In the hallways of schools across the country, as some students are trading notes and sharing gum, others may be seen putting a small, flavored, dissolvable pouch of nicotine in their mouth — a rising trend that is prompting concerns about the potential negative health impacts.
Nicotine pouches are placed in between a person’s lip and gum. The powder within the pouch, which often comes in different flavors, dissolves in the mouth. It is one of the fastest growing nicotine products in the United States. The U.S. Centers for Disease Control and Prevention reported that sales of nicotine pouches increased from 126 million in August 2019 to 808 million in March 2022.
These pouches, particularly from the brand Zyn, have become popular on social media platforms like TikTok, attracting the eyes of teens and youth. In 2024, 1.8% of middle and high school students — amounting to an estimated 480,000 students — reported currently using nicotine pouches, according to a recent study. In April, the U.S. Food and Drug Administration reported that nicotine pouches are a type of tobacco product and issued 119 warning letters to brick-and-mortar retailers that engaged in the sale of Zyn to people under the age of 21.
Critics of the product have voiced concerns about the marketing of nicotine pouches to young people, potentially leading to an addiction to nicotine and negative health impacts. Others have argued nicotine offers enhancements and that nicotine pouches are a beneficial alternative to cigarettes or chewing tobacco.
Looking for more clarity on commonly asked questions about nicotine pouches, we recently spoke with Gina Kruse, MD, a UCHealth internal medicine physician and visiting associate professor in the Division of General Internal Medicine at the University of Colorado Department of Medicine.
The following interview has been edited for length and clarity.