By now you’ve probably noticed the rapid ascent of nicotine pouches like Zyn and Velo. The little round cans are everywhere: advertised in convenience store windows, strewn across the sidewalk, filling social media feeds and infiltrating offices.
Zyn’s synthetic nicotine offers the kick of a cigarette or dip without the cancer-causing smoke and chemicals of tobacco, packaged in a pouch that can be discreetly tucked into the upper lip. But that doesn’t mean they’re risk-free. In fact, we know very little about how nicotine pouches could affect health or addiction trends in the U.S. Moreover, tobacco companies are selling the products in dosages and flavors that seem very clearly designed to appeal to younger users, even though buyers are supposed to be at least 21.
Even without a ton of data, researchers can already tick off reasons for teens to steer clear of Zyn. The most obvious is that nicotine is addictive. “Nicotine is not good for developing brains,” says Brittney Keller-Hamilton, an epidemiologist at The Ohio State University College of Medicine. The chemical commandeers the brain’s reward system, giving it a strong hit of dopamine at a time when the organ is particularly vulnerable to addiction. Using nicotine at a younger age creates a harder-to-kick habit, while priming the user for addiction in general, she says.
So far, industry has sponsored nearly all the scientific publications on nicotine pouches, says Tory Spindle, a professor at Johns Hopkins School of Medicine. The worry, of course, is that “there’s the ‘file drawer dilemma’ where you don’t publish things that aren’t beneficial,” Spindle says. “They’re showing us what is going to help their agenda.” Independent science, not company-funded research, should guide the regulation of nicotine pouches.
The threats posed by different nicotine products are not equal, and it’s fair to say that tobacco-free products like Zyn (sold by Phillip Morris International Inc.) sit at the lower end of the risk spectrum. Indeed, tobacco companies are trying to position them as a harm-reduction tool, suggesting pouches can help curb smokers’ cigarette cravings. The jury is still out on that claim, although at first blush, Zyn doesn’t sound like such a bad idea. My dad was a lifelong smoker, and I’d much rather have been riding shotgun in an Oldsmobile 88 littered with Zyn cans than one stained with cigarette smoke — for his health and mine.
But there’s a wrinkle: We don’t have strong evidence that pouches help people like my dad kick a cigarette addiction. Furthermore, there’s no evidence thus far that they are as safe and effective as products like gums, lozenges and patches, all of which have Food and Drug Administration approval as cessation aids.
Even if proven effective to help people quit tobacco, pouches could have a dangerous underbelly. They come in low-dosage forms that could create a welcoming entrée into nicotine use for teens — the way wine coolers or spiked seltzers are often more appealing to teens and 20-somethings than neat scotch or gin martinis.
Low-dose Zyns might ease a teen into a nicotine habit. “I don’t think it’s been designed for adult smokers,” says Vaughan Rees, director of the Center for Global Tobacco Control, at Harvard T.H. Chan School of Public Health. “Zyn has probably been designed for people who are beginning their tobacco career.”
True, recent data from the Centers for Disease Control and Prevention show that just 3.1% of high school students ever had used a nicotine pouch. But there’s reason to fear those numbers could change quickly. Consider vaping: After several years of little interest in e-cigarettes, teen use suddenly spiked between 2013 and 2015. For some, the habit was a gateway to old-fashioned cigarettes. With vaping rates finally declining, we should prevent this cycle from repeating with nicotine pouches.
Researchers are trying to work as quickly as possible to answer the many critical questions about these products. Those include: Are these an effective harm reduction tool for smokers? And if they are, is that benefit short or long term? Are there health risks to prolonged use? How often do people move from Zyn to riskier products?
And what might enhance their attractiveness or addictiveness to teens? While much attention has focused on flavors, it’s worth considering other factors that could draw teens in. Teen use of Juul skyrocketed after its manufacturer dropped the pH of its products, a move that increased the amount of nicotine absorbed with each puff — and as a result, made vaping more addictive.
And then there’s the gamification and memeification of Zyn. Phillip Morris has hooked users on a points-based rewards system that promises Amazon gift cards and iPads to the most devoted users.
Even if the research ends up proving nicotine pouches help smokers quit, regulators must find a sweet spot where the products are accessible to current tobacco users, but far less attractive to teens and nonusers. That might mean getting rid of those palatable low doses, limiting the flavors, and reining in the ads and games.
There’s no evidence of a mass teen migration to Zyn — yet. But given the tobacco industry’s astounding ability to hook people on their products, it’s not irrational to worry about it. Let’s hope scientists can stay a step ahead this time around.
Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.
Related Articles
Carl P. Leubsdorf: Nixon understood what Trump won’t acknowledge
Lisa Jarvis: Boys need the HPV cancer vaccine as much as girls
David French: Civil liberties make for strange bedfellows
Hal Brands: Putin’s shadow war against Europe is intensifying
Andreas Kluth: The U.S. can’t be protectionist and world leader
Leave a Reply