The majority of research to date on the advertising and promotion of oral nicotine products has been conducted overseas where there are fewer regulations on the products (see Section 18C.8). In Australia, it is unlawful to advertise nicotine pouches, including when advertising these products for the purposes of smoking or vaping cessation1 (see Section 18C.7). Nonetheless, there are recent reports of the products being promoted and sold in Australia, as outlined below.
18C.2.1 Exposure to advertising
In the US between January 2019 and September 2021, nicotine pouch manufacturers spent nearly $25 million advertising leading brands.2 A 2022 online survey of young adults in the US found that almost one-third (31.4%) of those aware of nicotine pouches had been exposed to advertising in the past month. The most common source by far was tobacco retailers, followed by social media or other websites.3
18C.2.2 Messages in advertising
Marketing materials for non-therapeutic oral nicotine products typically emphasise their variety of flavours, and describe them as discreet, convenient, and cost-effective compared with tobacco and e-cigarettes.4-6 Marketing headlines have focused on ‘freedom’ and ‘innovation’2 and emphasise that nicotine pouches can be used anywhere;7 descriptions of the products as ‘spit free’ and ‘smoke free‘ highlight their potential use in places where tobacco use is prohibited or discouraged.8 Companies also use descriptors such as ‘tobacco-free’ ‘tobacco leaf-free’ and ‘all white’ in their marketing.9, 10 ‘Tobacco-free’ pouches often refer to those that contain synthetic rather than tobacco-derived nicotine, which may be perceived as a better/healthier product by consumers.11
Packaging generally features the nicotine strength or concentration, and some brands highlight the satisfaction and enjoyment users will experience from nicotine.12 One analysis noted that terms such as ‘tobacco-free nicotine’ and ‘pharmaceutical grade nicotine’ and ingredients labelled “generally recognised as safe by FDA” could alleviate health concerns. 7 In the US, in response to policies restricting the sale of products with characterising flavours, nicotine pouches have been marketed at “flavour ban approved” or “unflavoured.”13 An analysis of these products found that they did in fact contain flavouring agents, highlighting that effective strategies are needed to prevent the industry circumventing regulations. 14
18C.2.3 Forms of advertising and promotion
An analysis of non-therapeutic oral nicotine marketing strategies in the US found that products were predominantly marketed via radio and television, with a smaller proportion occurring via mobile phones and online.2 Cross-promotion with tobacco products has also been documented; for example, advertisements for nicotine pouches appearing on cigarette websites.15 Tobacco companies have reportedly sponsored music and sporting events, and given away free samples of nicotine pouches at music festivals.16, 17
Exposure to promotion appears to increase willingness to use the products.18 Despite industry claims that their products will not appeal to youth, researchers have pointed out that strategies such as packaging that is colourful, sleek and sometimes indistinguishable from food products (e.g., chewing gum), claims of relative safety, appealing flavours, availability to young people, and use of social media for promotion may particularly attract youth and non-nicotine users.19
Product and packaging features
There is concern that the range of mint and fruit flavours available in non-therapeutic oral nicotine products, as well as the resemblance of the products to gum or lollies, could attract young people and facilitate and sustain use and addiction. Tobacco products and e-cigarettes in these flavours are known to appeal to adolescents and young adults.20, 21 Sales data in the US show strong growth of fruit-flavoured pouches in recent years,9 and among high school students who reported use of nicotine pouches in 2023, more than four in five reported using flavoured products.22 “Tobacco-free” descriptors may also promote an erroneous sense of safety among young people who are aware of the harms of tobacco, but not nicotine.11, 23 Nicotine pouch packaging is often sleek and uses appealing colours and flavours.12
An experimental study with young adults who vape and/or smoke found that mint-flavoured and menthol-flavoured pouches were more appealing than ‘smooth’ pouches. Hypothetical “modified risk” claims (e.g., “Using this product instead of cigarettes puts you at a lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema and chronic bronchitis”) increased perceptions of pouches as less harmful than cigarettes but not e-cigarettes, and increased intentions to use pouches. However, the authors note that intentions to switch were low, and dual use of nicotine pouches and tobacco products may be more likely—particularly as pouches can be used so discreetly.24 The ease of hiding the products from parents and teachers has been flagged as particularly concerning in light of the role this played in the proliferation of vaping.23
Social media
In 2021, a joint letter from 100 public health and other organisations from 53 countries to the CEOs of Facebook, Instagram, TikTok and Twitter called for an immediate ban on promotion of nicotine pouches on their platforms, including prohibiting paid promotion by influencers. The letter noted a sharp increase in tobacco companies using social media platforms to promote nicotine pouches to young people, including both the use of paid influencers and traditional advertisements on the platforms.25
Despite subsequently banning the promotion of nicotine pouches, marketing on social media still appears to be common. Australian fitness influencers are promoting nicotine pouches on TikTok as an effective method to quit vaping.26 An analysis of a social media campaign by BAT to promote Velo pouches in 2023 found that more than one-quarter (28%) of the audience was between 12 and 24 years old. Eleven influencers, including DJs, lifestyle influencers, and gamers, published 48 posts to an audience of more than 1.4 million people, mostly located in the UK. Instagram removed the content after being contacted by the Guardian.27 There are reports in the UK of nicotine pouches being promoted and sold on TikTok in tins labelled as Skittles, Tic Tacs and Millions, including products containing very high levels of nicotine.28 Users are also sharing their own product and use experiences with nicotine pouches on social media sites such as Reddit.29
18C.2.4 Retail accessibility
Each of the major brands of oral nicotine products has its own website, where products can easily be purchased. An analysis of brand websites in the US found that none used adequate ID verification to prevent sales to minors.7 In countries where non-therapeutic oral nicotine products are permitted to be sold by retailers, such as Canada, the US, and the UK, the products are widely available in convenience stores, supermarkets, and pharmacies.30, 31 In the UK and Canada, they can be sold to children (see Section 18C.8). In Australia, despite sale of the products being illegal (see Section 18C.7), there are reports of nicotine pouches entering physical retail settings. NSW Health recently announced that 284 containers were seized across 60 Sydney retailers between 29 th January and 2 nd February.32 Pouches are also reportedly being sold on several websites in Australia.26
References
1. Therapeutic Goods Administration. Nicotine pouches. Australian Government Department of Health and Aged Care, 2024. Available from: https://www.tga.gov.au/products/unapproved-therapeutic-goods/vaping-hub/nicotine-pouches
2. Duan Z, Henriksen L, Vallone D, Rath JM, Evans WD, et al. Nicotine pouch marketing strategies in the USA: an analysis of Zyn, On! and Velo. Tobacco Control, 2022. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35817549
3. Tosakoon S, Romm KF, and Berg CJ. Nicotine pouch awareness, use and perceptions among young adults from six metropolitan statistical areas in the United States. Tob Prev Cessat, 2023; 9:19. Available from: https://www.ncbi.nlm.nih.gov/pubmed/37293565
4. Majmundar A, Okitondo C, Xue A, Asare S, Bandi P, et al. Nicotine Pouch Sales Trends in the US by Volume and Nicotine Concentration Levels From 2019 to 2022. JAMA Netw Open, 2022; 5(11):e2242235. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36378312
5. Sparrock LS, Phan L, Chen-Sankey J, Hacker K, Ajith A, et al. Nicotine Pouch: Awareness, Beliefs, Use, and Susceptibility among Current Tobacco Users in the United States, 2021. International Journal of Environmental Research and Public Health, 2023; 20(3). Available from: https://www.ncbi.nlm.nih.gov/pubmed/36767414
6. Borowiecki M, Emery SL, and Kostygina G. New recreational nicotine lozenges, tablets, gummies and gum proliferate on the US market. Tobacco Control, 2022. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36319083
7. Ling PM, Hrywna M, Talbot EM, and Lewis MJ. Tobacco-Derived Nicotine Pouch Brands and Marketing Messages on Internet and Traditional Media: Content Analysis. JMIR Form Res, 2023; 7:e39146. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36790840
8. Czaplicki L, Patel M, Rahman B, Yoon S, Schillo B, et al. Oral nicotine marketing claims in direct-mail advertising. Tobacco Control, 2022; 31(5):663-6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33958422
9. Marynak KL, Wang X, Borowiecki M, Kim Y, Tynan MA, et al. Nicotine Pouch Unit Sales in the US, 2016-2020. Journal of the American Medical Association, 2021; 326(6):566-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34374729
10. Robichaud MO, Seidenberg AB, and Byron MJ. Tobacco companies introduce 'tobacco-free' nicotine pouches. Tobacco Control, 2020; 29(e1):e145-e6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31753961
11. Morean ME, Bold KW, Davis DR, Kong G, Krishnan-Sarin S, et al. "Tobacco-free" Nicotine Pouches: Risk Perceptions, Awareness, Susceptibility, and Use Among Young Adults in the United States. Nicotine & Tobacco Research, 2023; 25(1):143-50. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36000776
12. Mays D, Long L, Alalwan MA, Wagener TL, Shang C, et al. The Effects of Oral Nicotine Pouch Packaging Features on Adult Tobacco Users' and Non-Users' Product Perceptions. International Journal of Environmental Research and Public Health, 2023; 20(4). Available from: https://www.ncbi.nlm.nih.gov/pubmed/36834078
13. Tackett AP, Barrington-Trimis JL, and Leventhal AM. 'Flavour ban approved': new marketing strategies from tobacco-free nicotine pouch maker Zyn. Tobacco Control, 2023; 32(e1):e134-e5. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35459750
14. Jabba SV, Erythropel HC, Woodrow JG, Anastas PT, O'Malley S, et al. Synthetic cooling agent in oral nicotine pouch products marketed as 'Flavour-Ban Approved'. Tobacco Control, 2023. Available from: https://www.ncbi.nlm.nih.gov/pubmed/37380351
15. Talbot EM, Giovenco DP, Grana R, Hrywna M, and Ganz O. Cross-promotion of nicotine pouches by leading cigarette brands. Tobacco Control, 2023; 32(4):528-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34670870
16. Afanasieva D. Big Tobacco Pushes Nicotine Pouches as Vaping Hit by Curbs. Bloomberg, 2023. Available from: https://www.bloomberg.com/news/articles/2023-04-15/big-tobacco-pushes-nicotine-pouches-as-vaping-hit-by-curbs
17. Chapman M. New products, old tricks? Concerns big tobacco is targeting youngsters. The Bureau of Investigative Journalism, 2021. Available from: https://www.thebureauinvestigates.com/stories/2021-02-21/new-products-old-tricks-concerns-big-tobacco-is-targeting-youngsters
18. Vogel EA, Barrington-Trimis JL, Kechter A, Tackett AP, Liu F, et al. Differences in Young Adults' Perceptions of and Willingness to Use Nicotine Pouches by Tobacco Use Status. International Journal of Environmental Research and Public Health, 2022; 19(5). Available from: https://www.ncbi.nlm.nih.gov/pubmed/35270385
19. Unger JB, Barker J, Cruz TB, Leventhal AM, and Pentz MA. Lucy-Novel Flavored Nicotine Gum, Lozenges, and Pouches: Are They Misleading Consumers? Substance Use and Misuse, 2022; 57(8):1328-31. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35586938
20. US Department of Health and Human Services. Preventing tobacco use among young people: A report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2012. Available from: https://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm
21. Measham F, O’Brien K, and Turnbull G. “Skittles & Red Bull is my favourite flavour”: E-cigarettes, smoking, vaping and the changing landscape of nicotine consumption amongst British teenagers – implications for the normalisation debate. Drugs: Education, Prevention and Policy, 2016; 23(3):224-37. Available from: http://dx.doi.org/10.1080/09687637.2016.1178708
22. Birdsey J, Cornelius M, Jamal A, Park-Lee E, Cooper MR, et al. Tobacco Product Use Among U.S. Middle and High School Students - National Youth Tobacco Survey, 2023. Morbidity and Mortality Weekly Report, 2023; 72(44):1173-82. Available from: https://www.ncbi.nlm.nih.gov/pubmed/37917558
23. Tackett AP, Wong M, Cho J, Harlow AF, Vogel EA, et al. Willingness to Use Commercial Nicotine Gums, Lozenges, and Gummies Among Nontobacco Using Adolescents in Southern California. The Journal of Adolescent Health, 2023; 72(2):277-86. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36470691
24. Vogel EA, Tackett AP, Unger JB, Gonzalez MJ, Peraza N, et al. Effects of flavour and modified risk claims on nicotine pouch perceptions and use intentions among young adults who use inhalable nicotine and tobacco products: a randomised controlled trial. Tobacco Control, 2023. Available from: https://www.ncbi.nlm.nih.gov/pubmed/38148143
25. Over 100 Organizations Call on Social Media Companies to End Nicotine Pouch Advertising, Including by Paid Influencers. Campaign for Tobacco-free Kids, 2021. Available from: https://www.tobaccofreekids.org/press-releases/2021_10_26_nicotine-pouch-ads-social-media
26. May N. All good to take to school?’: Australian influencers promote flavoured nicotine pouches to vape-addicted youths. The Guardian, 2024. Available from: https://www.theguardian.com/australia-news/2024/feb/07/all-good-to-take-to-school-australian-influencers-spruik-flavoured-nicotine-pouches-to-vape-addicted-youths
27. Marsh S. Instagram influencers advertising nicotine products to young people, charity warns. The Guardian, 2023. Available from: https://www.theguardian.com/business/2023/jun/12/instagram-influencers-advertising-nicotine-products-to-young-people-charity-warns
28. Dresch M. Sweet flavour nicotine pouches as strong as 100 cigarettes promoted to kids on TikTok. Mirror, 2023. Available from: https://www.mirror.co.uk/news/uk-news/sweet-flavour-nicotine-pouches-strong-31304132
29. Shao Y, Zou J, Xie Z, Mayne RG, Ossip DJ, et al. Perceptions of Oral Nicotine Pouches on Reddit: Observational Study. Journal of Medical Internet Research, 2022; 24(7):e37071. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35838764
30. Dangerfield K. What are nicotine pouches? Why health experts are sounding the alarm in Canada. Global News, 2023. Available from: https://globalnews.ca/news/10090440/nicotine-pouches-canada-kids/
31. Callard C. Sesh+: Another nicotine product hits convenience store shelves. Physicians for a Smoke-Free Canada, 2023. Available from: https://gem.godaddy.com/p/240f261
32. NSW Health. Sixty retailers targeted in major vaping blitz across Sydney. 2024. Available from: https://www.health.nsw.gov.au/news/Pages/20240206_00.aspx.