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A new product category is emerging with several large tobacco companies now selling ‘tobacco-free’ nicotine pouches. These products are sold as preportioned pouches similar to snus, but instead of containing tobacco leaf, they are filled with white nicotine-containing powder (figure 1). The pouches are placed between the lip and gum, and require no spitting or refrigeration.1 2 At least five large tobacco manufacturers currently sell nicotine pouch products. British American Tobacco sells Lyft in the UK and Sweden,2 3 and Velo (through RJ Reynolds Vapor Company) in the USA.4 Swedish Match sells Zyn in Europe and the USA,5 Kretek International sells Dryft in the USA1 and Japan Tobacco International sells Nordic Spirit in Sweden.6 Moreover, Altria recently agreed to acquire 80% of the On! nicotine pouch brand, currently sold in Sweden, Japan and the USA.7
Nicotine pouches are sold in a variety of fruit (eg, black cherry and citrus) and other (eg, peppermint and coffee) flavours,1 4 8 and vary in nicotine content per pouch (eg, Dryft: 2 and 7 mg1; Velo: 2 and 4 mg4; and Lyft: 4 and 6 mg2). Companies use descriptors like ‘tobacco-free’8 or ‘tobacco leaf-free’4 in product marketing. Regarding ingredients, Zyn’s website says that their pouches contain ‘pharmaceutical-grade’ nicotine salt, hydroxypropyl cellulose, microcrystalline cellulose, maltitol, gum arabic, sodium carbonate, sodium bicarbonate, acesulfame K and food-grade flavourings.8 Similarly, Velo discloses that their products contain ‘nicotine-derived from the tobacco plant, microcrystalline cellulose, water, salt, sucralose, citric acid and artificial flavour’.4 Online marketing highlights how nicotine pouches can be used anywhere and how batteries and devices are not needed.1 8 In the USA, the products appear to be priced comparable to a pack of cigarettes. During the summer of 2019, we purchased Velo and Zyn (US$3.76 and US$5.11, respectively) from local retailers (North Carolina, USA), and Dryft and On! (US$5.54 and US$6.50, respectively) online.
Because they are not combusted and contain no tobacco leaf, nicotine pouches have the potential to be a lower-risk product. However, we are unaware of any independent testing of product constituents, exposure or biomarkers of harm. Moreover, research evaluating nicotine delivery is lacking.
In the USA, these products are presumably classified as tobacco products because they contain tobacco-derived nicotine.9 It is unclear how nicotine pouches are classified and regulated in other countries, and whether existing tax, youth-access, marketing and other tobacco control policies apply.
Research is needed to determine if nicotine pouches can help smokers transition from cigarettes to a less harmful nicotine source, or if these products would instead be used situationally by smokers, leading to dual-use. Moreover, because nicotine pouches are sold in a variety of fruit flavours and can be used discreetly, these products may appeal to youth and young-adult non-smokers. As seen with e-cigarettes (eg, Juul) in the USA,10 novel nicotine products have potential for rapid uptake by youth and young adults. Monitoring of product use and marketing are needed to ensure that nicotine pouches do not promote nicotine addiction among non-smokers, especially youth.
Contributors MOR led the writing of the manuscript’s first draft. ABS conceptualised the study and helped to draft and revise the manuscript. MJB helped to draft and revise the manuscript.
Funding Research reported in this publication was supported by the National Institute On Drug Abuse of the National Institutes of Health under Award Number F31DA045424. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on request