Young people using unregulated nicotine pouches despite health risks

Young people in Scotland are experimenting with nicotine pouches and reporting adverse effects such as sickness and fainting, according to new research from the Scottish Centre for Social Research (ScotCen) published today in the journal Addiction.

Nicotine pouches, which entered the UK market in 2019, are small tobacco-free sachets placed between the lip and gum to deliver nicotine. They are currently unregulated in the UK and can be legally sold to under-18s, although the UK Government’s Tobacco and Vapes Bill proposes new age restrictions on their sale.

Researchers from the Scottish Centre for Social Research (ScotCen), conducted the first qualitative study in the UK to explore how 14–16-year-olds understand and use nicotine pouches. The study involved 16 focus groups with 77 pupils and interviews with 13 school staff across four Scottish schools.

Key findings

• High awareness and experimentation: Most pupils knew about nicotine pouches, often referring to them as ‘snus’ or ‘upper deckies’. Experimental use was common, and more established use was also reported, particularly among older male pupils.
• Discreet use in schools: Many young people said they liked that pouches can be used discreetly, including during school hours or on public transport, unlike vapes or cigarettes.
• Adverse health effects: Pupils reported negative effects from using pouches, from gum pain and burning sensations in the mouth and throat, to sickness, sweating and fainting.
• Perceived as safer than vaping: Despite these effects, some young people believed pouches were “better for you” than vaping or smoking, because they avoided lung damage. One male pupil told researchers: “I’d rather have worse gums than worse lungs.”
• Staff unaware of use: School staff members had good knowledge and awareness of vaping among pupils in schools, and were taking measures to address this. In contrast, they had limited knowledge of nicotine pouches and were largely unaware that pupils were using them.

Andy MacGregor, Director of Policy Research at the Scottish Centre for Social Research, said: “Our study shows that awareness and experimentation with nicotine pouches among young people is already widespread and that these products are being used under the radar in schools.

Because pouches can be bought by under-18s and used discreetly, they pose a unique challenge for teachers, parents and policymakers. Stronger regulation and better public health messaging are urgently needed.”

Allison Ford, Associate Professor at the Institute for Social Marketing and Health at the University of Stirling and Principal Investigator of the New Nicotine Products (NNPs) in Scotland (NIPS) Study, said: “This important paper highlights the accessibility of nicotine pouches to young people in Scotland and young people’s awareness of nicotine pouch marketing and promotion. The wider NIPS study is examining the retail availability, marketing and display of NNPs in Scotland. Its findings will help the Scottish Government decide if new rules are needed on how vapes and nicotine pouches are displayed and marketed in shops, to protect young people from using these products.”

Jamie Pearce, Professor of Health Geography at the University of Edinburgh, said: “Nicotine pouches are becoming more widely used among young people in Scotland which may lead to long-term and harmful effects for health. There is an urgent need to take steps to reduce the marketing, availability and sale of nicotine pouches to young people.”