by Walk into a corner store and you’ll see them: colorful cans stacked next to the gum, with flavors ranging from frosty berries and lime storm to something called Tomorrowland. Welcome to nicotine pouches – the tobacco industry’s latest diversification strategy.
These little pouches are marketed as “tobacco-free,” but are full of nicotine and promise a discreet buzz. Sales are soaring and British ministers are considering tougher rules. But do they help smokers quit – or attract a new generation to nicotine? And what else do they do for people’s health?
Nicotine pouches are different from snus – a moist tobacco paste – and vapes, which deliver nicotine through inhalation. These small white pouches contain purified nicotine powder, fillers such as cellulose, and artificial sweeteners and flavors. You stick one under your upper lip, where it mixes with saliva and delivers a quick burst of nicotine through the lining of your mouth—along with a hit of sweet mint or fruit flavor.
They’ve been on UK shelves since around 2019 and are already big business: 92 million units were sold in 2022, and sales rose 55% in 2023 – a shift that some attribute to overhauled marketing. “At first they looked a bit boring, but in recent years they have become very colorful and interestingly packaged, which obviously appeals not only to a middle-aged person who smokes, but also to other, younger age groups,” said Prof Leonie Brose from the Nicotine Research Group at King’s College London.
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Recent research from the group suggests the proportion of UK adults who have tried them has doubled to 5.4% between 2020 and 2024, although only 1% use them regularly. Teen usage is at a similar level, but awareness may be growing.
In a study published this week in Addiction, researchers from the Scottish Center for Social Research conducted focus groups with 14- to 16-year-olds in four schools. Students were well aware of nicotine pouches and described them as easy to access and discreet to use. Some reported nicotine bursts, nausea or fainting. In contrast, teachers were mostly unaware that students were even using them.
These results mirror those observed elsewhere. A recent study by Dr. Nargiz Travis of Georgetown University in Washington DC and colleagues found that between 35 and 42% of US teenagers and young adults were aware of pouches, and 9 to 21% of non-tobacco users said they would consider trying them.
Health concerns center on two things: nicotine and the flavors and sweeteners in the pouches.
Nicotine itself does not cause cancer, but it is a powerful stimulant and highly addictive. “When nicotinic receptors are activated, this triggers the release of dopamine in the brain’s reward pathways,” said Prof. Barbara Sahakian, a neuroscientist at the University of Cambridge.
The nicotine content in pouches ranges from 1.8 mg to 97.5 mg – much higher than the 2-4 mg in nicotine gum. “Even more concerning is that not only do they have high total nicotine levels, but they also have very high levels of free nicotine, allowing for faster delivery into the bloodstream,” Travis said. “This means they deliver higher amounts of nicotine even more effectively than cigarettes.”
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One fear is that once addicted, users may switch to more harmful nicotine products – especially since many mistakenly believe that the nicotine in cigarettes causes cancer and other diseases. “A big concern is that people will switch to other products that are much more harmful because of the misconception that everything is the same,” Brose said.
Young people may be particularly at risk: Their brains have more nicotine receptors in reward-related areas, and animal studies suggest that nicotine exposure during adolescence could increase later use of other drugs or trigger mood or attention problems.
“It is particularly concerning that children and adolescents are using these nicotine pouches because their brains are still developing,” Sahakian said. “It is unknown what effects these nicotine pouches have on the developing brain.”
Aside from addiction, pouch users report gum irritation and stomach discomfort. Nicotine also increases heart rate and constricts blood vessels, which can be dangerous for people with heart disease.
But nicotine isn’t the only concern. Laboratory studies suggest that pouch extracts may trigger greater toxic and inflammatory effects in human cells than pure nicotine alone – with flavors being the prime suspect – although the effects on human health are still unclear. “We’ve found that for some brands, the amount of artificial flavor actually increases with nicotine strength – likely to mask the harshness and make it easier to use,” Travis said.
On the other hand, most experts agree that pouches are likely significantly less harmful than smoking and could even provide benefits in helping smokers quit. Cigarette smoke contains about 7,000 chemicals, many of them toxic or carcinogenic, while pouches typically contain about 180. Crucially, this is not a combustion process, which completely eliminates the most dangerous compounds.
“We have to remember that cigarettes are sold completely legally everywhere and 70,000 people die every year in England. That doesn’t mean I’m a fan of cigarette pouches, but we shouldn’t lose sight of the main enemy,” said Brose.
There is still little evidence that pouches help people quit smoking. A recent Cochrane review found no serious short-term health harms from nicotine pouches in smokers, but concluded that there are no robust long-term studies showing that they improve smoking cessation rates.
The real concern is their use among non-smokers. “A big challenge in regulating this area is recognizing that this is a reduced risk product, but not a risk-free product,” said Prof. Jamie Hartmann-Boyce of the University of Massachusetts at Amherst, who led the Cochrane review. “So how do we make sure it helps the people it can help and doesn’t harm the people who otherwise wouldn’t have used tobacco or nicotine?”
Earlier this week, the UK government announced plans to ban the sale of nicotine pouches to under-18s, cap nicotine levels and restrict flavors as part of its wider tobacco and vape legislation. Most experts welcome the move, but limiting flavors may not be easy. Brose points to the example of menthol-flavored cigarettes: Even though their sale is banned in Britain, “a recent study found that when people were asked to smell and consume cigarettes, they could very clearly identify which cigarettes tasted like menthol,” she said. “So even if you pick out one flavor, you can get a similar feeling with different things.”
A workaround might be to change the flavor names to be more factual and less entertaining. “Calling something unicorn vomit or gummy bears, no matter what it tastes like, is clearly youth-oriented,” Hartmann-Boyce said. “You could have gummy bear flavor but call it R-22, and that’s not necessarily going to appeal to young people to the same extent.”
Standardized or uniform packaging could also help. Dr. Eve Taylor, Brose’s colleague at King’s College London, recently examined the impact of standardized packaging and watered-down flavor labels on adults’ interest in bags and their perception of harm. Her team found little effect – encouraging news if policymakers want to deter young people without reducing their appeal to adult smokers.
The goal, researchers say, is to ensure that bags remain available to those who could benefit from them, while at the same time not looking like candy. Because while those pastel-colored cans may seem harmless at the checkout, they’re designed to contain one of the most addictive drugs we know. The challenge now is to ensure they don’t attract a whole new generation.
