Nicotine Pouches, Snus and Heat Not Burn Smokeless Tobacco Products

Nicotine pouches and smokeless tobacco products -evidence, risks and policy implications

Nicotine pouches and other smokeless tobacco products are an emerging area of interest for tobacco control, with growing visibility in the UK and increasing uptake among younger adults. While overall use remains relatively low, trends suggest rising experimentation and awareness, particularly among young people.

Julia Robson, Smoking Cessation Consultant, focuses on emerging evidence and policy considerations around nicotine pouches and heat not burn smokeless tobacco products.

In this recorded session, Julia provides a clear, evidence-led overview of:

• what nicotine pouches, snus and heat not burn products are and how they work

• current patterns of use in the UK, including among young people

• known and emerging health impacts

• whether these products have a role in smoking cessation

• how they are currently regulated, and where gaps remain

This video is aimed at local authority public health teams, tobacco control leads, commissioners and partners who need to understand these products in order to respond appropriately at a local level.

What are nicotine pouches and how do they work?

Nicotine pouches are small oral pouches placed between the lip and gum, where they slowly release nicotine that is absorbed into the bloodstream. They do not contain tobacco and are smoke-free and vapour-free.

Once in place, nicotine pouches are discreet and can be used without affecting speech, making them easier to hide than smoking or vaping. They are typically used for short periods (around 0–15 minutes) and are sold in a wide range of flavours and nicotine strengths.

Nicotine content varies significantly between products, with strengths ranging from approximately 1.5mg up to 30mg per pouch. Products with extremely high nicotine levels, including those exceeding 100mg, have been identified on sale, raising concerns about potential harm and dependency

How many people use nicotine pouches and how are they regulated?

Current use of nicotine pouches in the UK remains relatively low but is increasing:

• Around 1.1% of adults currently use nicotine pouches
• 6.0% of adults report having tried them
• Use among 18–34 year olds rose from 1.2% in 2023 to 2.6% in 2025
• Young men are around three times more likely to use nicotine pouches than women
• Nearly 4% of children aged 11–17 report having tried nicotine pouches (approximately 210,000 children)

Nicotine pouches are not currently well regulated in the UK and are not subject to age-of-sale restrictions, although this is expected to change under the proposed Tobacco and Vapes Bill. There is concern that marketing strategies position nicotine pouches as lifestyle products, potentially increasing their appeal to young people

Health effects of nicotine pouches

Evidence on the health effects of nicotine pouches is still limited, as they are relatively new products. A recent Cochrane systematic review found reduced exposure to harmful chemicals compared with smoking, which would be expected given the absence of combustion.

However, concerns remain:

• Nicotine is highly addictive
• Long-term oral use may lead to mouth ulcers, gum recession and other oral health issues
• Some products contain synthetic nicotine, while others use nicotine derived from tobacco, raising questions about contaminants and toxicity

Nicotine pouches for smoking cessation

Nicotine pouches are not currently recommended by NICE as a smoking cessation aid. Evidence supporting their effectiveness for quitting smoking is weak, with limited studies available. Guidance from the National Centre for Smoking Cessation and Training (NCSCT) is expected in 2026

What is Snus?

Snus is a form of smokeless tobacco that is placed in the mouth, usually under the upper lip next to the gum. It is typically sold either loose or in small pouches and releases nicotine slowly into the bloodstream through the lining of the mouth.

Snus is most commonly used in Sweden and other parts of Scandinavia, where it has a long history of cultural use and is widely available. Snus is illegal to sell in the UK.

Nicotine pouches and snus: key differences

Nicotine pouches are often confused with snus, but the two products are distinct.

Snus:

• Contains tobacco
• Is placed under the lip in a similar way
• Delivers high, steady levels of nicotine
• Is illegal to sell in the UK
• Has recognised health risks, including gum disease and tooth decay

Nicotine pouches:

• Do not contain tobacco
• Are legally sold in the UK (though currently unregulated by age)
• Are likely to be less harmful than snus or other smokeless tobacco products

Understanding this distinction is important for enforcement, education and public communication

Heat not burn (heated tobacco) products

Heat not burn products are electronic devices that heat tobacco to high temperatures without combustion. Although no smoke is produced, toxic chemicals are released into the vapour.

Evidence indicates:

• No clear proof that heat not burn tobacco products are less harmful than cigarettes
• They are more harmful than nicotine vaping products
• Some harmful chemicals are present at higher levels than in conventional cigarettes
• No improvement in lung health has been observed among people who switch from smoking

Use of heat not burn products is increasing:

• 2.6% of adults have ever tried them
• 0.9% currently use them
• Use among people who smoke has more than doubled since 2020
• Past-month use among 16–19 year olds increased three-fold between 2018 and 2023

Heat not burn tobacco products are regulated under the Tobacco and Related Products Regulations (2016), subject to tax, health warnings and age-of-sale restrictions. They are not recommended for smoking cessation

Summary

• Use of nicotine pouches and other niche tobacco products remains relatively low but is rising, particularly among young people
• Nicotine pouches do not contain tobacco, but still carry risks due to nicotine addiction
• They are not currently recommended for smoking cessation
• Regulation of nicotine pouches in the UK is limited, with no age-of-sale restriction at present
• Clear, evidence-based policy responses are needed to prevent harm and protect young people