Use of nicotine pouches by U.S. teens almost doubled between 2023 and 2024, according to a recent study. [1] The pouches, which can be easily concealed between the gum and lip, contain a high nicotine content, raising concerns about the long-term impacts, particularly on brain development. [1] This is a growing public health issue that requires urgent attention and regulations.
Recent data on teen nicotine pouch use
This recent study surveyed over 10,000 teens between 10th and 12th grade. Results showed that 5.4% of teens had used a nicotine pouch in 2024 compared to 3.0% in 2023. [1] It also showed that dual use of nicotine products (use of both nicotine pouches and e-cigarettes) increased over the same period, from 2.1% to 3.6%.
Additionally, another study looking at the wider age group of 15-24, found that 12% currently used nicotine pouches, and of these people, 73% concurrently smoked cigarettes. [2]
Similar patterns were also seen in an Australian study, indicating that 66% of the sampled adolescents and young adults were curious about nicotine pouches, with 46% intending to try them within the next 6 months. [3] These are all very worrying figures showing the sharp rise in nicotine use in this vulnerable age group.
What are nicotine pouches, and why do they appeal to the youth?
Nicotine pouches were invented in the 1980s and have been commercially available since the 1990s. They were first intended to be a helpful tool to give nicotine in a smoke-free way, however, they have now become increasingly popular with those who have never smoked.
The fact that the pouches are very subtle, so young people can feasibly use them while around friends and family without them knowing, is one of the big appeals. Their use has also become popular on social media, further increasing the appeal to young people.
The role of social media and the influence of "zynfluencers"
Zyn is a popular brand of nicotine pouches that has become popular on social media, with those promoting it being known as ‘zynfluencers’. [1] These people often link nicotine to many positive benefits, like increased mental ability, confidence, and masculinity, helping to fuel the nicotine epidemic among teens and young adults. [1]
Seeing it on social media helps to normalize its use in this age group, despite the potential detrimental long-term impacts. Following backlash concerning its social media and marketing, Zyn has been subject to flavour restrictions and an online sale ban in the U.S. Despite this, the company continues to grow, and nicotine use continues to increase, highlighting the popularity of Zyn’s products.
Sociodemographic factors influencing use
While the influence of nicotine pouches has been widespread, certain factors increase the risk of their use. Several studies have identified that being male, living in rural areas, and having a lower income were linked to an increased likelihood of nicotine pouch use. [1][2] Based on this, in any future public health interventions, these are the demographics that should be most targeted.
Dual use: Nicotine pouches and e-cigarettes
As mentioned, several studies have identified that many young people are concurrently using nicotine pouches alongside cigarettes or e-cigarettes. [1][2] This is a dangerous practice, increasing the amount of nicotine consumed, thus increasing the risk of adverse effects, both short and long-term. Nicotine is highly addictive, and by participating in dual use, the risk of addiction and ongoing nicotine dependence is also increased.
Health risks and addiction potential of nicotine pouches
While nicotine from sources other than traditional cigarettes is generally seen as safer, nicotine itself carries several health risks. These include an increased risk of cardiovascular, respiratory, and gastrointestinal disorders. [4] Nicotine has also been shown to impact reproductive health and has even been linked to various bodily processes that can lead to cancer. [4] Moreover, the use of nicotine in teens and young adults has been linked to effects on brain development, potentially altering memory and attention. [1] Nicotine in any form, therefore, is best avoided.
Nicotine is a highly addictive drug. It’s widely known that cigarettes are addictive due to their nicotine content, but this is sometimes not translated to nicotine in other forms. The strength of nicotine pouches varies, but is often the equivalent of several cigarettes, so they carry a high potential to cause addiction. [5]
Public health implications and prevention strategies
Nicotine pouches’ ease of accessibility, high addiction potential, and social media promotion have created the perfect storm for a rapidly growing public health issue. Many people start to use nicotine products without fully appreciating their addictiveness or the potential harmful effects. To help with this growing epidemic, several public health prevention strategies could be considered, including:
- Increased punishment for underage sales. The legal age to purchase nicotine in the U.S. was raised from 18 to 21 in 2019, however, teen nicotine use has increased during that time, indicating that this has not affected this group’s ability to obtain nicotine products. [6]
- Education and awareness campaigns. Increased education about the health risks associated with nicotine could help as a deterrent for its use in the younger age group.
- Support for quitting. Structured and easily accessible programs could help those who are struggling with nicotine dependence. There are many resources available to help stop smoking, such as the QUIT NOW telephone line, but these resources have often not yet diversified to other forms of nicotine consumption. [7]
Tips for parents, educators, and healthcare providers
If someone you’re in contact with is struggling with their nicotine use, here are some helpful tips to help you support them.
- Encourage them to speak with a medical professional about cessation options.
- Be patient and non-judgmental about relapses or struggles.
- Help them to identify personal triggers and plan to avoid these where possible.
- Offer distractions during periods of nicotine cravings, like walks, games, or other activities.
- Help them develop healthier mechanisms to manage stress, such as meditation.
It’s important to remember that quitting nicotine can be a challenging process and can sometimes require multiple attempts. It’s very difficult to stop using nicotine alone without any support, so having good healthcare and social support groups is key to success.
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