In response to growing concerns about the rising use of nicotine replacement therapies (NRTs) among youth, particularly nicotine pouches, Health Minister Mark Holland is putting through restrictions aimed at curbing their appeal and accessibility.
These measures, which will take effect Aug. 28, include strict advertising restrictions, prohibiting certain flavours and limiting sales to behind the counter at pharmacies, Holland announced Thursday.
“As of next Wednesday, there’s a couple of things that are going to happen. The first is these products are going to be moved behind the counter. They’re going to pharmacies and they’re going to only be available on the other side of the counter,” Holland told Global News in an interview.
“The second thing is these nonsense flavours targeting our kids are gone … so Tropical Breeze and Cool Berry Splash … whatever they have, it’s over. Those products will be recalled and unavailable.”
Nicotine pouches, designed for smoking cessation, have been approved for use in Canada since October 2023 and are regulated under the Food and Drugs Act.
Health Canada has approved the sale of Zonnic, a flavoured nicotine pouch from Imperial Tobacco, which sells flavoured pouches like Tropic Breeze and Berry Frost.
According to the company’s website, Zonnic helps adult smokers quit by delivering nicotine to the body in a controlled manner.
The authorized pouch contains four milligrams of nicotine per dose, roughly the equivalent of three to four cigarettes, and is used by placing it in the mouth between the gums and the cheek or the upper or lower lip. There it releases nicotine into the system, similar to snus pouches popular in Sweden.
Nicotine pouches are not authorized for those under 18 years old, but Health Canada has previously said that the pouches have become popular with youth and may lead to addiction.
Children and teenagers are especially susceptible to the addictive properties of nicotine as brain development continues throughout adolescence and into early adulthood. Even using small amounts of nicotine may increase the risk of developing a dependence on nicotine in the future, Health Canada warns on its website.
Last year, the introduction of nicotine pouches to the Canadian market sparked immediate concern from health organizations like the Canadian Cancer Society.
The Canadian Cancer Society voiced concern that without proper regulations, similar to those governing cigarette smoking, children face the risk of becoming addicted to these products.
This issue has raised concerns not only in Canada but also in other countries, where alarms have been sounded over the increasing use of nicotine pouches among youth. In 2023 the Netherlands and Belgium announced they were banning the sale of all types of nicotine pouches.
Get weekly health news
Receive the latest medical news and health information delivered to you every Sunday.
A 2024 study published in Nicotine and Tobacco Research found that while nicotine pouches are less toxic than cigarettes, they can still pose health risks, and the way tobacco companies market them may encourage youth initiation.
“In the United States, the potential public health impact of Oral nicotine pouches (ONPs) is especially relevant because of steadily rising trends in awareness and use, particularly among young adults,” the study said. “The wide variety of ONP flavors and aggressive marketing campaigns have the potential to appeal to youth and young adults, providing another pathway to nicotine dependence. ”
What are the new measures?
Last November, after Canada approved the sale of nicotine pouches, Holland vowed to close the regulatory loophole that allowed their introduction.
Since their launch, nicotine pouches have been available for sale across Canada, at places like gas stations and convenience stores, without being restricted to over-the-counter sales. They come in a wide variety of colours and flavours.
Despite their legality, British Columbia implemented restrictions in February, limiting the sale of nicotine pouches to behind-the-counter purchases in pharmacies. No prescription is required, but purchasers need to speak to a pharmacist to get it. Quebec also adopted a similar approach, allowing the sale of nicotine pouches only in pharmacies.
Now, Health Canada aims to cast a wider net by making these restrictions nationwide.
“We’ve been deeply disturbed by what the tobacco companies have done. They used a loophole that was supposed to be there to help people stop smoking to addict kids to nicotine pouches,” Holland said.
The measures being implemented include:
- Prohibit advertising or promotion, including labelling and packaging, that could be appealing to youth.
- Require NRTs in new and emerging formats, such as nicotine pouches, to be sold only by a pharmacist or an individual working under the supervision of a pharmacist, and to be kept behind the pharmacy counter.
- Prohibit NRTs in new and emerging formats, such as nicotine pouches, from being sold with flavours other than mint or menthol.
- Require a front of package nicotine addiction warning, as well as a clear indication of the intended use as a smoking cessation aid for adults trying to quit smoking.
- Require manufacturers to submit mock-ups of labels and packages for all new or amended NRT licences to ensure no youth appeal.
Holland noted that there isn’t a full ban on nicotine pouches, as he believes they serve a purpose in helping adults quit smoking.
He expressed hope that these restrictions will lead to the “denormalization” of the industry.
“And one of the things that we did that’s so important is we maintained a power that we can deploy now — before we had to get legislation. This is why it took so long. We had to legislate these powers,” Holland said.
“Now they’re in place. So if (tobacco companies) slink out of some new loophole, if they if they try to come out of some new crevice, we have the ability to act immediately using these powers to shut them down.”
‘Major concern is addiction’
Dr. Shawn Aaron, a respirologist at the Ottawa Hospital, emphasized that the Canadian government’s measures against nicotine pouches are “very important.”
“The big danger with nicotine pouches is that the tobacco companies are marketing them towards the young people, they were adding all sorts of fancy fruit flavors, and they’re putting them in attractive looking packaging,” he said. “This was obviously designed to entice young people… perhaps even teenagers and adolescents to start buying these products.”
Nicotine patches aren’t technically tobacco, he said, but rather they contain synthetic nicotine. Often, these patches are enhanced with flavorings and pleasant scents to make them more appealing.
Aaron explained that it works by having a person take the pouch, place it in their mouth between their gum and lip, and suck on it. The nicotine is then absorbed into the bloodstream.
“It’s a it’s a way of, delivering nicotine into the body, without having to smoke it,” he said. “But the major concern is still addiction. If you’ve never used nicotine and you start using it in this form, you will quickly get addicted to nicotine. Nicotine is one of the most highly addictive substances known to man.”
— with files from Global News’ Elizabeth McSheffrey