Nicotine pouches, such as ZYN, are growing in popularity — especially after the FDA recently authorized the marketing of certain products. But does tobacco-free and smoke-free really mean risk-free?
"Nicotine is addictive and never comes without health concerns," says Dr. Gabriela Zambrano Hill, a primary care doctor at Houston Methodist. "That said, people looking to reduce the health risks associated with their current smoking or chewing tobacco habits may find these nicotine pouches to be an intriguing option, so it's important to understand what's in the pouch and what that means for you."
Here's what you should know about these products, their potential health effects and what the FDA's decision actually means.
What are nicotine pouches?
Commonly referred to as Zyns — a nod to the most popular brand — nicotine pouches are a smoke-free, tobacco-free way to consume nicotine.
These small pouches contain nicotine in the form of salt or powder, along with other ingredients that help stabilize, fill, sweeten and preserve the product. They come in various flavors, from peppermint to coffee, and different strengths of nicotine.
They're used by placing the pouch between the upper lip and gum, allowing the nicotine to be absorbed into the bloodstream through the mouth's lining — rather than inhaled into the lungs. Many people are turning to nicotine pouches to quit smoking or chewing tobacco.
Nicotine pouch side effects: What to know
Even though nicotine pouches contain fewer harmful chemicals than cigarettes and smokeless tobacco, they aren't without risks. Some common side effects include:
- Increased heart rate (felt as jitteriness)
- Mouth irritation or lesions with prolonged use
- Nicotine dependence and addiction
"It's important to stop using nicotine pouches if you're not tolerating them well," says Dr. Zambrano Hill, "particularly if you have heart disease, since these products can add further stress to the heart."
She adds that there are no "safe" tobacco-related products, nicotine pouches included. This is especially true for pregnant and breastfeeding women, children and young adults.
"Nicotine is very harmful to a developing baby," Dr. Zambrano Hill warns. "It can also affect brain development up until around age 25 — affecting mood, impulse control, attention and learning. And adolescents can get addicted very quickly, even without daily use."
Can nicotine pouches cause cancer? What about gum disease?
Scientists are still learning about the long-term effects of using nicotine pouches, including how it affects a person's overall cancer risk and oral health.
"It's been published that they're associated with less of the risks for cancer and other health issues as compared to cigarettes and smokeless tobacco products, but that does not mean there are no risks," explains Dr. Zambrano Hill.
Evidence of the lower risk was contained in the data the FDA reviewed when authorizing the marketing of nicotine packages. But the agency still stated that this "does not mean these tobacco products are safe, nor are they 'FDA approved.'"
For those who don't already use tobacco, the best choice remains to avoid nicotine altogether.
What the FDA's marketing authorization does and doesn't mean
The FDA recently granted marketing authorization for 20 specific ZYN products. However, this doesn't mean nicotine pouches are "approved" in the way that other smoking cessation products are.
"The FDA authorized the marketing of these products to customers ages 21 and up," stresses Dr. Zambrano Hill. "But that does not mean this is an FDA-approved product. These are two very different things."
The agency's authorization was based on a public health standard that considers overall risks. The review found that certain nicotine pouches contained significantly fewer harmful chemicals than cigarettes and smokeless tobacco products, making it a viable alternative for people already using these more harmful products.
Still, the FDA states that, "there is no safe tobacco product. Youth should not use tobacco products and adults who do not use tobacco products should not start."
If you're trying to quit smoking, talk to a health care provider about safe and FDA-approved options, which include prescription medications and over-the-counter options like patches, gum and lozenges.
