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Nicotine pouches

Advisory Alert

March 6, 2024

*Cette information est seulement disponible en anglais.

To: Local Health System Partners

FOR IMMEDIATE ATTENTION

New Nicotine Product: Nicotine Pouches

Nicotine pouches are being marketed and sold without age restrictions and have become widely available to youth. The flavoured pouch is placed under the lip and against the gum for absorption and can be legally purchased at convenience stores and gas stations to those under 18 years of age in Ontario without age verification.

In July 2023, Health Canada gave approval to sell nicotine pouches under the Natural Health Product Regulations as a Nicotine Replacement Therapy (NRT) product because it does not contain tobacco; it only contains nicotine. Nicotine pouches are now sold under the Health Canada approval without adhering to the restrictions of the Federal Tobacco and Vaping Products Act, 1997 and the Smoke-Free Ontario Act, 2017, including;

Canadian health organizations are urging Health Ministers to reclassify nicotine pouches as a prescription product or to suspend sales until regulations are put in place to prevent them from being sold to anyone under 18 years of age. These health organizations include The Canadian Cancer Society, Action on Smoking & Health, Canadian Lung Association, Heart and Stroke, Physicians for a Smoke-Free Canada, and Coalition Québécoise pour le contrôle du tabac.

In response to these concerns, Health Minister Mark Holland pledged to take action to prevent sales of nicotine pouches to minors by reviewing the approval process, acknowledging that Health Canada approved the sale of flavoured nicotine pouches with no restrictions on how the product can be advertised or sold.

Until tighter restrictions of nicotine pouches are imposed, the widely available and accessible product continues to expose youth to nicotine. Nicotine is highly addictive and use in any form is unsafe among youth1. Exposure to nicotine can have negative consequences to the young developing brain. These include deficits in attention, changes in cognition, mood disorders, and increased chance of addiction of other substances1. This exposure could contribute to future tobacco use2.

Adverse effects

Short-term adverse effects include the following3:

Long-term health effects for nicotine pouches usage are still unknown.

Health care providers

Health care providers are encouraged to speak with youth and parents about nicotine pouches and other nicotine products as well as the risk of nicotine addiction. It is important to have open, honest, and ongoing conversations about these risks.

Many of the same tips for speaking to youth about smoking and vaping can be used for any nicotine product. We are including some resources here that may help you talk to parents and youth about nicotine pouches, nicotine and vaping, or any substance use:

Sincerely,

Original Signed By

Dr. Marlene Spruyt
Acting Medical Officer of Health

On behalf of Dr. Penny Sutcliffe, Medical Officer of Health and Chief Executive Officer

NOTE: All Advisory Alerts are found on our website.

References

  1. National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. (2016). E-cigarette Use Among Youth and Young Adults: A Report of the Surgeon General.
    https://www.cdc.gov/tobacco/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf
  2. National Institute on Drug Abuse (NIDA). (2022). Tobacco, Nicotine, and E-Cigarettes Research Report. nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/how-many-adolescents-use-tobacco.
  3. Sparrock, L., Phan, L., Chen-Sankey, J., Hacker, K., Ajith, A., Jewett, B., & Choi, K. (2023). Nicotine Pouch: Awareness, Beliefs, Use, and Susceptibility among Current Tobacco Users in the United States, 2021. International Journal of Environmental Research and Public Health, 20(3), 2050. org/10.3390/ijerph20032050.

This item was last modified on March 6, 2024