Sharp rise in nicotine pouch use among young men

More than half a million people across England, Scotland and Wales now use nicotine pouches, according to new research led by University College London (UCL).

The study, funded by Cancer Research UK and published in Lancet Public Health, found that use of the pouches – small white sachets, placed between the gum and lip, that contain nicotine but no tobacco – has risen from 0.1% to 1% of adults over the last five years.

The figure – calculated with study data from 127,793 people aged 16 and over in England, Scotland and Wales – translates to around 522,000 people now using the pouches.

The increase has been driven largely by young men, with one in 13 (7.5%) men aged 16 to 24 now using the products.

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Most users (69%) also reported using other nicotine products such as cigarettes or vapes, but one in six (16%) had never regularly smoked.

Currently there are no age restrictions on the sale of nicotine pouches, though the government’s forthcoming Tobacco and Vapes Bill is set to prohibit sales to under-18s.

Lead author Dr Harry Tattan-Birch, from UCL’s Institute of Epidemiology and Health Care, said: ‘The rise in nicotine pouch use has been driven almost exclusively by young people, especially young men, while use among adults over 35 remained stable and low.

‘This may be due in part to aggressive advertising targeting this group on social media, billboards, in bars and train stations, and through sponsorships of motorsports and music festivals.’

Tattan-Birch observed that pouches have a substantially lower risk to health than cigarettes and are likely less harmful than e-cigarettes.

‘However, they are not harmless and can currently be sold to children with no marketing restrictions and no cap on nicotine content,’ he added.

According to Tattan-Birch, the study findings emphasise the urgency of the Tobacco and Vapes Bill. ‘Proportionate measures are important to limit uptake among teenagers,’ he said.

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The study also found a threefold increase in the use of nicotine pouches as a smoking cessation aid, accounting for 6.5% of recent quit attempts in 2025.

This was higher than the use of prescription treatments such as varenicline (1.1%) and nicotine replacement therapy (4.5%), but lower than over-the-counter NRT (17.3%) and e-cigarettes (40.2%).

Dr Tattan-Birch said: ‘We do not currently know if nicotine pouches are effective in helping people quit smoking – our findings highlight the urgent need for more research on this.’

He added: ‘Whether nicotine pouches are good or bad for public health depends on who is using them. If it’s a young person who would otherwise start smoking, then the use of pouches might help to reduce harm.

‘However, if it’s a person who otherwise would not use nicotine at all, then the potential for harm increases. We need to see how this balance plays out.’

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The researchers added that further measures such as caps on nicotine strength should be considered carefully to avoid undermining their potential role in helping people quit smoking.

A version of this article first appeared on our sister title, The Pharmacist.