# Nicotine Pouches Side Effects: Everything You Need to Know

> This guide explores nicotine pouches’ benefits and risks, usage trends within younger demographics, and status as a tobacco-free nicotine delivery product.   

By Liam Day · June 26, 2025

## Key takeaways

- Nicotine pouches may be a less harmful alternative to traditional tobacco products.
- The popularity of nicotine patches—particularly Zyn—among adolescents and youth has raised public health concerns and fueled debate about the product’s potential as a harm reduction tool.
- Common side effects associated with nicotine pouches include gum irritation, gastrointestinal upset, and cardiac changes related to their nicotine content. 
- Nicotine pouches are not an FDA-approved Nicotine Replacement Therapy (NRT). 
- The public health community warns that FDA authorization of marketing for Zyn products may encourage nicotine pouch use and lead to nicotine addiction in youth.

## What Are Nicotine Pouches?

[Nicotine pouches](https://www.cdc.gov/tobacco/nicotine-pouches/index.html) belong to a relatively new [category](https://www.fda.gov/tobacco-products/products-ingredients-components/regulation-and-enforcement-non-tobacco-nicotine-ntn-products) of smokeless, tobacco-free nicotine products that has become [increasingly popular](https://pmc.ncbi.nlm.nih.gov/articles/PMC9667333/) in recent years. They are disposable, pre-portioned pouches that [contain](https://www.webmd.com/smoking-cessation/nicotine-pouches) a powdered formulation of [nicotine](https://www.trybrst.com/blog/nicotine-a-definitive-guide/) in addition to flavorings, sweeteners, and other food-grade additives. 

Nicotine pouches are designed to be placed between the lip and gum, where nicotine is [absorbed](https://pmc.ncbi.nlm.nih.gov/articles/PMC10611559/#:~:text=Introduction,in%20countries%20such%20as%20Sweden.) into the bloodstream through mucus membranes in the mouth. They come in a variety of flavors and [strengths](https://www.northerner.com/us/the-northerner/research/nicotine-strength-guide). In the United States, popular brands include [Zyn](https://en.wikipedia.org/wiki/Zyn#:~:text=Zyn%20pouches%20are%20sold%20in,for%20up%20to%20one%20hour.), Velo, and On!

## Side Effects of Nicotine Pouches

### Common Side Effects

Common side effects of nicotine pouches include:

- [Oral Health Risks](https://www.nature.com/articles/s41415-023-6383-7): Nicotine pouches may cause gum irritation, soreness in the mouth or throat, [tooth discoloration](https://health.clevelandclinic.org/are-nicotine-pouches-safe), and gum recession.
- [Gastrointestinal Issues](https://www.healthline.com/health/nicotine-pouches#risks): Nausea, [hiccups](https://health.unl.edu/nicotine-pouches-are-they-safer-chewing-smoking-or-vaping/), and [gastrointestinal reflux](https://health.clevelandclinic.org/are-nicotine-pouches-safe).
- [Nicotine Dependence and Addiction](https://health.clevelandclinic.org/are-nicotine-pouches-safe): Nicotine is highly addictive. Regular use can lead to dependence. Withdrawal symptoms may include irritability, anxiety, and difficulty concentrating. Nicotine dependence is [especially](https://www.yalemedicine.org/news/nicotine-pouches) harmful in teenagers and can interfere with healthy brain development, lead to impulsivity and attentional deficits, and predispose a young person to additional substance use challenges. 

### Can Nicotine Pouches Cause Cancer?

The most harmful chemicals in [tobacco](https://adf.org.au/drug-facts/nicotine/) products are [tobacco-specific nitrosamines (TSNAs)](https://pubmed.ncbi.nlm.nih.gov/3286030/), potent [carcinogens](https://my.clevelandclinic.org/health/articles/25081-carcinogens) that are [naturally occurring](https://www.cancer.gov/publications/dictionaries/cancer-terms/def/tsna) substances in the tobacco plant and [intensify](https://www.cabidigitallibrary.org/doi/full/10.5555/19880712009) during the process of [curing](https://en.wikipedia.org/wiki/Curing_of_tobacco#:~:text=Curing%20tobacco%20is%20necessary%20to,often%20found%20at%20tobacco%20farms.) tobacco leaves. Nicotine is the [addictive element](https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/symptoms-causes/syc-20351584) in tobacco products, but the toxic [chemicals](https://www.cancer.org/cancer/risk-prevention/tobacco/carcinogens-found-in-tobacco-products.html) in tobacco are the main reason tobacco consumption is [dangerous](https://www.fda.gov/tobacco-products/health-effects-tobacco-use/nicotine-why-tobacco-products-are-addictive#:~:text=Some%20of%20these%20chemicals%2C%20known,disease%20(COPD)%20and%20cancer.&text=Tobacco%20products%20containing%20nicotine%20pose,Teen%20Quit%20Smoking%20or%20Vaping?%5C%E2%80%9D). 

Since nicotine pouches do not contain TSNAs, they may be safer than traditional tobacco products. However, more research is [needed](https://www.vcuhealth.org/news/how-safe-are-nicotine-pouches-tobacco-free-does-not-mean-risk-free--vcu-expert-says/#:~:text=The%20cancer%20risk%20associated%20with,that%20could%20elevate%20cancer%20risk.) to determine whether these products may pose a cancer risk.   

### Impact on Heart Health and Blood Pressure

Nicotine—regardless of delivery method—[increases](https://www.trybrst.com/blog/is-zyn-bad-for-your-heart/) heart rate and blood pressure, which can raise the risk of cardiac disease and heart attack, particularly in individuals with pre-existing cardiovascular conditions.

### Are Nicotine Pouches a Smoking Cessation Aid?

Nicotine pouches are currently not an FDA-approved [Nicotine Replacement Therapy (NRT)](https://www.trybrst.com/blog/nicotine-replacement/). Traditional NRTs—such as [patches](https://www.trybrst.com/blog/how-to-use-nicotine-patches/), [gum](https://www.trybrst.com/blog/how-to-chew-nicotine-gum/), [lozenges](https://www.trybrst.com/blog/how-to-use-nicotine-lozenges-to-quit-smoking/), and [inhalers](https://www.trybrst.com/blog/nicotine-inhaler/)—are regulated for safety and efficacy in smoking cessation. While some users may find nicotine pouches helpful in reducing or quitting smoking, as of June 2025, there is no evidence supporting their effectiveness [compared](https://www.nature.com/articles/s41415-023-6383-7) to approved NRTs.

### Side Effects Specific to Zyn

Many of the side effects associated with Zyn—such as irritation of the gums, stomach upset, and [cardiac symptoms](https://www.trybrst.com/blog/is-zyn-bad-for-your-heart/)—are common reactions to nicotine pouches and the consumption of nicotine in general. However, the [high concentrations](https://www.lung.org/blog/zyn-nicotine-addiction) of nicotine in Zyn may exacerbate side effects and possibly [heighten](https://health.clevelandclinic.org/are-nicotine-pouches-safe) the product’s abuse potential.

## Nicotine Pouches and Smokeless Tobacco: A Comparison

### What is Smokeless Tobacco?

Unlike [conventional](https://www.tobaccotactics.org/article/tobacco-industry-product-terminology/) forms of tobacco like cigarettes and cigars, [smokeless tobacco products](https://my.clevelandclinic.org/health/articles/smokeless-tobacco) are chewed, sniffed, or sucked on rather than smoked. This category includes [chewing tobacco](https://www.cancer.gov/publications/dictionaries/cancer-terms/def/chewing-tobacco), snuff, snus, and [dissolvable products](https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/in-depth/chewing-tobacco/art-20047428). 

### Smokeless Tobacco and Harm Reduction

While smokeless tobacco has historically been promoted as a [less harmful alternative](https://www.annualreviews.org/content/journals/10.1146/annurev-publhealth-040617-013849) to smoking, all forms of tobacco consumption—whether [combustible](https://health.wyo.gov/publichealth/prevention/substanceabuseandsuicide/tobacco-prevention/tobacco-products/#:~:text=Combustible%20tobacco%20is%20any%20type,and%20other%20less%20common%20types.) or smokeless—are associated with significant [health risks](https://www.cdc.gov/tobacco/other-tobacco-products/smokeless-tobacco-health-effects.html), including several types of [cancer](https://www.cancer.org/cancer/risk-prevention/tobacco/smokeless-tobacco.html), [gum disease](https://www.cdc.gov/oral-health/data-research/facts-stats/fast-facts-tobacco-use-and-oral-health.html), and tooth decay. 

### Nicotine Pouches vs. Smokeless Tobacco

Nicotine pouches are [similar](https://health.unl.edu/nicotine-pouches-are-they-safer-chewing-smoking-or-vaping/) to traditional forms of [smokeless tobacco](https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/in-depth/chewing-tobacco/art-20047428), such as chewing tobacco and [snus](https://gsthr.org/resources/briefing-papers/what-is-snus/what-is-snus/), insofar as they do not involve smoking or burning to deliver nicotine. A key [difference](https://www.healthline.com/health/nicotine-pouches#comparison) is that unlike conventional smokeless tobacco products, nicotine pouches do not contain the [tobacco leaf](https://my.clevelandclinic.org/health/articles/smokeless-tobacco), which has been linked to a host of [health conditions](https://pubmed.ncbi.nlm.nih.gov/14570033/). For this reason, nicotine pouches have been proposed as a less harmful [alternative](https://pubmed.ncbi.nlm.nih.gov/39621395/#:~:text=Taken%20together%2C%20the%20current%20data,APA%2C%20all%20rights%20reserved).) to smokeless tobacco for current users. 

### Are Nicotine Pouches Safer Than Smoking?

While nicotine pouches are likely significantly [less damaging](https://health.clevelandclinic.org/are-nicotine-pouches-safe) than smoking, high-dose versions of these products may contain more nicotine than cigarettes, which could potentially [increase](https://health.clevelandclinic.org/are-nicotine-pouches-safe) their addictive properties. More research is [needed](https://www.vcuhealth.org/news/how-safe-are-nicotine-pouches-tobacco-free-does-not-mean-risk-free--vcu-expert-says/#:~:text=The%20cancer%20risk%20associated%20with,that%20could%20elevate%20cancer%20risk.) to understand the long-term benefits and risks associated with nicotine pouches. 





## Nicotine Pouches & Public Health

### Zyn’s FDA Authorization 

Earlier this year, the Food and Drug Administration (FDA) [authorized](https://edition.cnn.com/2025/01/16/health/zyn-pouches-fda/index.html) the marketing of Zyn products, [citing](https://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-20-zyn-nicotine-pouch-products-after-extensive-scientific-review#:~:text=Today%2C%20the%20U.S.%20Food%20and,newly%20authorized%20nicotine%20pouch%20products.) the product’s harm reduction potential and lower risk profile relative to other forms of nicotine consumption. At present, Zyn remains the only product of its kind to have received such an authorization through the FDA. 

The FDA’s decision was met with considerable [pushback](https://www.nbcnews.com/business/business-news/fda-authorizes-zyn-nicotine-pouches-sale-health-review-rcna187997), with critics voicing concern over the limited research on Zyn’s long-term health effects, [possible carcinogenic properties](https://www.lung.org/blog/zyn-nicotine-addiction#:~:text=Because%20of%20their%20smokeless%2C%20odorless,industry%20to%20sustain%20lifelong%20customers.), and [popularity](https://www.lung.org/media/press-releases/fy25-zyn-pmta-statement#:~:text=Most%20concerning%2C%20nicotine%20pouches%20contain%20high%20levels,cause%20additional%20harm%20to%20kids%20and%20adults.) among youth. In a [press release](https://www.tobaccofreekids.org/press-releases/2025_01_16-fda-authorization-flavored-zyn-products), Campaign for Tobacco-Free Kids called the move “a dangerous precedent” while [other](https://www.lung.org/blog/zyn-nicotine-addiction) public health organizations cited the product’s high abuse potential among youth and minors. 

### Popularity Among Young People

Nicotine pouches may represent a [harm reduction strategy](https://www.annualreviews.org/content/journals/10.1146/annurev-publhealth-040617-013849) for current smokers or those who use conventional smokeless tobacco products, but their popularity among [young people](https://keck.usc.edu/news/use-of-nicotine-pouches-increases-significantly-among-u-s-teens/)—especially [adolescents](https://theconversation.com/adolescents-who-smoke-or-vape-may-believe-tobaccos-perceived-coping-benefits-outweigh-accepted-health-risks-254294), [youth](https://www.fda.gov/tobacco-products/public-health-education/youth-and-tobacco#:~:text=Almost%2090%20percent%20of%20adult,day%20in%20the%20United%20States.&text=In%20fact%2C%20use%20of%20tobacco,most%20vulnerable%20to%20nicotine%20addiction.&text=These%20facts%20highlight%20a%20critical,designed%20to%20protect%20America's%20kids.), and young adults, many of whom have never used tobacco products before—raises significant public health [concerns](https://www.fda.gov/tobacco-products/ctp-newsroom/youth-tobacco-product-use-25-year-low-yet-disparities-persist). 

In particular, the popular nicotine pouch manufacturer [Zyn](https://us.zyn.com/)—which is owned by tobacco industry giant [Philip Morris International (PMI)](https://en.wikipedia.org/wiki/Philip_Morris_International)—has drawn [scrutiny](https://keck.usc.edu/news/use-of-nicotine-pouches-increases-significantly-among-u-s-teens/) from the public health community for allegedly using marketing tactics that [appeal](https://www.theguardian.com/business/2021/feb/20/tobacco-giant-bets-1bn-on-social-media-influencers-to-boost-lung-friendlier-sales) to youth.

The rise in nicotine pouch use among youth has been linked to several marketing strategies: 

- **Social media promotion**: Nicotine pouch manufacturers, particularly Zyn, have been criticized for promoting these products on social media platforms that are popular among young people, such as TikTok and Instagram. Zyn has been specifically linked to youth-centric [marketing campaigns](https://www.cbsnews.com/baltimore/news/maryland-zyn-nicotine-pouches-flavors-deceptive-marketing/) on social media, where young people post images or [videos](https://www.tiktok.com/@looseygooseyco/video/7491879749304798495?is_from_webapp=1&web_id=7517773819009877559) of themselves using Zyn, often [glamorizing](https://www.cbsnews.com/baltimore/news/maryland-zyn-nicotine-pouches-flavors-deceptive-marketing/) the product and normalizing its use within this age cohort. 
- **Strategic ad placement**: The brand [strategically](https://pmc.ncbi.nlm.nih.gov/articles/PMC11827556/#S14) places ads in media outlets that cover entertainment, sports, and other industries that are popular within this age group, further embedding itself in youth culture. 
- **Targeted lifestyle messaging**: Zyn uses themes of “freedom” and “[innovation](https://uu.diva-portal.org/smash/get/diva2:1780984/FULLTEXT01.pdf)” to [attract](https://pmc.ncbi.nlm.nih.gov/articles/PMC11827556/#S14) an audience of young people, appealing to their desire for independence, self-expression, and modernity.
- **Influencer partnerships**: Zyn’s popularity among teenagers and youth has been linked to the brand’s pervasive social media presence, where young influencers–often referred to as “[Zynfluencers](https://www.theguardian.com/business/2021/nov/08/firms-under-fire-for-using-uk-influencers-to-push-nicotine-products)”–promote the product to their same-aged followers. While Zyn’s parent company, PMI, has [historically](https://www.cnbc.com/2019/05/11/philip-morris-suspends-social-media-campaign.html#:~:text=Philip%20Morris%20suspends%20social%20media%20campaign%20after,by%2021%2Dyear%2Dold%20social%20media%20influencer%20Alina%20Tapilina.) partnered with influencers, the company [denies](https://www.pmi.com/sustainability/integrated-report-2020/responsible-marketing-and-sales-practices-progress-2020#:~:text=In%20addition%2C%20we%20use%20all%20native%20age,media%20influencers%20to%20advertise%20our%20smoke%2Dfree%20products.) current partnerships. Public health experts and advocacy groups remain skeptical, citing the company’s [long history](https://jamanetwork.com/journals/jamapediatrics/fullarticle/347724) of targeting youth and [ongoing efforts](https://publichealth.jhu.edu/2025/how-oral-nicotine-pouch-ads-appeal-to-the-youth-market) to appeal to this demographic. 
- **Flavor variety, convenience, and relative safety**: Zyn marketing [emphasizes](https://truthinitiative.org/our-top-issues/flavored-tobacco) the product’s variety of flavors, convenience, and purported lower risk profile as a “[tobacco-free](https://publichealth.jhu.edu/2025/how-oral-nicotine-pouch-ads-appeal-to-the-youth-market#:~:text=The%20leading%20brand%20Zyn%20was,Tobacco%20Control%20in%20December%202024.)” nicotine delivery system. 

### The Use of Artificial Sweeteners in Nicotine Pouches

The artificial sweeteners in Zyn and other nicotine pouch brands may [indirectly contribute](https://pmc.ncbi.nlm.nih.gov/articles/PMC10032193/) to health risks. Research has shown that the use of sweeteners in nicotine pouches can lead to [higher](https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntae293/7917194) rates of consumption by masking the naturally bitter or unpleasant taste of nicotine, which can make these products [more addictive](https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntae293/7917194). 

Sweeteners and flavor variety may also make these products [appealing](https://pmc.ncbi.nlm.nih.gov/articles/PMC10032193/) to adolescents. In the United States, Zyn is the most popular brand among middle and high school students who use nicotine pouches, representing [68.7%](https://www.cdc.gov/mmwr/volumes/73/wr/pdfs/mm7335a3-H.pdf) of nicotine pouch consumption in this demographic. 

### Industry Funding of Scientific Research 

Much of the existing scientific research on the risks of tobacco and nicotine products was [funded](https://tobaccocontrol.bmj.com/content/30/e1/e65) by the tobacco companies that manufacture these products. The public health community warns that tobacco companies’ financial involvement in studies evaluating the safety of the products they manufacture represents a [conflict of interest](https://truthinitiative.org/research-resources/tobacco-industry-marketing/new-report-tobacco-industry-funded-group-obscures-its), allowing them to [manipulate](https://pubmed.ncbi.nlm.nih.gov/10994263/) public perception and policy decisions. 

Leaked documents [revealed](https://extranet.who.int/fctcapps/fctcapps/fctc/kh/TIInterference/news/new-research-reveals-tobacco-company-has-secretly-funded#:~:text=An%20analysis%20of%20leaked%20documents%20by%20the,to%20carry%20out%20research%20on%20smoking%20cessation.) that Philip Morris International (PMI)—the company that manufactures Zyn nicotine pouches—established a research foundation called the Foundation for a Smoke-Free World, which conducts research on smoking cessation. PMI and other Big Tobacco companies have also [sponsored](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253272) scientific conferences and similar events, further embedding themselves in the scientific community.  

Public health professionals and organizations [recommend](https://www.ncbi.nlm.nih.gov/books/NBK236766/#:~:text=point%20of%20sale.-,3.,artistic%2C%20or%20other%20public%20event.) that regulatory programs require independent funding for research on tobacco and nicotine products. 

## Summary

Nicotine pouches have become a popular tobacco-free nicotine product. Unlike traditional forms of smokeless tobacco, nicotine pouches do not contain TSNAs—the most harmful chemicals associated with tobacco—and therefore may represent a safer alternative to tobacco-based nicotine products. To date however, there is no scientific research on the possible long-term health risks associated with nicotine pouches.

Common short-term side effects include nausea, gum irritation, and tooth discoloration. Since nicotine is the active ingredient, nicotine pouches may increase a person’s heart rate and blood pressure and lead to addiction. 

The popularity of nicotine pouches among adolescents and youth has raised concern among public health experts, which has escalated following the FDA’s decision to authorize marketing and sales of Zyn products in the United States. The public health community warns that nicotine pouch manufacturers use targeted advertising and flavor variety to appeal to young people, particularly in the case of Zyn, a subsidiary of tobacco industry titan Philip Morris International. These concerns arise in the context of the tobacco industry’s long history of manipulating scientific research, public perception, and policy in its favor. 

Resources to Quit Smoking

- [Smokefree.gov](http://smokefree.gov/) - Provides tools, tips, and support that can help you quit smoking.
- [Centers for Disease Control and Prevention (CDC) - Quit Smoking](https://www.cdc.gov/tobacco/quit_smoking/index.htm) - Offers resources on how to quit smoking, including tips on quitting, benefits of quitting, and quit plans.
- [American Cancer Society - How to Quit Using Tobacco](https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking.html) - Provides detailed information on why to quit, how to quit, and dealing with the emotional and physical aspects of quitting.
- [Mayo Clinic - Quit Smoking](https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/basics/quitsmoking-action-plan/hlv-20049487) - Features articles, tools, and tips on quitting smoking and overcoming nicotine dependence.
- [Truth Initiative](https://truthinitiative.org/) - Provides innovative tools and resources for young people, including a text-to-quit program.

## Glossary

- [**Nicotine Pouch**](https://www.cdc.gov/tobacco/nicotine-pouches/index.html): A smokeless, tobacco-free product that delivers nicotine via oral absorption through the lining of the mouth.
- [**Smokeless Tobacco**](https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/in-depth/chewing-tobacco/art-20047428): Tobacco products consumed without burning, including chewing tobacco, snus, and snuff.
- [**TSNAs (Tobacco-Specific Nitrosamines)**](https://pubmed.ncbi.nlm.nih.gov/3286030/): Potent carcinogenic compounds found in tobacco and associated with cancer risk.
- [**NRT (Nicotine Replacement Therapy)**](https://www.trybrst.com/blog/nicotine-replacement/): FDA-approved products like nicotine gum, patches, and lozenges designed to help people quit smoking.
- [**Zyn**](https://en.wikipedia.org/wiki/Zyn#:~:text=Zyn%20pouches%20are%20sold%20in,for%20up%20to%20one%20hour.): A popular nicotine pouch brand manufactured by Philip Morris International, often scrutinized for youth-targeted marketing.
- [**Harm Reduction**](https://pmc.ncbi.nlm.nih.gov/articles/PMC7581601/): Strategies intended to minimize the negative health effects associated with risky behaviors, such as smoking.
- [**Addiction**](https://my.clevelandclinic.org/health/diseases/6407-addiction): A chronic condition characterized by compulsive use of a substance despite harmful consequences.
- [**Cardiovascular Risk**](https://pmc.ncbi.nlm.nih.gov/articles/PMC3477342/): Health issues such as increased heart rate and blood pressure that elevate the likelihood of heart disease.
- [**Artificial Sweeteners**](https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/artificial-sweeteners#:~:text=Artificial%20sweeteners%20are%20synthetic%20non,the%20proportions%20of%20Bacteroides%20spp.): Non-nutritive sugar substitutes used in many nicotine pouch products, potentially increasing their appeal and addictive potential.
- [**FDA Authorization**](https://www.lawinsider.com/dictionary/marketing-authorization): Official approval from the Food and Drug Administration to market a product based on a risk-benefit assessment.