Nicotine pouches: a summary of regulatory approaches across 67 countries

Abstract

IntroductionNicotine pouches are small, permeable pouches containing nicotine. The nicotine may either be derived from tobacco plants or synthetically produced. Nicotine pouches are available worldwide, but little is known as to how various countries regulate these products. This study summarises nicotine pouch regulatory policies across 67 countries.MethodsThis research summarises insights obtained through active policy surveillance work in which we requested information on the availability of nicotine pouches and applicable policies and analysed responses from representatives of 67 countries (representatives included subject matter experts in government or civil society organisations). These countries span all WHO regions.ResultsWe found significant variation in how countries classify nicotine pouches, with many countries’ current regulatory approach failing to regulate nicotine pouches that used synthetic nicotine. We found 34 countries regulate nicotine pouches with 23 of these countries’ policies encompassing synthetic nicotine. Countries regulating both synthetic and tobacco-derived nicotine pouches generally (1) rely on existing policies for tobacco products and/or medicines or (2) have developed new policies or regulatory classifications that specify nicotine as the substance at issue rather than linking policies solely to tobacco.ConclusionOur work offers novel insight into nicotine pouch markets and national regulatory approaches. Policy approaches vary from not regulating nicotine pouches at all to banning both forms of nicotine pouches. Policies used by countries regulating both tobacco-derived and synthetic nicotine pouches offer a roadmap for how other jurisdictions can add effective guardrails to the use of these and other non-medicinal nicotine products.

Small pouches, but high nicotine doses—nicotine delivery and acute effects after use of tobacco-free nicotine pouches

“…In the landscape of alternative nicotine delivery systems (ANDS), nicotine pouches are among the most recent products. Where available, they are mostly not adequately addressed with specific regulations regarding, for example, the nicotine content ( Duren et al, 2023 ). Scientific knowledge on these products is scarce and was predominantly generated by the manufacturers of the products.…”

Tobacco industry strategies to influence the regulation of new and emerging tobacco and nicotine products in Latin America and the Caribbean

“…Published documents in the Latin America and Caribbean region or that mentioned this region were included. Analysis only focused on electronic cigarettes and heated tobacco products since oral nicotine products or other new products were just beginning to enter the region at the time of this study ( 19 ). We found 81 documents of which 63 were considered relevant.…”

Tobacco control policy and regulation from diverse perspectives and contexts

“…Other nicotine and related products present regulatory conundrums. Duren et al bring together regulatory approaches for nicotine pouches across 67 countries, 21 highlighting the challenge of products that do not easily fit existing product categories. Moving from a global to local approach, Kong et al describe the emergence of 'tobacco-free blunts' in the USA, 22 with youth-appealing features used to smoke cannabis.…”