Will Lamas wasn’t a regular cigarette smoker when a friend first introduced him to Zyn nicotine pouches.
“I told myself it was pretty safe because there was no tobacco in it,” said Lamas, of Stamford, Connecticut. “I liked the feeling. And it tasted good. And I was hooked.”
The 32-year-old quickly became addicted to Zyn, saying he was using up to 20 packets a day, in both three and six milligram sizes. You can get nicotine in a variety of flavors, including coffee, mint, and citrus.
“It releases dopamine, which makes you feel a little more energetic, happier, and more focused,” Llamas says.
Nicotine pouches like Zyn have soared in popularity in recent years. The Swedish brand, which was acquired by Philip Morris in 2022, sold more than 131 million cans in the first three months of this year, up 80% from the same period last year. Last month, a Zyn shortage sparked an outcry on social media. Other products include Rogue, Velo and On!, most of which are marketed as smoke-, spit- and hands-free alternatives to cigarettes and other tobacco products.
“Typically, when something is said to be free of something, it seems less harmful,” says Tory Spindler, an associate professor of psychiatry and behavioral sciences at the Johns Hopkins School of Medicine in Baltimore. “What we’re concerned about is whether it will be more appealing to people who otherwise wouldn’t try a tobacco product.”
Spindler said nicotine pouches — which users place between their lips and gums and then discard — could be a better alternative for existing tobacco users, but “the challenge is how to make the product accessible to those people while also not unintentionally hooking a new wave of people who have never tried nicotine before.”
“We are committed to developing products like Zyn that are scientifically proven to offer a better alternative to continued smoking,” Philip Morris said in a statement.
Llamas said he had tried other smokeless tobacco products but didn’t like the taste.
“It was pretty gross to be honest with you, so there was no benefit to it,” Llamas said. “I wasn’t addicted to those, but this is something else entirely,” he said of Zinn.
But about a year after starting Zyn, he began experiencing gastrointestinal problems that he now blames on the nicotine pouches.
“I had a lot of tests, I went to the hospital, I had an ultrasound and a colonoscopy, and all that came out was that I had stomach inflammation,” he says. After researching his symptoms online, he suspected the bag was the cause of his symptoms. “I haven’t had any stomach problems since the day I quit smoking.”
Llamas wears an Apple Watch every day, and the device detected that his resting heart rate dropped by 10 beats per minute after he stopped using the pouch.
“I wish I had more information when I first started taking the pouch,” he says. “If I’d known it would cause so many health problems, I never would have started.”
Adverse health effects
Dr. Donna Shelley, professor and vice dean for research at New York University’s School of Global Public Health, said that while nicotine pouches don’t pose the same health problems as tobacco-containing products, they still aren’t “safe.”
“The adverse health effects of nicotine pouches include gastrointestinal symptoms such as nausea, sore gums and ulcers, as well as cardiovascular risks such as increased heart rate,” said Shelley, the tobacco control researcher, adding that “the full safety picture is not yet known.”
A 2023 study comparing Zyn pouches to smokeless tobacco and nicotine replacement products found that Zyn “does not contain nitrosamines or any known carcinogens, but does contain chemicals such as formaldehyde that the FDA has said are potentially harmful,” she said.
Dr. Barisha Parikh, a prosthodontist at Parikh Prosdontics in Los Angeles, warned on social media about the potential impacts of nicotine pouches on dental health.
“When you put chemicals on gum tissue for an extended period of time, it just creates problems in that area,” she said.
Sydney Cunningham said her gin use caused her gums to recede. The 30-year-old from Safford, Arizona, got into the gin habit because she “needed a nudge” to stay focused and study hard for exams while working on her PhD.
“I put the Zyn pouch as far back in my mouth as possible, near the top of my mouth, near my wisdom teeth,” Cunningham says, “and that’s where I have gum problems.”
Risks to children and young people
One of the major concerns medical experts have is that these products are not only being used by adults, but also by children and teenagers.
“When young people use nicotine, it changes how the brain works, which can lead to lifelong nicotine addiction,” said Judith Gordon, professor and associate dean for research at the University of Arizona College of Nursing.
“They seem to be marketed pretty heavily to young people,” said Spindle, who has studied how addictive different flavors of nicotine pouches are.
“The design really makes it youth-friendly, convenient and easy to conceal,” says Vaughn Rees, director of the Center for Global Tobacco Control at the Harvard School of Public Health. Pouches of different strengths might make it easier to get started, he says. “The design may encourage use among youth rather than being a viable alternative for adult smokers.”
A study published Wednesday in the Journal of the American Medical Association found that despite rising sales, nicotine pouch use among U.S. adults remains low.
But the study only looked at adults, said co-author Adam Leventhal, director of the University of Southern California’s Institute of Addiction Sciences, who said minors could also be the reason for the increased sales.
“Although this study focused on adults, published and soon-to-be published data show that a significant proportion of teenagers also use nicotine pouches at rates higher than adults,” Leventhal said.
Earlier this year, the Food and Drug Administration issued 119 warnings to retailers selling Zyn to minors.
“The FDA remains concerned about all tobacco products that may appeal to young people,” an agency spokesman said in a statement.
The FDA is reviewing applications to market Zyn and other nicotine pouches, but in the meantime has allowed them to be sold in the U.S. Several medical groups have urged the FDA to remove the products from the market during the review period.
Philip Morris suspended online sales of Zyn last month amid questions about whether it violated Washington, D.C.’s ban on the sale of flavored tobacco, but the product remains widely available online through other sellers.
“The marketing of Zyn is directed to legal nicotine users aged 21 or older,” Philip Morris said in a statement.
It’s been six months since Lamas quit smoking, but he says he still has the urge to quit.
“I don’t know if it’s ever going to go away,” he says, adding that it was hard to quit because he used the Zyn pouches for almost every activity.
“So I had to relearn how to enjoy these activities and my body had to make its own dopamine,” Llamas said. “So I had to relearn how to enjoy going to the gym, driving my car, being at work, all of these things.”
