Nicotine pouches can be marketed as 'lower risk' than cigarettes. Is that dangerous?

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Fresh Air Wild Card with Rachel Martin It's Been a Minute Embedded Get NPR+ More Podcasts & Shows Search Newsletters NPR Shop Get NPR+ Tiny Desk New Music Friday All Songs Considered Music Features Live Sessions About NPR Diversity Support Careers Press Ethics FDA allows labeling nicotine pouches 'lower risk' than cigarettes The FDA allowed some Zyn nicotine pouches to be marketed as "lower risk" than cigarettes. Public health experts agree they can help current smokers, but worry young people may become addicted. Your Health Nicotine pouches can be marketed as 'lower risk' than cigarettes. Is that dangerous? August 5, 20265:00 AM ET By Joseph Kim The FDA allowed some Zyn nicotine pouches to be marketed as "lower risk" than cigarettes. Michael M. Santiago/Getty Images hide caption It comes in flavors like "Cool Mint," "Smooth" and "Chill." It's on the Ferrari F1 race car. And it's addictive. A paperclip-size pouch filled with bleach-white fibers and nicotine crystals, placed between the lip and gum, leeches nicotine and other chemicals into the user's bloodstream — allowing anyone to use nicotine discreetly. One of the most popular brands of nicotine pouches, Zyn, got a boost from the Food and Drug Administration recently. The FDA authorized the company to advertise: "Using Zyn instead of cigarettes puts you at a lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and chronic bronchitis." Bret Koplow, acting director of the FDA's Center for Tobacco Products, said in a press release that the decision "is intended to ensure that adult users have clear, science-based information about the relative harms of tobacco products, so they can make informed choices." For the latest stories on the science of healthy living, subscribe to NPR's Health newsletter. Some public health researchers say that Zyn is a safer alternative to cigarettes and it can help curb the 480,000 or more U.S. deaths attributable to tobacco each year. But others also say it can be a gateway to riskier nicotine habits like smoking and hook people in adolescence. Nicotine is a drug extracted from the tobacco plant, though some companies use lab-made nicotine in their products. Advocates of nicotine pouches emphasize their safety compared to cigarettes and other tobacco products that users burn. Mitch Zeller, a professor at Dartmouth Geisel School of Medicine and former director at the FDA's Center for Tobacco Products, says the pouches are "demonstrably less harmful than burning tobacco leaves and inhaling the 7,000 chemicals that are in tobacco smoke." He says when it comes to heavy smokers who want to quit, it's a "no-brainer" to switch to nicotine pouches. Zyn underscored that idea in an interview with NPR. Brian Erkkila, director of external affairs and head of scientific engagement for Zyn's parent company Philip Morris International, says Zyn helped him quit cigarettes and he wonders if it could have helped his father — who died from lung cancer — had it been available. Still, Erkkila says "nicotine is addictive and is not risk-free." When it comes to nicotine pouches, Bonnie Halpern-Felsher, a professor of pediatrics at Stanford University, agrees they have "meaningful harm reduction potential" for current smokers. She notes risks may include heart issues, neurological and psychiatric illnesses and dental problems. It is too soon to know if nicotine pouches raise the risk of oral cancer. "We don't know all the effects of these newer oral nicotine products," she says, explaining that it took over 50 years to fully understand the harmful effects of cigarettes. Zyn products have been around for about a decade in the U.S. Shots - Health News RFK Jr.'s MAHA report on children's health leaves something out: nicotine Dr. Robert Jackler is a Stanford University professor emeritus who runs a research group on tobacco advertisements. He points out that Zyn and other nicotine pouches aren't approved smoking cessation tools, such as nicotine gum or patches. He also says Zyn's positioning with high-nicotine products, flavored products and relentless marketing runs counter to promoting cessation. Jackler says names for flavors with words like "cool," "smooth" and "chill" work to promote Zyn "as a lifestyle enhancer." He adds that Zyn has advertisements with active people like mountain climbers and compares Zyn to coffee and alcohol — to "portray it as safe and healthy." In response, Erkkila told NPR that Philip Morris International is committed to responsible marketing and that they only target advertisements to adults. What does this mean? Mary Hrywna, a professor at Rutgers School of Public Health, agreed that flavors may help adult tobacco users switch to nicotine pouches. But Hrywna and all the experts we spoke to say it should not be used by kids. The risks may outweigh the benefits "if kids start to use this product," Zeller says. If that happens, he notes the FDA may pull authorization. "That's not harm reduction," he says. The same study found 4.4% of 12th-graders in 2025 reported using nicotine pouches within the past 30 days. The number of teens saying they had tried using nicotine pouches has experts worried. Emily Hilliard, a senior press secretary for the Department of Health and Human Services, told NPR: "[the] FDA remains committed to preventing youth access to and use of tobacco products and continues to enforce the federal minimum age of 21 for the sale of all tobacco products." She also reiterated that "there is no safe tobacco product." Halpern-Felsher says schools find evidence of nicotine pouch use as litter, and they are easy for students to conceal and hard for schools to police. Her lab publishes a curriculum for adolescents on the risks of oral tobacco and other drugs. Halpern-Felsher collaborates with several school systems, and she encourages parents to talk to their kids about Zyn. Hrywna says nicotine has "an impact on brain development" and stresses there is "no compelling health reason" for adolescent use of nicotine. Jackler says he's seen many patients with complications from nicotine use. He says: "Don't start. Don't get hooked on this. You know, it's not worth it.