As we have covered before in this blog, nicotine is a fascinating substance. It is a toxin produced by many plants as a means of protecting themselves against predators. But as with other toxic substances like alcohol, used in smaller doses, toxins have other effects on humans. this has created a bit of a conundrum.
While for example alcohol intoxicates, nicotine sharpens the senses. This is probably why nicotine pouches have become a huge success with athletes and other high performers. If it wasn’t for the highly addictive properties of nicotine, there would be very little reason to argue.
Two sides of the story
In a long-read article in The Atlantic, headlined “What’s so bad about nicotine?” (August 1st, 2025), the author Nicholas Florko takes a neutral look at the discussions for and against nicotine. In the article (which might require a user account) he writes:
“For the better part of the past century, the case against nicotine was simple: Smoking a cigarette might feel nice, but it will eventually kill you. Nearly one in five deaths in the United States is caused by complications from cigarette smoke. Chewing tobacco is less dangerous, but still deadly: It has long been associated with head and neck cancers. But in 2025, nicotine isn’t so straightforward. Smoking is so deadly not because of nicotine, per se, but because of tobacco(…)”
Smoking tobacco means that the nicotine comes with over 20 other unwanted toxins. Chewing tobacco, which has a long history in the US, means chewing on prepared tobacco leafs. Chewing has shown to put the user at risk of oral cancers and other related issues. Enter the new nicotine generation where the toxin is inhaled or absorbed via the mucus membrane under the upper lip. Great, problem solved? Not so fast.
FDA approved, so…
In the beginning of 2025, FDA approved the sale of Zyn, the best known brand for nicotine pouches. According to the article, Philip Morris shipped 190 million cans to stores in the US last year. FDA also reversed a prior ban and approved Juul e-cigarettes. According to the FDA, these products have lower health risks than smoking tobacco.
New types of nicotine products have been advertised on the US market as miracle products. According to the advertising, they make people energized, calm, and focused. The adverting also credits the nicotine pouches with a number of other positive cognitive properties. Celebrities like Joe Rogan and Tucker Carlson have also joined the movement and started cashing in on the development.
While academic research confirms some of these effects, some users need to “up the dose” to achieve the positive effects. And there is that highly addictive property meaning that after a while, the user might have to increase the dose just to feel alright.
The muddled picture
According to the author of the article, the field of public health used to be united in that no one should be using cigarettes, and thus nicotine. Now the message is more muddled than ever. In Europe, several strong and well-financed lobbyists and organizations are going all in on stopping the new generation of nicotine products. Their pitch is that the nicotine pouches only aim to lure young people into a life-long nicotine addiction. That it is a much safer option to by far more dangerous products is not considered.
In Sweden, the leading anti-smoking NGO – A Non Smoking Generation – has published a barrage of more or less unsubstantiated articles claiming that nicotine pouches are to be avoided at all costs. It can be a bit perplexing to people that an NGO fighting smoking has done a complete 180 degree turn and started fighting one of the best smoking substitutes. For those interested in conspiracy theories, it is perhaps an interesting fact that the organization is sponsored by a pharmaceutical company producing smoking cessation plasters and chewing gums…
Currently, the debate in the US is a bit more balanced and can perhaps be summarized like this:
In the US, 1 in 5 deaths are related to smoking. Nicotine pouches and other new nicotine products are far less dangerous. So from a societal total cost perspective, shifting all smokers to nicotine pouches would have a massive positive impact. At the same time, one cannot disregard the risk of some young people starting using nicotine pouches – whilst they would never had considered smoking.
