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A UBC OkResearcher Anagan is sounding the alarm about how nicotine pouches are portrayed on TikTok, saying the videos are normalizing their use and making them look trendy, especially among young people.
Nicotine pouches, which are placed in the mouth between the gum and cheek, are authorized by Health Canada to help adults quit smoking, but are not allowed for those under 18 years of age.
UBCO School of Nursing Associate Professor Dr. Laura Struik and a team analyzed 250 videos that had garnered nearly two million shares and generated more than 16 million likes according to the platform’s metrics.
On the platform, Users emphasized how nicotine pouches can be used discreetly.
“Many of the videos featured people describing how these bags fit naturally into their lifestyle,” Struik explained, “you can use them no matter what you’re doing, whether it’s exercising or socializing.”
A study conducted at the University of BC’s Okanagan campus analyzed more than 250 TikTok videos and found that nicotine pouches were portrayed in a resoundingly positive light to young people. Laura Struik, who works at UBCO’s nursing school, says the portrayal can be problematic since exposure to nicotine at a young age can interfere with body development.
This, he said, comes as the use of nicotine pouches among young people has increased. A cross-sectional study of survey data from the United States indicates that use among high school students nearly doubled between 2023 and 2024.
TikTok creators also talked about how being a nicotine pouch user made them part of a shared group, Struik explained.
“That’s particularly appealing to young people because teenagers are still in the process of figuring out who they are.”
While most of the videos “loved” the use of bags, Struik said only six percent of them talked about the serious health problems that can result from prolonged use, including gum recession, oral cancer and heart problems.
For a young person, the problems may be more serious. Nicotine disrupts brain development and interferes with memory, learning, stress and impulse control, Struik said.
Health Canada said only two pouch brands are authorized for sale in the country, Zonnic and NEÖ, but Struik said researchers found young people are finding and purchasing unauthorized brands online, in convenience stores and at vape shops.
“The regulations exist, but enforcement is clearly lacking,” Struik said.
Health authorities take strong measures
BC says it was the first jurisdiction to crack down on recreational bag use and, in 2024, restricted the sale of buccal (cheek) nicoBags of teeth behind the counter in pharmacies.
“This measure ensures that pharmacists can exercise their professional judgment and prevents young people from accessing retail settings for all ages,” a Health Ministry spokesperson said in a statement, adding that officials from regional health authorities monitor compliance.
The federal government announced similar measures several months after BC, after it said there were growing concerns that the popularity orf nicotine replacement therapies (NRT) led to recreational use by youth under 18 years of age.
Multiple health organizations are calling on the Canadian government to stop the marketing and sale of flavored nicotine pouches to minors.
Federal measures included banning ads or promotions that might appeal to young people, allowing sales only to pharmacists or those who work under their supervision, and restricting mint or menthol flavors.
“In an effort to prevent unauthorized nicotine products from reaching the public, Health Canada is also working closely with the Canada Border Services Agency, the Royal Canadian Mounted Police and provincial and territorial public health units,” it said in a statement.
Health Canada said since 2024 it has handled more than 300 enforcement cases involving the sale or advertising of unauthorized nicotine pouch products at various retailers. It said it issued enforcement notices, conducted site visits and seized products.
Struik believes young people should have a seat at the table with decision makers when it comes to setting rules related to nicotine pouches.
“We need young people to drive the messages,” he said, “young people know their context. Adults just don’t know it, we don’t understand it.”
