For two years, Austin Collins consumed roughly 14 mg of nicotine a day — the equivalent of nine to 14 cigarettes — while vaping. Now, he consumes more than double the amount of nicotine, the equivalent of at least two packs of cigarettes, using nicotine pouches.
They’re one of the latest ways that people are getting their nicotine fix.
Some nights, Collins, who lives in Charlotte, said he falls asleep with a pouch in his mouth.
“It’s really been a blessing that they’re there,” said Collins, who began using nicotine pouches about a year ago to quit vaping after he noticed it was affecting his breathing. “I’m only 25, and it’s hard for me to run a mile.”
Oral nicotine pouches are tobacco-free pouches similar in size to a piece of gum. They’re generally tucked behind a user’s upper or lower lip, and they contain nicotine salts and flavors such as mint or citrus. Though the pouches are small and discreet, research shows they are able to deliver more nicotine than a cigarette.
They’ve exploded in popularity in the past few years, and one brand in particular has led the charge: Zyn.
Online influencers, called “Zynfluencers,” have ignited a subculture with posts promoting the pouches that rack up millions of views on social media. Some use “Zynonyms,” which play on common words or phrases to include the brand name, like “George WashingZyn” and “Lord forgive me, for I have Zynned.”
As Zyn becomes more in vogue, there have been growing pains, too. Zyn’s parent company, Philip Morris International, in June paused online sales in response to a subpoena questioning its compliance with a ban on flavored tobacco in the District of Columbia. That led to a supply shortage, which some lamented as “the Great Zynpression.”
Even so, the company announced July 23 that it expects to to ship at least 560 million tins of the pouches in 2024, nearly 50% higher than the previous year. A can of 15 Zyn pouches is sold for about $5.
Though nicotine pouch sales shot up 641% between 2019 to 2022, few U.S. adults use them, a new study shows. In a nationally representative sample of about 39,000 adults, researchers found just 2.9% had used nicotine pouches. Some experts fear that teens are responsible for the spike in sales.
‘Pouch packed with problems’
A call for a regulatory crackdown on Zyn from U.S. Senate Majority Leader Chuck Schumer (D-N.Y.) put the product at the center of a political culture war earlier this year. Schumer called it a “pouch packed with problems,” saying the products seemed to “lock their sights on young kids, teenagers and even younger.”
North Carolina’s Republican Sen. Thom Tillis and Rep. Richard Hudson (N.C.-9) both fired back on X, formerly known as Twitter, touting Zyn cans.
“Come and take it, Chuck,” Tillis wrote. Georgia Republican Rep. Marjorie Taylor Greene responded with a call for a “Zynsurrection.”
"They took your freedom once,” read an image one user posted to X, the words imposed over a photo of flavored Juul pods, which the federal Food and Drug Administration banned in 2022. Below that, over a photo of Zyn cans, the text read, “Don’t let them take it again.”
Experts are also comparing Zyn to Juul. They’re worried that the easy-to-conceal oral nicotine pouches that boast a variety of flavors have the same characteristics that lured teens to e-cigarettes.
“This is an attraction to youngsters so they can start as a gateway of using oral to e-cigarette to smoking,” said Irfan Rahman, dean’s professor of environmental medicine, pulmonary medicine and public health sciences at the University of Rochester Medical Center.
Youth use
Philip Morris International maintains that it only markets and sells Zyn to people of legal age for purchasing tobacco, which is 21 in the U.S., and it has said that it doesn’t use online influencers to promote the product.
“We also only market and sell these products to people that would otherwise continue to smoke or use other nicotine products,” said Moira Gilchrist, Global Chief Communications Officer at Philip Morris International in a video the company shared in January.
The 2023 National Youth Tobacco Survey found that 1.5% of U.S. middle and high school students reported they currently used nicotine pouches.
Still, Bonnie Halpern-Felsher, a developmental psychologist and professor of pediatrics at Stanford University who’s spent 25 years studying adolescent tobacco use, said her research shows its marketing is particularly enticing to youth.
Halpern-Felsher found that when teens were exposed to Zyn’s marketing that suggests the product helps people feel comfortable in social situations, they were more likely to buy it. Because youth are experiencing depression and anxiety at a rising rate, using nicotine pouches as a social lubricant or a way to relieve stress could be appealing to them, she said.
Like Rahman, Halpern-Felsher is also worried that teens who’ve never consumed nicotine before are starting with nicotine pouches. She said many aren’t informed about the potential health risks of that use.
“If teens are starting with Zyn, it doesn't matter if it's healthier than an e-cigarette or less harmful,” Halpern-Felsher said. “If they're initiating with it, if that's their on-ramp, it's bad.”
Health risks
Though Zyn has been on the market in the U.S. since 2014, scientists are still researching the long-term health impacts of using nicotine pouches. Rahman said some users have seen their gums become inflamed or recede, while others have complained of gastric issues from swallowing saliva after using pouches.
A 2023 study found Zyn didn’t contain the cancer-causing chemicals present in tobacco called nitrosamines but did contain low levels of other chemicals that the FDA says have potentially harmful effects.
The FDA has not authorized Zyn products or other oral nicotine pouches for sale in the U.S., nor has it approved nicotine pouches for smoking cessation. The agency has issued hundreds of warning letters to manufacturers, importers and online retailers for selling the unauthorized products.
For adults who are looking to wean from vaping or smoking to avoid the dangerous lung impacts, using nicotine pouches could be a harm reduction option, Rahman said, but “you close one Pandora box, you open another.”
Thomas Wyatt, a 24-year-old who lives in Asheville, made the switch to Zyn because he thought that vaping weakened his lungs. Now, he uses five to seven pouches a day, usually peppermint-flavored. He said when he started using the pouches about two years ago, his gums burned, but that feeling went away over time. When he went to the dentist recently, he said they didn’t point out any gum issues from Zyn.
For youth, however, Halpern-Felsher said the health risks are higher. Adolescents are more vulnerable to nicotine addiction than adults because their brains are still developing, she said. Research suggests exposure to nicotine as a young adult can lead to long-term cognitive and mental health impacts.
“It's a pediatric issue,” Halpern-Felsher said. “And the industry knows that. That's why they go after teenagers.”
Halpern-Felsher said there needs to be more education and prevention efforts for nicotine pouch use among youth.
“We need to get the word out,” Halpern-Felsher said. “Hopefully parents are made aware of these products as well.”
This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.
North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org.