Nicotine pouch
Nicotine pouches are small rectangles containing nicotine, flavorings and other ingredients. Unlike snus, they do not include tobacco leaf, dust, or stem. The nicotine may either be derived from tobacco plants or may be synthetic.
Like with snus or dipping tobacco the user puts a pouch between their lip and gum, and leaves it there while the nicotine and taste is being released. The nicotine enters the bloodstream via mucous membranes in the gums. When finished, the pouch is disposed of. The small pouches differ from chewing tobacco in that the user does not need to spit, since the contents of the pouches stay inside the pouches during use.
There is limited independent testing of the constituents, exposure, or biomarkers of effects for nicotine pouches, although independent research is now emerging. Global sales of nicotine pouches expanded rapidly between 2018 and 2023, increasing from an estimated 292 million units to 20.1 billion units, with approximately 85 percent of purchases occurring in the United States, and one brand, Zyn, accounting for more than 70 percent of the global market share. Since 2021, sales of nicotine pouches have grown with Zyn as the global leader. This popularity has led to controversy among government regulators who view the product's appeal to youth as concerning.
Usage
While relatively new, nicotine pouches share similarities with Swedish snus. The first pouch product was developed in the beginning of the 2000s by a small start up company Niconovum. This company registered the product in 2008 as a medicinal nicotine replacement product with 2 mg of nicotine. In 2009, RJ Reynolds bought Niconovum. Thereafter tobacco companies, particularly Swedish Match, became active in the pouch category. Many of Sweden's leading snus manufacturers, such as Swedish Match, Skruf and AG Snus created their nicotine pouch brands as a direct response to demand for a nicotine option with less conspicuous, smokeless usage. While discreet and tobacco-free, nicotine pouches can still, potentially, cause some side effects like: hiccups, gum irritation, nausea and headaches.It is unclear whether smokers might switch to nicotine pouches or if they would continue to smoke and use nicotine pouches, resulting in dual use.Retail prices for nicotine pouches vary across countries and sales channels. In the United States, convenience store data from 2018 to 2022 indicate that inflation-adjusted prices for modern oral nicotine products, including nicotine pouches, ranged from approximately US$4.22 to $4.57, compared to about $5.73 to $8.55 per pack of cigarettes over the same period. Recent analyses of the U.S. retail market indicate that oral nicotine pouches are often priced lower than cigarettes, in part because many states do not tax them in the same way as other tobacco products, a factor that may contribute to their uptake among price-sensitive users. Unlike vaping products, they require no batteries and no accessory device.
Nicotine pouches may entice youth as well as young adult never-smokers because they are available in an array of flavors and may be used unobtrusively.
In pharmacies in Norway, Finland, Denmark, and Sweden, nicotine pouches are also sold as a delivery mechanism for nicotine replacement therapy. In Norway, the brand Zonnic is approved by the Norwegian Medicines Agency for smoking cessation. In Canada, 4 mg nicotine pouches became available for sale in gas stations and convenience stores in 2023 as a form of nicotine replacement therapy under the brand Zonnic.
Contents
In addition to nicotine, the pouches typically contain food-grade fillers, sweeteners, and flavorings. The main ingredient in nicotine pouches in terms of volume is plant fiber. Plant fibers are used to fill the pouch and give it the desired shape, fit, and properties. Different brands use different fibers, but some of the most common derive from eucalyptus and pine.Nicotine pouches are sold in a wide array of flavors, such as peppermint, black cherry, coffee or citrus. The nicotine content among nicotine pouch brands typically varies from 1 mg/pouch to 10 mg/pouch although some have much more. Nicotine pouches usually have a longer shelf-life than traditional snus.
Health risks
Nicotine pouches contain the addictive chemical nicotine.Major public health authorities in the United States emphasise that these products should not be used by youth, young adults, or pregnant individuals who are classed as vulnerable to the effects of nicotine exposure.Recent scoping and scientific reviews conclude that nicotine pouches expose users to substantially fewer tobacco-related toxicants than combustible cigarettes and generally fewer than traditional smokeless tobacco products. However, there is limited independent testing of the constituents, exposure, or biomarkers of effects for nicotine pouches, with many studies funded or conducted by industry, and long-term effects on oral, cardiovascular and overall health remain uncertain. These reviews also highlight concerns about dual usage with other nicotine products, and the need for longer-term independent research to assess their broader public health impact. Nicotine itself is currently classified as non-carcinogenic according to the International Agency for Research on Cancer, and according to the Royal College of Physicians, nicotine in itself is not a hazardous drug. In turn, it is hypothesized that if nicotine can be delivered without tobacco and smoke inhalation, most, if not all of the harm of smoking can be avoided. However, if not carcinogenic, nicotine is still moderately harmful to cardiovascular health, therefore long-term use of non-tobacco nicotine pouches very likely causes higher risks for cardiovascular diseases, stroke, and reproductive harms.
Several recent clinical studies and reviews have further evaluated the health effects and nicotine delivery profile of nicotine pouches. A 2025 study from Japan Tobacco International showed that nicotine uptake from pouches increased proportionally with dose, showing plasma nicotine levels comparable to Swedish snus and faster than nicotine gum. No major safety concerns were observed after single use.
An independent 2024 clinical trial evaluating high-nicotine pouches found that 30-mg pouches delivered plasma nicotine levels twice as high as cigarettes. These pouches caused significant increases in heart rate and arterial stiffness, raising concerns about cardiovascular effects and addiction potential. The authors recommended setting upper limits on nicotine content.
Additionally, a 2024 scoping review summarized existing research and noted that nicotine pouches likely pose fewer toxicant exposures compared to cigarettes, but highlighted concerns regarding youth uptake and the lack of long-term independent studies assessing public health impact.
Advocacy groups opposed to the introduction of nicotine pouches in Kenya have protested that they may raise the risk of cancer, heart disease, and reproductive or developmental harms. The Kenya Tobacco Control Alliance alleged that given the higher levels of some toxic chemicals, and what the US Food and Drug Administration said was a lack of medical data showing the pouches are safer than cigarettes, the government should not license the product.
Major health and cancer organisations in the United States, including MD Anderson Cancer Center, the Cleveland Clinic, and the America Cancer Society recognise that nicotine pouches generally expose users to fewer toxic substances than combustible cigarettes because they contain no tobacco lead and involve no combustion.
As leading scientific bodies such as the Royal College of Physicians and National Academies of Sciences have emphasized, it is the products of burning tobacco, not nicotine itself, that cause the majority of cardiovascular disease and respiratory illness.
Accidental ingestion in children
Reports of accidental ingestion of nicotine pouches by young children have increased in recent years. A 2025 analysis of U.S. poison-control center data found that reported pouch ingestions among children under six rose by approximately 763 percent between 2020 and 2023, with most cases involving toddlers under the age of three, highlighting the importance of safe storage practices in households where nicotine products are present. In 2025 with accidental ingestions still on the rise, the FDA issued a press release urging nicotine pouch manufacturers to use child-resistant packaging.Classification
Nicotine pouches are regulated differently around the world.Although nicotine pouches are not heavily regulated in the European Union, some regulatory characteristics fall under the European Union CLP-Regulation 1272/2008.
Canada
In Canada, 4 mg nicotine pouches are available for sale in pharmacies as a form of nicotine replacement therapy under the Zonnic brand. Nicotine products in Canada with a standard dosage exceeding 4 mg are considered a prescription drug, therefore personal imports of nicotine pouches containing over 4 mg of nicotine per pouch are prohibited. Exceptions exist for those who are a health practitioner or medical practitioner, a drug manufacturer, a wholesale druggist, a pharmacist, or a resident of a foreign country while a visitor in Canada.In February 2025, the department also opened a public consultation on revising the Prescription Drug List entry for 'nicotine or its salts' to clarify the conditions under which nicotine buccal pouches may be sold without a prescription.