Under the lip, under the radar

Health harms and smoking cessation

There is limited research on the health effects of nicotine pouches, and their nicotine levels are not regulated – ASH says a typical pouch contains between 5mg and 20mg of nicotine. Worryingly, products containing 100mg or more nicotine per pouch have been found on sale.

This is far higher than the average cigarette, which generally contain between 10mg and 12mg of nicotine, although some contain up to 28mg.

A health risk assessment on nicotine pouches by the German Federal Institute for Risk Assessment concluded that the main risk of using nicotine pouches is the high levels of nicotine, which has strong effects on the cardiovascular system.

Pouches also present high risks to children, pregnant and breastfeeding women, and people with cardiovascular disease.

There is also insufficient research to assess how effective nicotine pouches are as a smoking cessation product. A recent study led by Dr Harry Tattan-Birch from University College London’s Institute of Epidemiology & Health Care, published in Lancet Public Health and funded by Cancer Research UK, found that use of pouches in Great Britain over the last five years had increased from 0.1 to one per cent of all adults, equivalent to about 522,000 people.

Most users (69 per cent) also reported using other nicotine products such as cigarettes or vapes, although one in six (16 per cent) had never regularly smoked, the researchers found.

“We do not currently know if nicotine pouches are effective in helping people quit smoking, and whether nicotine pouches are good or bad for public health depends on who is using them,” says Dr Tattan-Birch.

“If it’s a young person who would otherwise start smoking, then the use of pouches might help to reduce harm. However, if it’s a person who otherwise would not use nicotine at all, then the potential for harm increases. We need to see how this balance plays out, and our findings highlight the urgent need for more research on this.”

Where are the regulations?

Concerns about the increasing popularity of nicotine pouches are echoed across Europe, USA, Canada and Australia.

In March 2023, Belgium became the first nation in the EU to ban nicotine pouches, followed by the Netherlands and then France in 2025. In Germany, they are banned as an ‘unauthorised novel food ingredient’.

At least six EU countries have introduced legal age restrictions, and two countries have restricted flavours. Some nations have also introduced restrictions covering nicotine content as well as advertising and promotions.

In the UK, however, nicotine pouches are not covered by tobacco or e-cigarette regulations, but by general consumer product safety regulations.

This means that nicotine pouches and nicotine gummies are not required to adhere to the same controls on advertising and retail displays as tobacco, or the age-of-sale restrictions that are in place for cigarettes and nicotine-containing e-cigarettes.

Calls for a crackdown

This lack of regulation in the UK means that nicotine pouches can be sold legally to under-18s, and experts are concerned that they are being marketed as trendy lifestyle brands on social media and at music festivals.

ASH data shows that in 2024, the two most popular nicotine pouch brands, Velo and Nordic Spirit, grew by 96 per cent and 75 per cent, while another popular brand, Zyn, grew by 161 per cent.

According to ASH, this continued significant growth in the nicotine pouches sector is likely due to marketing campaigns with shop displays, bus banners and social media promotion of the products.

“The surge in teen awareness and growing levels of use in young adults indicates that the industry’s marketing strategies are working,” warns Hazel Cheeseman, CEO of ASH.

“Products are highly promoted in shops and on social media with football stars and male influencers used to further raise their profile”.

In addition, a recent BBC investigation found that extra-strong nicotine products designed to appeal to children – including some that have ripped off the logos of popular sweet brands – are being openly sold in shops.

This led Trading Standards to say it is concerned about products with a “worrying child appeal” as well as flavours and “eye-catching packaging” that mimicks confectionery.

Legislation on the horizon

Stories such as this have increased calls for the UK government to speed up legislation to shut down loopholes. The Tobacco and Vapes Bill, which is currently going through the House of Lords, should do just that.

The Bill covers the supply of tobacco, vapes and other products – including nicotine pouches – and proposes prohibiting the sale of tobacco to people born on or after 1 January 2009.

It also includes regulating things like where nicotine pouches can be positioned in shops – as is already the case for tobacco products – as well as limits on flavours, strengths, packaging and advertising.

The Bill also sets out regulations covering:

• Licensing of retail sales and registration of retailers
• Product and information requirements for tobacco, vapes and other products
• The advertising and promotion of tobacco, vapes and other products
• Smoke-free, vape-free and heated tobacco-free places.

Despite these proposals, the slow progress of the Bill – which was introduced to the House of Commons in November 2024 – has drawn criticism.

“The Tobacco and Vapes Bill will allow government to regulate all aspects of these products and ensure they do not get into the hands of children but can be used by adults as an alternative to smoking,” says ASH.

“But the Bill does not yet have a date when it will progress to the next stage of legislative scrutiny necessary for it to become law and may not progress until after the summer recess in the Autumn.”

Bob Blackman MP, co-chair of the All-Party Parliamentary Group (APPG) on Smoking and Health, warns that: "Many of the big nicotine pouch brands are owned by tobacco companies with decades of experience targeting our children, so the longer it takes for this government to regulate, the more time the tobacco industry has to promote their products to the next generation."

It’s not just public health experts who are worried. Tobacco and Vapes lead for the Chartered Trading Standards Institute, Kate Pike, says she is also hearing concerns from the public.

“I hear from trading standards teams across the country who are getting reports from concerned citizens who have seen teenagers being sold these products,” says Kate. “However, there is no action we can take until the law is changed as no offence is being committed.”

Until the Bill is passed, and although nicotine pouches are likely to be less harmful than smoking, these highly addictive products continue to pose a risk to the health of users of all ages.