You have
to hand it to the ever-resilient tobacco industry. While the rest of us were
focused on e-cigarettes and the dangers of vaping, they were busy creating new
nicotine products for our kids to ingest. The latest is called the oral
nicotine pouch. It is sold at gas stations and convenience stores for about five-to-ten
dollars per package, with brand names like Velo, On!, and Rogue. The brand Zyn
is the JUUL equivalent in the nicotine pouch world, accounting for most of the
marketing and sales.
Unlike
chewing tobacco, which remains fairly popular in the south, oral nicotine
pouches contain nicotine powder, not tobacco. The nicotine is ingested by
placing the pouch between the upper lip and gum, cleverly hidden from parents
and teachers. According to the Zyn website, the pouch activates in about 10
minutes and the user will experience the famous “Zyn tingle” (or “Zyngle”!),
which is another way of describing a massive stimulant
rush, and can enjoy the nicotine sensation for another 20 to 30 minutes. Across
brands, these pouches come in various strengths, from 1.5 mg to 8 mg, with
about 15-to-20 pouches per package. As a point of reference, each pouch more or
less offers the nicotine equivalent of one traditional cigarette.
Of
course, nicotine pouch companies market their product as tobacco-free and
smoke-free, much safer than traditional cigarettes. All of this is probably
true, but since most anything in this world is safer than lighting up a
Marlboro or Camel, the bar has been set pretty low. The companies also suggest
that pouches might help people reduce or quit cigarettes or vapes, though no
research has been conducted in this area. The wide variety of fruity and mint
flavors provide a good idea of whom the companies want to attract to these
pouches. They might as well be sold next to the Froot Loops or Oreos.
The
beleaguered FDA, kept insanely busy with these annoying new addictive products,
is aware of nicotine pouches and requires companies to use standard nicotine
warning labels. I suspect that more regulation will be coming soon, though by
that time, millions of kids will already be regular users. It is a great
strategy, not unlike marketing a bad movie: Advertise heavily to bring in as
many people as possible to see it during the first weekend before the bad
reviews start rolling in.
While
consumers must be 21 years or older to purchase and use this product, nicotine
pouches are quickly getting into the hands of adolescents. A recent national
survey of people between the ages of 15 and 24 shows that 16% have tried the
pouches and that pouch use is favored by males and those with lower incomes. While
most people who use this product have experience with traditional cigarettes or
vapes, a sizeable segment of adolescents and young adults seem to have
initiated nicotine use with these pouches.
For
parents who are having trouble keeping score of all of the roadblocks to
healthy adolescent development, nicotine pouches provide a familiar set of
worries to add to an already growing list of concerns. We worry that our kids
can use the pouch right in front of us without detection. We worry that regular
nicotine use will lead to addiction and negatively impact brain functioning. We
worry that use of nicotine products will make our children more vulnerable to
other addictive substances. We also worry that this new and largely unregulated
product will cause medical harms that we cannot yet foresee. I suspect that
these pouches will be related to gum disease and other dental problems. The
dentists in our community were likely the first adults to be aware of this
product.
If
your teenagers are using nicotine pouches, please discuss with them the
unintended harms. Because regular nicotine use that is so convenient and easy
to conceal may quickly lead to addiction, some kids may ultimately require
professional help to stop. An adolescent using pouches to improve focus or mood
may likely benefit from prescribed medications that have less adverse impacts
and do not lead to tolerance or withdrawal. Speaking with your pediatrician is
always a good place to start. As more
scientific data emerges, we will have a better idea about the dangers
associated with exposing new nicotine products to more and more of our
children.
Michael Kidorf, Ph.D., is a
clinical psychologist, Associate Professor of Psychiatry at Johns Hopkins
University School of Medicine, and Director of Education at Chayeinu. The Where What When welcomes
readers’ questions to this column.
