Will Llamas, a resident of Stamford, Connecticut, was not a regular tobacco user until a friend introduced him to Zyn nicotine pouches. Llamas, 32, says he became convinced that the tobacco-free products were relatively safe.
The pleasant feel and taste of the pouches got him hooked quickly, consuming up to 20 packets a day. Available in 3- or 6-milligram nicotine strengths and in a variety of flavors including coffee, mint and citrus, the pouches gave him a dopamine boost that made him feel more energized and focused.
Nicotine pouches, like those from Zyn, have seen a significant rise in popularity in recent years. Zyn, a Swedish brand acquired by Philip Morris in 2022, sold more than 131 million pods in the first three months of this year, representing an 80% increase compared to the same period last year.
The Zyn shortage last month sparked an outcry on social media. Other similar products include Rogue, Velo and On!, which are marketed as spit-free and hands-free alternatives to cigarettes and other smokeless tobacco products.
Tory Spindle, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins School of Medicine, expresses concern about how the perception that these products “contain nothing” could make them more attractive to people who might not otherwise try tobacco products.
Spindle suggests that while nicotine pouches may be a better alternative for regular tobacco users, it is crucial to find a way to make these products accessible without causing addiction to a new wave of individuals.
Philip Morris maintains that it is committed to developing products like Zyn that are scientifically proven to be a better alternative to continuing to smoke. Llamas, who had tried other smokeless tobacco products without liking them, found Zyn to be a different experience.
However, after a year of use, she began experiencing gastrointestinal problems, which she now attributes to the nicotine pouches. After multiple medical tests and consultations, she concluded that these problems disappeared once she stopped using Zyn.
Llamas also noticed a decrease in his resting heart rate, as measured by his Apple Watch, after he stopped using the bags. He regrets not having had more information when he started taking Zyn, saying that if he had known about the potential health problems, he would not have started.
Dr. Donna Shelley, a professor and vice dean for research at New York University’s School of Global Public Health, notes that while nicotine pouches don’t cause the same health problems as tobacco products, they can’t be considered “safe.” Shelley says negative effects include gastrointestinal symptoms, gum problems, and cardiovascular risks such as elevated heart rate. The safety profile of these products is not yet fully understood.
A 2023 study compared Zyn pouches to other smokeless tobacco and nicotine replacement products, finding that while Zyn does not contain certain known carcinogens, it does contain potentially harmful chemicals like formaldehyde, according to the FDA.
Dr. Varisha Parikh, a dental technician in Los Angeles, warns about the potential dental health effects of nicotine pouches, saying that placing a chemical agent on gum tissue for an extended period of time can lead to gum problems. Sydney Cunningham, 30, of Safford, Arizona, says she suffers from receding gums from Zyn use, a habit she picked up while pursuing her doctorate in search of an extra boost to focus.
The concern among medical experts is that these products are not only used by adults, but also by children and teens. Judith Gordon, a professor and associate dean for research at the University of Arizona College of Nursing, warns that nicotine can change the way young people’s brains function, leading to lifelong addiction. Spindle says nicotine pouches appear to be heavily marketed to young people, with a design that makes them easy to use and conceal, making them attractive to teens.
A recent study published in the Journal of the American Medical Association found that nicotine pouch use among adults in the United States remains low despite rising sales, but underage users may be driving the increase. Adam Leventhal, director of the Institute of Addiction Sciences at the University of Southern California, suggests that teens may be using these products at higher rates than adults.
Earlier this year, the FDA issued 119 warnings to retailers selling Zyn to minors and remains concerned about any tobacco products that may appeal to young people. The FDA is reviewing marketing applications for Zyn and other nicotine pouches, though it is allowing their sale in the meantime.
Philip Morris recently suspended online sales of Zyn due to concerns about violating a ban on flavored tobacco sales in Washington, D.C., but the products remain available online through other sellers. Philip Morris says its marketing is targeted at users 21 and older. Llamas, who stopped using Zyn six months ago, says she still has cravings and that quitting was difficult because she used the pouches for so many daily activities. Now, she is relearning to enjoy these activities without the need for a nicotine pouch.
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