Nicotine pouches glamourized on social media, little talk about risks for youth, study finds

A UBC Okanagan researcher is sounding the alarm over how nicotine pouches are portrayed on TikTok and says videos are normalizing their use and making them seem trendy, especially among youth.

Nicotine pouches, which are placed in the mouth between the gum and cheek, are authorized by Health Canada to help adults quit smoking but not permitted for use by those under 18.

Associate professor at UBCO’s school of nursing Dr. Laura Struik and a team analyzed 250 videos that had garnered nearly two million shares and generated more than 16 million likes according to the platform’s metrics. 

On the platform, users emphasized how nictoine pouches can be used discretely.

“Many of the videos portrayed people describing how these pouches naturally fit into their lifestyle,” Struik explained, “you can use it no matter what you’re doing, whether you’re exercising or socializing.”

TikTok videos glamorizing use of nicotine pouches for youth, study finds

This, she said, comes as the use of nicotine pouches among youth has spiked. A cross-sectional study of survey data from the United States indicates use among high school students nearly doubled between 2023 and 2024.

TikTok creators also talked about how being a user of nicotine pouches made them part of a shared group, Struik explained.

“That’s particularly appealing to young people because teenagers are still in the process of figuring out who they are.”

While the majority of videos “glamourized” the use of pouches, Struik said only six per cent of them discussed the serious health problems that can stem from prolonged use, including gum recession, oral cancer, and heart issues.

For a young person, the issues can be more severe. Nicotine disrupts brain development and interferes with memory, learning, stress, and impulse control, Struik said.

Health Canada said only two pouch brands are authorized for sale within the country, Zonnic and NEÖ, but Struik said researchers found young people are finding and purchasing unauthorized brands online, at convenience stores and in vape shops.

“The regulations are there, but the enforcement clearly is lacking,” Struik said.

B.C. says it was the first jurisdiction to take action against recreational use of pouches, and in 2024, restricted the sale of buccal (cheek) nicotine pouches to behind the counter in pharmacies.

“This measure ensures pharmacists can exercise professional judgment and prevents youth access in all-ages retail environments,” a ministry of health spokesperson said in a statement, adding that regional health authority officers monitor compliance.

The federal government announced similar measures several months after B.C., after it said there were growing concerns that the popularity of nicotine replacement therapies (NRTs) was leading to recreational use by youth under 18.

Stop marketing, selling nicotine pouches to kids: advocates

The federal measures included banning ads or promotions that could appeal to youth, allowing only pharmacists or those working under their supervision to sell them, and restricting the flavours to mint or menthol.

“In an effort to prevent unauthorized nicotine products from reaching the public, Health Canada is also working closely with the Canada Border Services Agency, the Royal Canadian Mounted Police, and provincial and territorial public health units,” it said in a statement.  

Health Canada said since 2024 it has managed more than 300 compliance cases related to selling or advertising unauthorized nicotine pouch products at various retailers. It has issued compliance notices, conducted site visits, and seized products, it said.

Struik believes young people should be at the table with decision makers when it comes to making rules related to nicotine pouches.

“We need young people to be driving the messaging,” she said, “youth know their context. Adults just simply don’t, we don’t understand it.”