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Middlesex-London Health Unit

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Nicotine Pouches

A new alternative to smoking and vaping is quickly gaining popularity: oral nicotine pouches. Nicotine pouches are pre-portioned pouches with varying concentrations of nicotine, along with cellulose, water, flavouring, and sodium carbonate, which are placed in between the lip and gum of the mouth.1

Zonnic is the only nicotine pouch product authorized for sale by Health Canada under the Natural Health Product Regulations. Zonnic nicotine pouches, along with many other brands, are now readily available for purchase at convenience stores and gas stations without sales, advertising, and promotion restrictions. These products have been identified as a public health concern and Health Canada is currently reviewing how nicotine pouches are being marketed and sold to youth.

Understanding The Risks

Nicotine is not a harmless substance. It is highly addictive in any form and has adverse effects on youth and young adult brain development. Nicotine can impact the parts of the brain responsible for attention, learning, mood, and impulse control.2 3 Exposures to nicotine during adolescence when the brain is still maturing can also put a person at risk of developing addiction to other substances later in life.2 3

Other negative health side effects associated with nicotine pouch use may include:4

  • Nicotine dependence
  • Nausea
  • Gum/mouth irritation

Excessive amounts of nicotine can lead to nicotine poisoning, which can cause severe headache, dizziness, vomiting, severe heartburn, cold sweats, blurred vision, mental confusion, and chest pain.5 Long term use of products containing nicotine can increase a person’s risk of cardiovascular, respiratory, and gastrointestinal disorders.6 Nicotine can also negatively impact immune system function and reproductive health.6

Health Canada's Public Advisory

Health Canada has issued a public advisory stating that nicotine pouches should not be used by youth or by those who do not smoke. Health Canada’s advisory stresses that authorized nicotine pouches should be used as directed.5

Nicotine Replacement Therapy (NRT)

Health Canada's advisory on nicotine pouches and approved Nicotine Replacement Therapy are important considerations when thinking about supports for quitting smoking and vaping. Given the concerns around nicotine pouches, it is important that you choose products that have been proven to be effective in helping people quit. Nicotine Replacement Therapy, such as the nicotine patch, lozenge, gum, mouth spray, and inhaler, are designed to provide relief from the symptoms of nicotine withdrawal and have demonstrated success in supporting individuals in their journey to quit smoking and vaping. Learn more about Nicotine Replacement Therapy.



1Back, S., Masser, A. E., Rutqvist, L. E., & Lindholm, J. (2023). Harmful and potentially harmful constituents (HPHCs) in two novel nicotine pouch products in comparison with regular smokeless tobacco products and pharmaceutical nicotine replacement therapy products (NRTs). BMC Chemistry, 17(1), 9–9. Retrieved from
2Goriounova, N. A., & Mansvelder, H. D. (2012). Short- and long-term consequences of nicotine exposure during adolescence for prefrontal cortex neuronal network function. Cold Spring Harbor perspectives in medicine, 2(12), a012120. doi:10.1101/cshperspect.a012120. Retrieved from
3Centers for Disease Control and Prevention. (2023). Quick facts on the risks of e-cigarettes for kids, teens, and young adults. Centers for Disease Control and Prevention. Retrieved from,%
4Sparrock, L. S., Phan, L., Chen-Sankey, J., Hacker, K., Ajith, A., Jewett, B., & Choi, K. (2023). Nicotine Pouch: Awareness, Beliefs, Use, and Susceptibility among Current Tobacco Users in the United States, 2021. International Journal of Environmental Research and Public Health, 20(3), 2050. Retrieved from
5Health Canada. (2024). Public advisory: Only use authorized nicotine pouches as directed, and do not use unauthorized nicotine pouches. Retrieved from
6Mishra A, Chaturvedi P, Datta S, Sinukumar S, Joshi P, Garg A. (2015). Harmful effects of nicotine. Indian J Med Paediatric Oncololgy. Jan-Mar;36(1):24-31. Retrieved from
doi: 10.4103/0971-5851.151771. PMID: 25810571; PMCID: PMC4363846.