With sleek branding and “tobacco-free” claims fuelling their rapid rise among young users, nicotine pouches are drawing growing concern from public health experts ahead of World No Tobacco Day. Prof (Dr) Sonu Goel, a leading tobacco control expert at PGI, explains what these products are, how they are used and why their growing popularity is raising red flags.What are nicotine pouches?According to the US Centers for Disease Control and Prevention (CDC), nicotine pouches are small microfiber sachets containing nicotine, flavourings and other chemicals. Users place them between the lip and gum, allowing nicotine to be absorbed through the oral lining.Unlike traditional smokeless tobacco, they do not require spitting and are fully disposable.Introduced in India in the early 2020s mainly via online platforms, they are now available in tin cans and loose packs at small tobacco shops, indicating rising market penetration.The ‘tobacco-free’ mythA 2026 World Health Organization (WHO) report notes that these products are termed “tobacco-free” simply because they do not contain tobacco leaf, a distinction that can be misleading.“The nicotine is still derived from tobacco or made synthetically. Labels like ‘clean’ and ‘pure’ can create a false sense of safety,” Dr Goel said. While they eliminate exposure to smoke, less harmful does not mean harmless, he added.High nicotine punchHealth experts warn that nicotine pouches may deliver significantly higher nicotine doses than conventional products.A cigarette typically contains 10–12 mg nicotineApproved nicotine gums/lozenges contain 2–4 mgSome pouches, as per WHO, deliver 50–150 mg per gramManufacturers also modify chemical composition to increase absorption speed, enhancing addiction potential.Why youth are drawn to themGlobal sales of nicotine pouches have surged, crossing 23 billion units in 2024, with a sharp rise among adolescents and young adults. Experts attribute this to:Aggressive social media marketing and influencer campaignsFlavoured variants like mint, berry, coffee and candyDiscreet use, with small packs easy to conceal in classrooms or public spaces“These are positioned as lifestyle products linked to productivity and fitness, which resonates strongly with youth,” Dr Goel said.Not a quitting aidDespite being perceived by some as a smoking alternative, nicotine pouches are not approved as cessation tools by regulators in India or the US.Studies suggest that instead of replacing cigarettes, users often engage in dual or multiple product use, increasing overall nicotine intake rather than reducing it.Health risks emergingRecent studies highlight a range of physical and psychological effects linked to pouch use:Gastrointestinal: nausea, bloating, heartburnOral health: mouth ulcers, gum irritation, drynessRespiratory/sensory: breathing issues, altered taste or smellSystemic/mental: appetite changes, poor concentration, sleep disturbance, anxietyImpact on young brainsNicotine exposure is particularly harmful during adolescence, as the brain continues developing till about 25 years of age.“Early exposure can affect attention, memory, mood regulation and impulse control, while dependence can develop rapidly—even without daily use,” Dr Goel warned.Hard to detectUnlike smoking or vaping, nicotine pouches leave no smoke, vapour or strong odour, making them easy to conceal. Warning signs may include:Hidden tins or sachets in bags or pocketsFrequent use of mints or chewing gumMouth soreness, nausea, headachesSudden mood swings, irritability or secrecyHelp for quittingExperts emphasise early intervention. Support options in India include:National Tobacco Quitline: 1800-11-2356mCessation programme: Missed call to 011-22901701Tobacco cessation centres across govt hospitalsWHO Quit Tobacco AppDr Goel stressed the need for awareness and regulation, saying, “These products may appear modern and harmless, but their long-term health impact—especially on young users—cannot be ignored.”
