blares: “WARNING: This product contains nicotine. Nicotine is an addictive chemical.”
As a research report by the National Institute on Drug Abuse (Nida) explains, nicotine is addictive; like other “drugs of abuse”, it increases levels of dopamine in the brain’s reward circuits, which motivates users to keep taking it. Repeated exposure to these drugs of abuse, like nicotine, can alter the brain’s sensitivity to dopamine, which means one needs to consume more of the substance to feel the same effects.
When the body becomes dependent on nicotine, being without the drug for too long can cause regular users to experience “irritability, craving, depression, anxiety, cognitive and attention deficits”, the report says.
While the risks of tobacco and smoking cigarettes are well-known (per the CDC, these include cancer, heart disease, stroke, lung diseases, diabetes and chronic obstructive pulmonary disease), the long-term risks of nicotine use alone are not fully understood.
Are nicotine pouches better for you than smoking cigarettes?
“There’s no hard evidence to point to exactly what the level of risk of these products are relative to cigarettes,” says Dr Benjamin Chaffee, professor at the University of California, San Francisco (UCSF) School of Dentistry and the UCSF Center for Tobacco Control Research and Education. He adds that since, unlike cigarettes, the pouches don’t involve any combustion and inhaling of smoke, “it’s reasonable to expect that these products would be less dangerous than smoking cigarettes.”
Still, Chaffee warns, there is no concrete evidence that these nicotine products help people quit smoking regular cigarettes. They might even make quitting nicotine more difficult.
“For many individuals who smoke cigarettes and who try using, for example, an e-cigarette or another type of nicotine product, they end up using both products and remaining dependent on nicotine,” he says. “So it doesn’t necessarily reduce the smoking of oldfashioned cigarettes.”
This may be partly due to how the body absorbs nicotine. A November 2023 study in the medical journal Addiction found that using nicotine pouches doesn’t do much to curb a current smoker’s nicotine addiction. Researchers
found that cigarette smokers experienced greater relief from their nicotine cravings sooner than pouch users did, because smoking causes nicotine levels to spike in the bloodstream after only five minutes, whereas with pouches, the spike can take up to 30 minutes.
Proponents say nicotine pouches have benefits. Is that true?
Former Fox News host Tucker Carlson – who once endorsed testicle tanning – described the pouches as being like “the hand of God reaching down and massaging your central nervous system”. Peter Thiel, the tech mogul, told the Atlantic that he suspects nicotine is a “really good nootropic drug that raises your IQ 10 points”, and that he is considering wearing nicotine patches as part of his health regimen. And an article in Bloomberg in January noted that Zyn has “inspired a fervent devotion among some workers in demanding industries like finance and tech”, circles in which the stimulant is sometimes used as a “performance-enhancing drug”.
As Nida notes, nicotine can temporarily boost certain aspects of cognition, “such as the ability to sustain attention and hold information in memory”.
However, Chaffee says that “nicotine in and of itself has some risks”. He explains that it can elevate the heart rate, raise one’s blood pressure and be harmful to those with underlying heart conditions. And, he says: “Anyone can be strongly addicted to nicotine.”
This is particularly concerning when it comes to children. While the number of children who use nicotine pouches is still low, Chaffee notes that young people are especially vulnerable to nicotine addiction. “[Nicotine] can really change the chemistry of their brains while their brains are still developing,” he says. “And that can be a longterm risk.”