SAFE GC Coalition: The Truth About Oral Nicotine Pouches and Youth Use

As youth e-cigarette use remains a public health concern with 1.63 million middle and high school students reporting e-cigarette use in 2024, a different type of flavored nicotine product is gaining popularity: oral nicotine pouches. Oral nicotine pouches include brands such as Zyn, On! and Velo and have gained popularity in recent years as they are now the second most commonly used tobacco product among middle and high school students, following e-cigarettes- especially in rural areas and among White non-Hispanic youth.

According to the 2025 Monitoring The Future Survey, use of nicotine pouches (e.g., “Zyn”) continued an upward trend among high school students. In 2025, lifetime use increased in all grades, although not significantly. From 2024 to 2025, it increased from 7% to 10% in 12th grade, from 4% to 5% in 10th grade, and from 0.8% to 1.4% in 8th grade.

Research from December 2021 to May 2022 by The Truth Initiative said 16% of participants ages 15-24 reported to ever using nicotine pouches, and 12% reported current use and that current oral nicotine pouch use among 10th and 12th graders doubled from 1.3% in 2023 to 2.6% in 2024. According to JAMA Network Open research, 5.4% of 10th and 12th graders reported using nicotine pouches in their lifetime – up from 3% the previous year.

Oral nicotine pouches are small white pouches, containing nicotine powder and flavorings, that are inserted into the mouth. The pouches are sometimes referred to as a "lip pillow" or "upper decky" because of where they are placed between the lip and gum, often under the upper lip. Oral nicotine pouches are used similarly to snus – an oral pouch containing shredded tobacco leaf – but unlike snus, they contain a nicotine powder instead of tobacco leaf and are therefore not classified as smokeless tobacco products. Nicotine pouches contain nicotine which is harmful to young people in any form and share multiple characteristics with e-cigarettes that have been shown to lead to significant youth usage, including high concentrations of nicotine, youth-appealing flavors, a significant presence on social media, and they are easy to conceal.

Overall sales of nicotine pouch products increased from 126.06 million units from August to December 2019 to 808.14 million units from January to March 2022. During this period, sales of nicotine pouch products containing a higher concentration of nicotine (8 mg) increased more rapidly than products with lower nicotine concentrations (e.g., 4 mg and 6 mg). Most recently, the total monthly nicotine pouch sales increased by 207% between January 2023 and April 2025, from $145.5 million to $446.8 million.

Advertisements for oral nicotine pouches highlight flavors and emphasize the “freedom” of using nicotine pouches anywhere, according to research co-authored by Truth Initiative. Leading nicotine pouch brands spent nearly $25 million on ads between January 2019 and September 2021. It is essential that these highly addictive products are marketed responsibly and do not contribute to youth tobacco initiation.

Nicotine concentrations differ across oral nicotine pouch brands. For example, in the United States Zyn is sold in 3 and 6 mg, Velo is sold in 2, 4, and 7 mg, and On! is sold in 1.5, 2, 3.5, 4, and 8 mg, according to each brand’s website. Altria’s new On! nicotine pouch product, called On! Plus, offers nicotine strengths of 6, 9, and 12mg.

Oral nicotine pouches come in an array of youth-friendly flavors, including flavors. As of April 2025, mint flavors account for 62.1% of sales, while other flavors (e.g. fruits, candy, drinks) make up 23.2%, and smooth/original flavors at 10.6%.

The availability of sweet, fruity, and candy-like flavors is troubling because, as pod-based e-cigarettes like JUUL face federal flavor restrictions in response to high rates of youth vaping, young people may switch to other nicotine products that still offer flavors. For example, disposable e-cigarettes, which were exempted from the partial flavor restrictions FDA enacted in January 2020, have skyrocketed in popularity. Sales of menthol-flavored e-cigarettes, which were also exempted, experienced a drastic, immediate rise in sales with an doubled. Flavors play a significant role in drawing youth to tobacco products – 87.6% of young e-cigarette users reported using a flavored product in 2024.

Oral nicotine products are currently not regulated as tightly as other tobacco products. The FDA places some regulations on these products, including requirements that manufacturers submit certain information to the agency, use nicotine warning labels, and comply with some basic marketing restrictions.

While specific long-term health effects of nicotine pouches like Zyn remain unknown, youth use of nicotine in any form is unsafe. Nicotine use during adolescence can disrupt the formation of brain circuits that control attention, learning, and susceptibility to addiction. Research has shown early age of nicotine use is correlated with daily use and lifetime nicotine dependence. Nicotine addiction can also intensify symptoms of depression and anxiety.

Truth Initiative strongly urges the FDA to remove all unauthorized oral nicotine products from the market. To prevent youth from using these products, eliminating all flavors from tobacco products is crucial, as is instituting restrictions to curb exposure to marketing.

The Truth Initiative is the nation’s largest nonprofit public health organization dedicated to preventing youth and young adult nicotine addiction and empowering quitting. Research is conducted through the Truth Initiative Schroeder Institute that produces independent research to provide evidence for policy change and leadership in cessation research. For more information, please visit www.truthinitiative.org.

SAFE, Inc. is the only alcohol and substance abuse prevention, intervention, and education agency in the City of Glen Cove. Its Coalition is concerned with all combustible and electronic products with tobacco. The Agency employs environmental strategies to educate and update the community regarding the negative consequences of smoking and vaping. To learn more about the SAFE Glen Cove Coalition please follow www.facebook.com/safeglencove or to learn more about electronic products visit the Youth and Tobacco Use and Vaping Facts and Myths Pages of SAFE’s website to learn more about how vaping is detrimental to your health at www.safeglencove.org.