Nicotine pouches are being marketed to young people on social media. But are they safe, or even legal?

Flavoured nicotine pouches are being promoted to young people^[1] on social media platforms such as TikTok and Instagram.

Although some viral videos have been taken down following a series of reports in The Guardian^[2], clips featuring Australian influencers^[3] have claimed nicotine pouches are a safe and effective way to quit vaping. A number of the videos have included links to websites selling these products.

With the rapid rise in youth vaping and the subsequent implementation of several reforms^[4] to restrict access to vaping products, it’s not entirely surprising the tobacco industry is introducing more products to maintain its future revenue stream.

The major trans-national tobacco companies, including Philip Morris International and British American Tobacco, all manufacture nicotine pouches. British American Tobacco’s brand of nicotine pouches, Velo, is a leading sponsor of the McLaren Formula 1 team^[5].

But what are nicotine pouches, and are they even legal in Australia?

Like snus, but different

Nicotine pouches are available in many countries around the world, and their sales are increasing rapidly^[6], especially among young people^[7].

Nicotine pouches look a bit like small tea bags and are placed between the lip and gum. They’re typically sold in small, colourful tins of about 15 to 20 pouches. While the pouches don’t contain tobacco^[8], they do contain nicotine that is either extracted from tobacco plants or made synthetically. The pouches come in a wide range of strengths.

As well as nicotine, the pouches commonly contain plant fibres (in place of tobacco, plant fibres serve as a filler and give the pouches shape), sweeteners and flavours. Just like for vaping products, there’s a vast array^[9] of pouch flavours available including different varieties of fruit, confectionery, spices and drinks.

The range of appealing flavours, as well as the fact they can be used discreetly, may make nicotine pouches particularity attractive to young people.

Users absorb the nicotine in their mouths and simply replace the pouch when all the nicotine has been absorbed. Tobacco-free nicotine pouches are a relatively recent product, but similar style products that do contain tobacco, known as snus^[11], have been popular in Scandinavian countries, particularly Sweden, for decades.

Snus and nicotine pouches are however different products. And given snus contains tobacco and nicotine pouches don’t, the products are subject to quite different regulations in Australia.

What does the law say?

Pouches that contain tobacco, like snus, have been banned in Australia since 1991, as part of a consumer product ban^[12] on all forms of smokeless tobacco products. This means other smokeless tobacco products such as chewing tobacco, snuff, and dissolvable tobacco sticks or tablets, are also banned from sale in Australia.

Tobacco-free nicotine pouches cannot legally be sold by general retailers, like tobacconists and convenience stores, in Australia either. But the reasons for this are more complex.

In Australia, under the Poisons Standard^[13], nicotine is a prescription-only medicine, with two exceptions. Nicotine can be used in tobacco prepared and packed for smoking, such as cigarettes, roll-your-own tobacco, and cigars, as well as in preparations for therapeutic use as a smoking cessation aid, such as nicotine patches, gum, mouth spray and lozenges.

Read more: From today, new regulations make it harder to access vapes. Here's what's changing^[14]

If a nicotine-containing product does not meet either of these two exceptions, it cannot be legally sold by general retailers. No nicotine pouches have currently been approved by the Therapeutic Goods Administration^[15] as a therapeutic aid in smoking cessation, so in short they’re not legal to sell in Australia.

However, nicotine pouches can be legally imported for personal use only if users have a prescription from a medical professional who can assess if the product is appropriate for individual use.

We only have anecdotal reports of nicotine pouch use, not hard data, as these products are very new in Australia. But we do know authorities are increasingly seizing these products^[16] from retailers. It’s highly unlikely any young people using nicotine pouches are accessing them through legal channels.

Health concerns

Nicotine exposure may induce effects including^[17] dizziness, headache, nausea and abdominal cramps, especially among people who don’t normally smoke or vape.

Although we don’t yet have much evidence on the long term health effects of nicotine pouches, we know nicotine is addictive and harmful to health^[18]. For example, it can cause problems in the cardiovascular system (such as heart arrhythmia), particularly at high doses. It may also have negative effects on adolescent brain development^[19].

The nicotine contents of some of the nicotine pouches on the market is alarmingly high. Certain brands offer pouches containing more than 10mg of nicotine^[20], which is similar to a cigarette. According to a World Health Organization (WHO) report^[21], pouches deliver enough nicotine to induce and sustain nicotine addiction.

Pouches are also being marketed as a product to use when it’s not possible to vape or smoke, such as on a plane^[22]. So instead of helping a person quit they may be used in addition to smoking and vaping. And importantly, there’s no clear evidence^[23] pouches are an effective smoking or vaping cessation aid.

Further, some nicotine pouches, despite being tobacco-free, still contain tobacco-specific nitrosamines^[24]. These compounds can damage DNA, and with long term exposure, can cause cancer.

Overall, there’s limited data on the harms of nicotine pouches because they’ve been on the market for only a short time. But the WHO recommends a cautious approach^[25] given their similarities to smokeless tobacco products.

Read more: The missing ingredient Australia needs to kick its smoking addiction for good^[26]

For anyone wanting advice and support to quit smoking or vaping, it’s best to talk to your doctor or pharmacist, or access trusted sources such as Quitline^[27] or the iCanQuit website^[28].

References

1. ^{^} being promoted to young people (www.theguardian.com)
2. ^{^} The Guardian (www.theguardian.com)
3. ^{^} Australian influencers (www.tiktok.com)
4. ^{^} implementation of several reforms (theconversation.com)
5. ^{^} McLaren Formula 1 team (www.formula1.com)
6. ^{^} increasing rapidly (iris.who.int)
7. ^{^} young people (www.ncbi.nlm.nih.gov)
8. ^{^} don’t contain tobacco (www.ncbi.nlm.nih.gov)
9. ^{^} a vast array (storage.googleapis.com)
10. ^{^} Aleksandr Yu/Shutterstock (www.shutterstock.com)
11. ^{^} known as snus (tobaccotactics.org)
12. ^{^} consumer product ban (www.productsafety.gov.au)
13. ^{^} Poisons Standard (www.legislation.gov.au)
14. ^{^} From today, new regulations make it harder to access vapes. Here's what's changing (theconversation.com)
15. ^{^} Therapeutic Goods Administration (www.tga.gov.au)
16. ^{^} seizing these products (www.9news.com.au)
17. ^{^} may induce effects including (adf.org.au)
18. ^{^} harmful to health (iris.who.int)
19. ^{^} adolescent brain development (www.tga.gov.au)
20. ^{^} 10mg of nicotine (truthinitiative.org)
21. ^{^} report (iris.who.int)
22. ^{^} on a plane (www.velo.com)
23. ^{^} no clear evidence (factcheck.afp.com)
24. ^{^} tobacco-specific nitrosamines (tobaccocontrol.bmj.com)
25. ^{^} recommends a cautious approach (iris.who.int)
26. ^{^} The missing ingredient Australia needs to kick its smoking addiction for good (theconversation.com)
27. ^{^} Quitline (www.health.gov.au)
28. ^{^} iCanQuit website (www.icanquit.com.au)