Nicotine pouches are a dangerous new trend among teens

Nicotine pouches – small, flavored packets placed between the gum and lip – have become a fast-growing trend among teenagers. A new study shows that the use of these pouches by high school students in the U.S. nearly doubled between 2023 and 2024.

The research was conducted by scientists at the Keck School of Medicine of the University of Southern California. The team surveyed more than 10,000 high school students across the country to understand their use of nicotine pouches and other tobacco products.

Teen nicotine pouch use soars

The data highlights a worrying trend. In 2023, just 3% of 10th and 12th graders reported using nicotine pouches. By 2024, that number had jumped to 5.4 percent. More teens said they had used the pouches in the past month and past year, and the number who used both nicotine pouches and e-cigarettes also increased during that period.

Interestingly, while pouch use went up, the number of teens who reported vaping declined slightly – from 20% in 2023 to 17.6% in 2024.

But dual use rose, with 3.6% of teens saying they had used both products in the past year, up from 2.1% the previous year.

“This growing public health issue needs more attention,” said Dae-Hee Han, PhD, the study’s lead author. “Like flavored e-cigarettes when they first emerged, use of this new oral nicotine product is becoming more widespread, particularly among adolescents.”

Teens most at risk

Some teens are more likely to use nicotine pouches than others. Boys, non-Hispanic white teens, and students in rural areas showed higher rates of use. These groups mirror the typical profile of smokeless tobacco users, like those who chew tobacco, according to the researchers.

“We’re finding that the risk profile differs quite a bit between nicotine pouches and e-cigarettes, which means we need prevention approaches that are targeted for each,” Han said.

The health risks of nicotine pouches are still unclear, but there are known concerns. Some users have reported mouth sores and gum irritation. And nicotine addiction itself is a real issue, especially for teens.

Studies suggest that nicotine exposure during adolescence can hurt brain development and affect memory, attention, and learning.

Influencers and FDA approval

Part of the pouch popularity seems to be driven by social media. A wave of “Zynfluencers” – influencers promoting the Zyn brand – has helped tie pouch use to ideas of confidence, masculinity, and mental focus.

In January, the U.S. Food and Drug Administration (FDA) gave Zyn permission to market flavored pouches to adults aged 21 and older. The decision was based on the idea that these products might be less harmful than cigarettes for adults trying to quit. But unlike nicotine gum or patches, pouches are not approved as tools to stop smoking.

The same university behind the teen survey also found in a separate study that fewer than 1% of adults were actually using nicotine pouches. That raises a big question: Who is really buying them?

“Parents, teachers, and pediatricians should be aware that teen nicotine pouch use is increasing across the nation,” said senior author Adam Leventhal, PhD.

“To reverse this trend, we need to heighten public awareness about pouches and educate youth about them. Policymakers might also consider ramping up regulation of the booming pouch market – including cinnamon, fruit, and other attractive flavors – to protect youth.”

Monitoring nicotine pouch use among teens

The FDA’s decision relied partly on results from a different national survey, the National Youth Tobacco Survey (NYTS). That survey did not find a statistically significant rise in monthly teen use of pouches. However, like the USC-led study, the NYTS did find a big increase in lifetime use among teens.

The FDA didn’t mention that rise in its decision, but researchers say it matters. Tracking lifetime and yearly use helps identify when teens are experimenting with substances, even if they aren’t using them often.

Monitoring pouch use again in 2025 will be key to understanding how the FDA’s authorization is affecting behavior. Future research should also track long-term use, when teens first start using pouches, how strong the nicotine is, and what health problems may follow.

Researchers say more attention is needed to see whether new policies and prevention programs are working – especially for groups at higher risk, like teens in rural areas or those using both pouches and e-cigarettes.

“Nicotine pouches are relatively new, so we need time to collect data on prevalence, policy, and prevention,” Han said.

The full study was published in the journal JAMA Network Open.

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