What are Nicotine pouches and how safe are they?

There are growing concerns over the rise in a nicotine replacement product targeting vape-addicted youths. Here is what you need to know.

It is the latest trend that has authorities worried – the illegal sale of “nicotine pouches” targeting younger Aussies claiming it’s a safer and effective way of quitting vaping.

Flavoured nicotine pouches - the size of a piece of chewing gum and tucked under the lip - allow for the nicotine to be absorbed into the bloodstream faster.

The product is not only being promoted to young people on social media platforms such as TikTok and Instagram, but also being sold both online and in some stores.

In Australia, it’s illegal for retailers such as tobacconists and convenience stores to sell or advertise nicotine pouches because they have not been approved by the Therapeutic Goods Association (TGA).

Nicotine pouches are being marketed to young people as an alternative to vaping and smoking. Supplied

“Pouches contain extraordinarily high levels of synthetic nicotine. Common side effects include nausea and vomiting, dizziness, rapid heart rate, sweating, headaches and in severe cases can cause breathing difficulty and seizures,” AMA Vice President Dr Danielle McMullen said.

“The use and easy availability of these pouches is very concerning to the AMA . This is yet another underhanded tactic for tobacco companies to make money with complete disregard to the impacts on human health.”

“As is the case with vapes, there is no safety data because these products are not registered with the TGA.

“Doctors are reporting some increased uptake, and are particularly concerned about the impacts on adolescents who are more susceptible to overdose, the impact of addiction and the damage nicotine causes to the developing brain.”

Dr Dilhan Rajasingham, Associate Dentist from Maven Dental at their practice in the City.Picture: Herald Sun

It comes as it News Corp revealed how vaping is wrecking the teeth and jaws of young people in a way similar to illicit drugs.

Bad breath, dental cavities, yellowing of teeth, mouth sores and fungal infections of the mouth have all been linked to vaping.

“Dentists are seeing a trend of patients aged 12 to 15 years presenting with black bacteria on their gums – previously this bacterium had been found in older adults who vape,” Dentist Dr Dilhan Rajasingham said.

Here is everything you need to know about nicotine pouches.

ARE NICOTINE POUCHES LEGAL?

Australia’s national regulatory body the TGA oversees the supply and advertising of products like nicotine pouches. They are deemed to be a therapeutic good because they contain nicotine — a drug.

The TGA says they are aware of the “rising profile” of nicotine pouches in Australia, especially the promotion of the product as an “aid to support smoking or vaping cessation”.

“Nicotine pouches are subject to strict regulation and can only be imported, supplied and advertised in accordance with the Therapeutic Goods Act 1989 and state and territory medicines and poisons law,” the TGA said.

Nicotine pouches are illegal in Australia. Supplied

“No nicotine pouches have been evaluated by us for quality, safety or efficacy in Australia. No nicotine pouch is included in the Australian Register of Therapeutic Goods.

“Nicotine pouches are small pouches (or bags) containing nicotine and sometimes other ingredients such as sweeteners and flavours. Designed to be placed between the lip and gum, nicotine pouches do not contain tobacco leaf, dust, or stem, and are usually described as containing ‘synthetic nicotine’.

“There is no strong evidence to support the use of nicotine pouches for smoking or vaping cessation. Evidence shows nicotine can be harmful and may have adverse impacts on adolescent brain development.

IS IT SAFE TO USE?

Dr Brandon Mu from men’s online health platform Mosh said with insufficient evidence around the use of nicotine pouches, people who self-medicate and aren’t under the supervision of a medical professional “are at risk of nicotine overdose”.

“These symptoms can be life-threatening usually requiring hospital care,” Dr Mu said.

“The symptoms of nicotine overdose arise from overstimulation of the nicotine cholinergic receptors, which can cause a host of different side effects such as confusion, seizures, tachycardia and respiratory depression.”

The long-term health impact of nicotine pouches is still unknown. However, some side effects can include:

• Irritation of the gum
• Nausea
• Headache
• Sore mouth
• Hiccups
• High blood pressure
  
• Vomiting
• Diarrhoea
  
• Nicotine addiction and dependency

CAN THE POUCHES BE ADVERTISED?

It is illegal to advertise nicotine pouches, including when advertising these products for the purposes of smoking or vaping cessation. This also includes online advertising.

The TGA says a nicotine pouch cannot be publicly advertised because “the supply of a nicotine pouch for a purpose other than smoking cessation requires a prescription”. The advertisement of prescription medicines is prohibited.

HOW ARE THE POUCHES SUPPLIED?

To be lawfully supplied in Australia, nicotine pouches must be included in the Australian Register of Therapeutic Goods (ARTG) or have an authority or approval under the Therapeutic Goods Act 1989.

At the time of publication, no nicotine pouch has been included in the ARTG or received an authority or approval, which means nicotine pouches cannot be lawfully sold to consumers by Australian retailers.

However, the TGA said consumers could import nicotine pouches for personal use with a prescription from an Australian-registered medical practitioner.

“A TGA approval or authority to supply goods of this nature would be conditional on the product being sold in pharmacy settings. Tobacconists, convenience stores and other retailers cannot sell these goods to consumers,” the TGA said.

“Any nicotine pouch that is not expressly intended for smoking cessation – including when represented to be for recreational use – is a prescription medicine under Australian law.

“This means that it is illegal for consumers to buy nicotine pouches online or from retail outlets without a valid prescription from an Australian doctor.”

Originally published as What are Nicotine pouches and how safe are they?