Nicotine pouches: health challenge?

Pakistan’s nicotine pouch market represents a complex intersection of public health concerns, regulatory challenges, and shifting consumer behaviors that demand a careful scrutiny. Recent studies indicate that approximately 17.2% of surveyed participants reported using nicotine pouches, highlighting their growing presence in Pakistani society (2023). These products, while marketed as a safer alternative to traditional tobacco, raise significant concerns about their impact on public health and their potential to create new pathways to nicotine addiction.

The demographic patterns of nicotine pouch use in Pakistan reveal troubling trends, particularly among young adults. Research shows that the mean age of users is 20.6 years, with many initiating use either out of curiosity or as an attempted pathway to quit conventional cigarette smoking.

This youth-centric adoption pattern is particularly concerning given that these products are being marketed in Pakistan at an unprecedented rate, despite limited information about their adverse effects (2023). The situation is further complicated by the fact that Pakistan operates in a regulatory vacuum regarding nicotine pouches, with no specific regulations governing their sale or distribution.

The rapid expansion of nicotine pouches in Pakistan’s market is driven by sophisticated marketing strategies and social media influence. Companies actively promote these products through social media platforms, with a sudden upsurge in advertisements and even free distribution across various cities.

This marketing approach particularly targets youth through appealing flavors and discrete usage possibilities, making the products especially attractive to younger demographics (2024). Industry figures demonstrate the success of these strategies, with one brand alone reporting sales of 40 million pouches monthly in Pakistan.

The health implications of nicotine pouch use present a complex challenge for Pakistan’s public health system. While these products may appear less harmful than traditional tobacco, they carry significant risks. These include increased heart rate and blood pressure, which may elevate cardiovascular disease risks.

Additionally, users frequently report mouth sores and gum irritation, particularly in areas where pouches are placed. The lack of saliva production caused by nicotine can lead to increased risk of tooth decay and other dental problems.

These health concerns are particularly worrisome, given that Pakistan already struggles with a substantial burden of tobacco-related illness, with tobacco responsible for over 163,600 deaths annually. Among these, approximately 31,000 are attributed to secondhand smoke exposure, underscoring the widespread impact of tobacco consumption on public health.

The regulatory environment surrounding nicotine pouches in Pakistan remains notably inadequate. Despite being a signatory to the WHO Framework Convention on Tobacco Control since 2004, Pakistan’s tobacco laws primarily focus on cigarettes and lack comprehensive coverage of newer nicotine products.

This regulatory gap has created a situation where nicotine pouches are sold as consumer products without specific oversight, potentially compromising public health interests and making it difficult to implement effective control measures.

The economic dynamics of nicotine pouches in Pakistan reflect a broader shift in tobacco consumption patterns. Traditional smokeless tobacco use remains significant, with about 10 million users in Pakistan comprising over 40% of overall tobacco use.

However, the rapid adoption of nicotine pouches, particularly in urban areas, suggests a potential disruption to established tobacco markets. This transition, while potentially reducing exposure to some harmful tobacco components, raises concerns about creating new pathways to nicotine addiction, particularly among youth who might not otherwise have initiated tobacco use.

The situation demands immediate attention from policymakers and public health officials. Current evidence suggests that about 40% of participants have adequate knowledge about these products, while 50.6% maintain a negative attitude towards them (2023). However, the lack of comprehensive research on long-term health effects, combined with aggressive marketing strategies, creates a dangerous environment where young people might initiate nicotine use without fully understanding the risks.

As Pakistan continues to grapple with this emerging public health challenge, there is an urgent need for comprehensive regulations, enhanced public education, and stronger measures to prevent youth access to these products, particularly given the country’s existing burden of tobacco-related mortality and morbidity.

Introducing stringent regulatory measures to monitor the manufacturing, marketing, and distribution of nicotine pouches is imperative. Additionally, public health campaigns aimed at raising awareness about the risks of nicotine pouches, especially among youth, are essential to curb their widespread adoption.

Collaboration with international organizations, such as the WHO, could help Pakistan develop a robust framework for regulating nicotine products. Learning from countries that have successfully implemented nicotine product regulations can also provide valuable insights. Furthermore, engaging local communities and youth advocacy groups in prevention campaigns could significantly impact reducing the appeal of nicotine pouches to younger demographics.

Research institutions and public health experts must prioritize longitudinal studies to assess the long-term health effects of nicotine pouch use. Such research will not only fill critical knowledge gaps but also equip policymakers with evidence-based data to formulate effective strategies for tackling this issue.

In conclusion, while nicotine pouches are marketed as a harm-reduction product, their growing prevalence in Pakistan poses a significant public health challenge. The combination of aggressive marketing, lack of regulation, and youth-centric adoption patterns underscores the urgent need for action.

Without timely interventions, nicotine pouches may exacerbate the country’s existing tobacco-related health crisis, creating new avenues for addiction and perpetuating health disparities. Addressing this issue requires a multifaceted approach, combining regulation, education, and community engagement to safeguard public health and mitigate the risks associated with nicotine pouch use.

(Radma is a Research Assistant at SDPI, and Mahrukh is an Intern at SDPI. The views expressed in this article are not necessarily those of the newspaper)

Copyright Business Recorder, 2025