What you need to know 

  • Nicotine pouches are small, tobacco-free packets that deliver nicotine through the gums. They have rapidly grown in popularity, especially among young people and people trying to quit tobacco. 
  • The FDA has not approved nicotine pouches as a tool to quit smoking, but it has recently authorized the marketing of certain products. 
  • Some experts say these products may help reduce cigarette use. Others warn they are highly addictive and increasingly used by young people.

Nicotine pouches have grown rapidly in popularity in recent years, especially among people trying to quit smoking and young adults. In January 2025, the Food and Drug Administration authorized the marketing of certain nicotine pouches. The agency is now considering whether they can be marketed as a safer alternative to cigarettes. 

While nicotine pouches are generally less harmful than cigarettes, health experts caution that they are not “risk-free,” as they are highly addictive and have potential health risks, especially for young people. 

Here’s everything you need to know.

What are nicotine pouches?

Nicotine pouches are small packets made of microfiber that contain nicotine, flavorings, and other ingredients such as fillers and stabilizers. Users place them between the gum and lip, where nicotine is absorbed into the bloodstream within minutes. 

Nicotine pouches do not contain tobacco. But many leading brands are sold by large tobacco companies, including Philip Morris International, Altria (the parent company of Philip Morris USA), and British American Tobacco.

Who is using nicotine pouches? 

Since entering the U.S. market in 2014, nicotine pouches have grown quickly in popularity. They are now the second-most commonly used nicotine product among adolescents, after vapes. Teen nicotine pouch use nearly doubled between 2023 and 2024, and overall sales have more than doubled in the last two years.

Experts say targeted online marketing has played a major role. Some campaigns promote a lifestyle or identity tied to pouch use. 

“We’ve seen [nicotine pouches] marketed using themes relating to masculinity, which is a tactic used in cigarette advertising,” Meghan Moran, a Johns Hopkins University researcher who studies how advertising influences public health, tells Public Good News.

On social media, influencers often promote nicotine pouches as a way to “boost” energy and focus. Marketing also highlights flavors and the ability to use pouches in places where smoking or vaping is restricted. Some ads describe nicotine pouches as “clean” because they don’t contain tobacco-related carcinogens (cancer-causing substances).

Moran adds, “I am concerned that young people may construe marketing depicting the products as ‘clean’ or ‘pure’ to mean ‘harm-free,’ which they certainly are not.”

What are the health risks of nicotine pouches?

Research on nicotine pouches is still emerging, and long-term effects are not fully understood yet. While they are less harmful than products containing tobacco, they still carry health risks, especially for young people.

“A key challenge related to the FDA’s marketing authorization for certain nicotine pouches is ensuring that people—especially young people—understand that these products are not harm-free and that not using these products is the healthiest option,” Moran says.

Nicotine poisoning

Some users report experiencing “nic-sickness,” or nicotine poisoning. Symptoms typically appear within an hour of exposure and may include nausea, diarrhea, stomach pain, rapid heart rate, excessive sweating, shallow breathing, fatigue, muscle weakness, dizziness, and confusion. Symptoms may worsen over time and may require medical attention. 

High doses of nicotine can be toxic and, in rare cases, fatal. The CDC says that 50 to 60 milligrams is deadly to a 150-pound person. The highest-strength pouches contain between 30 and 50 milligrams of nicotine.

Addiction

Even occasional nicotine use can lead to dependence, or the inability to function without the substance. Over time, the brain adapts to nicotine, leading to cravings and the need for higher doses to feel the same effects.

Young people are especially vulnerable because their brains are still developing. Nicotine exposure during adolescence has been linked to problems with attention, impulse control, memory, and mood regulation. 

“A young person consuming a nicotine product can increase the risk of developing nicotine dependence that can be impactful in terms of a person’s health and well-being,” says Vaughan Rees, director of the Center for Global Tobacco Control at the Harvard T.H. Chan School of Public Health, to PGN.

Oral health 

Nicotine pouches may also be harmful to oral health. Some users experience irritation, inflammation, or lesions (white sores caused by damage to the protective mucus layer that lines the mouth) where the pouch is placed. 

Evidence is still limited, and more research is needed to understand long-term effects. 

Do nicotine pouches help people quit smoking or vaping?

We’re not sure yet. Nicotine pouches are not approved by the FDA for quitting smoking or vaping, though some adults are using them as an alternative to cigarettes.

“A nicotine pouch represents an opportunity to reduce [a smoker’s] health risks because it doesn’t contain carcinogens compared to cigarette smoke,” says Rees.

Early research suggests nicotine pouches may help reduce smoking, but the evidence is limited and mixed. One small clinical trial found pouches reduced smoking over four weeks, while another found pouches were less effective than cigarettes at relieving cravings—likely because they deliver nicotine more slowly.

A 2025 review found much of the available evidence comes from studies funded by nicotine pouch manufacturers, underscoring the need for independent research.

Still, some experts are encouraged by evidence that nicotine pouches may offer a path for some people to quit smoking. “I think it’s been a public health victory that we’re seeing a historic low prevalence of smoking among young people, even if that reduction has been offset by an uptick in the use of products like nicotine pouches,” says Rees.

Treatments to quit smoking should be undertaken with a doctor’s supervision to reduce the risk of inappropriate or unsafe use. 

Should people use nicotine pouches? 

Ideally, no. For adults trying to quit smoking, some experts see potential—if pouches are used instead of cigarettes for a short period of time. But key questions remain about how well they work long term. 

For everyone else—and especially for young people—the takeaway is more straightforward: These products have risks and can lead to nicotine addiction. With use rising, the safest path is still to avoid nicotine altogether. 

For more information about quitting tobacco or nicotine products, speak with your health care provider. 

Resources to quit smoking:

This article was supported by the New Jersey Quitline. Public Good News retains full editorial control over its reporting.