Recent studies reveal a startling fourfold increase in nicotine pouch usage among youth and young adults. While these products may not carry the same cancer risks as traditional tobacco, they are still highly addictive and can lead to serious health concerns.
Moreover, the alarming rise in accidental nicotine poisoning among children highlights the need for vigilance and open conversations about these seemingly innocuous products.
In this article, we’ll explore the reasons behind the surge in nicotine pouch use, the potential dangers they pose, and how to engage with young people to promote healthier choices.
Quick Read
Nicotine pouches, small flavored packets designed for oral use, have seen a dramatic fourfold increase in usage among teenagers and young adults in recent years, raising significant health concerns. While marketed as a safer alternative to traditional tobacco products, these pouches are highly addictive and can lead to serious health issues, including cardiovascular risks and negative impacts on brain development. The rise in accidental nicotine poisonings among children, attributed to these products, underscores the urgent need for parental awareness and open discussions about their dangers.
As nicotine pouch use becomes more prevalent, especially among youth, it is crucial for parents to recognize the signs of use and engage in conversations about the risks associated with these products. Resources for quitting are available, including support hotlines and professional treatment programs, which can help young people navigate their dependence on nicotine and promote healthier choices.
What Are Oral Nicotine Pouches?
Oral nicotine pouches are small microfiber packets of nicotine powder that are often flavored and sweetened. They are designed to deliver a dose of nicotine through a pouch placed between the upper lip and gum, where oral tissues are highly vascular and nicotine absorption occurs within about 20 to 60 minutes.
Though nicotine pouches are sometimes marketed as a smoke free alternative to cigarettes because they reduce exposure to harmful combustion byproducts associated with smoking, nicotine itself is still harmful and very habit-forming. Nicotine pouches contain nicotine and other ingredients, and are sold in nicotine strengths ranging from 1.5 mg to 12 mg.
The Rise in Nicotine Pouch Use
The use of nicotine pouches among youth and young adults has increased fourfold in recent years. Here are additional facts on nicotine pouch use among youth and young adults from the CDC Foundation’s TEEN+ Study:
- Approximately 78.5 percent of youth and 80 percent of young adults using nicotine pouches reported using at least one additional tobacco product
- Nicotine pouch use was more common among males (5.2 percent) than females (1.9 percent)
- In the survey, the most common reason for nicotine pouch usage was “to get a high or a buzz from nicotine”
Nicotine pouches are very addictive because the amount of nicotine they can deliver may be substantial, with the pouch held against the lip and gum for direct absorption into the bloodstream. According to Frontiers in Public Health, this can increase cardiovascular risks and other side effects, especially in teens.
Signs of Nicotine Pouch Use
Here are some signs that your loved one may be using nicotine pouches:
- Changes in mood or appetite
- Trouble sleeping
- An increase in cavities, mouth sores, or gum recession
- Nausea
- Dizziness
- Anxiety or restlessness
- Irritability or frustration
- Sadness or depression
Nicotine pouch use will drive highs and lows, and more frequent use will dull the stimulant sensation and create withdrawal symptoms.
What Are the Health and Harmful Effects of Nicotine Pouches?
Because nicotine pouches are marketed as tobacco free, they are often promoted as healthier than traditional tobacco products like chewing tobacco and snus, which contain shredded tobacco leaf; however, the long-term cancer risks of these small white pouches are still unknown.
One study found that 26 of 44 nicotine pouch samples contained cancer-causing chemicals. Some social media influencers and companies selling nicotine products have promoted nicotine as a brain-boosting chemical. While nicotine has stimulant effects on the nervous system, temporarily improving focus, the risks to young people may outweigh the benefits.
Effects on Brain Development
Parts of the brain that influence rational decision-making, risk assessment, impulse control, and solving complex problems are not fully developed till age 25. Chemicals like nicotine can negatively affect the development of these critical areas. The teen brain is especially sensitive to nicotine, and the CDC says adolescent nicotine use can disrupt brain circuits that control attention, learning, and vulnerability to nicotine addiction.
For young adults, the temporary cognitive stimulation reaches a point of diminishing returns. Psychiatry Research found that heavy or chronic use of nicotine becomes detrimental to cognitive function, with frequent exposure and daily use raising the risk of dependence.
Oral Health Effects
Nicotine pouches alter the chemical balance in your mouth, increasing the risk of bacteria and plaque accumulation, and placement against the lip and gum can also irritate soft tissues locally. Nicotine reduces blood flow to the gums, which can impair healing.
Not only does this cause bad breath, gum irritation, mouth sores, and gum recession, but it can mask symptoms of gum disease and cause tooth and enamel decay, with an increased risk to exposed root surfaces. For example, using a 6 mg pouch results in 17.5 ng/ml nicotine in blood after 30 minutes through oral tissue absorption.
Cardiovascular and Other Systemic Effects
As a stimulant, nicotine acts on the nervous system, increasing heart rate and blood pressure. While long-term studies have yet to be completed on nicotine pouches, previous research on nicotine products has indicated a greater risk of heart disease.
Dependence and Addiction
Nicotine addiction can develop from nicotine in any form. Like other stimulants, nicotine provides a short-term feel-good effect that can produce temporary benefits like increased attention and focus. Increased use will blunt this effect and cause withdrawal symptoms like brain fog, irritability, and mood issues.
Users will begin to feel dependent on nicotine to relax, think clearly, or get through the day. Nicotine pouch use may also raise concern about dual use with e cigarettes or other nicotine products, increasing overall exposure and dependence risk.
Youth Use, Marketing of Nicotine Products, and Public Health
Under the 2009 Tobacco Control Act, new tobacco products must receive FDA authorization before being marketed. As of January 2025, 26 oral nicotine pouch products were cleared for sale, including 20 flavored Zyn products. However, the FDA emphasized that these products are not FDA approved and do not carry a safety endorsement. While the intent was to help adult smokers quit, this has inadvertently made nicotine and tobacco use more accessible to younger individuals.
Tobacco companies have no qualms about marketing extensively to youth and young adults, promoting nicotine products in places where young people spend time, from concert venues to social media. From 2019 to 2021, tobacco companies spent nearly $25 million on nicotine pouch ads. ZYN, and Velo, and other nicotine pouches reflect how major brands are promoted across the broader market. ZYN was also heavily marketed on social media, with its TikTok campaign reaching 700 million views by early 2024.
The CDC reports that in 2024, one in 100 middle and high school students reported using nicotine pouches in the last 30 days. Two in five students using nicotine pouches reported that they had never used a tobacco product. Sales of nicotine pouches increased from 126 million to 808 million units, and flavors play a significant role in their appeal.
Accidental Poisonings on the Rise
Researchers have found that accidental poisonings of young children, specifically from nicotine pouches, rose 760 percent between 2020 and 2023. Incidental ingestion of nicotine from pouches posed a 150 percent higher risk of serious medical effects and doubled the risk of hospitalization in children under 6 compared to other smokeless tobacco products.
Symptoms of nicotine ingestion include nausea and vomiting, clammy skin, confusion, increased heart rate, extreme lethargy, and shallow breathing. Call Poison Control (1-800-222-1222) immediately if you think that a child may have accidentally ingested nicotine.
Quitting Nicotine Pouches: Resources for Youth and Families
There are a number of reasons why youth and young adults may use nicotine pouches. Some may just want to fit in with friends and experiment with substances in a discreet way. Others may be trying to quit other tobacco products or are attempting to control issues with mood and focus.
Mental health conditions, such as depression or anxiety, and neurodevelopmental conditions like ADHD may be causing symptoms that young people are trying to mitigate with nicotine use. If you or someone you love is trying to quit nicotine pouches, here are options to try:
Get screened for mental health conditions
Understanding whether you have an underlying issue that is driving your desire to self-medicate can be instrumental in treatment and recovery. Talk to your primary care physician or reach out to a treatment professional to get an assessment.
Wean off nicotine pouches step by step
Quitting cold turkey may result in intense withdrawal symptoms and cravings. If you get support from friends and family, use fewer pouches each day, and practice breaks from nicotine, you can wean yourself off entirely.
Call the Quit helpline
You can get support for quitting nicotine pouches by calling 1-800-QUIT-NOW. You’ll be connected to your state’s quit line for local resources that can support your journey to freedom from nicotine.
Treatment for Teens Young Adults
At Newport Academy, our program for children and teens, and at Newport Institute, our young adult program, we are dedicated to supporting young people who struggle mental health and co-occurring substance use issues. We offer a comprehensive approach, empowering young people with the tools and support they need to overcome their challenges.
If you’re concerned about a young person in your life, reach out to us today to learn more about how we can help them on their journey to healing and a healthier future.
