How Nicotine Pouches Are Hooking the Young in Pakistan

APP 

Islamabad: Sleek tins, fruity flavours, and the promise of “smoke-free relief” are quietly luring a growing number of young Pakistanis into addiction. Nicotine pouches — small white packets placed between the gum and lip — deliver a sharp dose of nicotine without smell or ash and are rapidly becoming a daily habit among teenagers and young adults.

Recent global studies indicate that use of nicotine pouches among 16- to 24-year-olds has tripled since 2022, rising from under one percent to 3.6 percent in 2024. 

Experts warn that Pakistan is following a similar trajectory, with shops and online sellers offering the products freely, with no age restrictions or warning labels.

Zar Wali, a cobbler in Islamabad who also sells pouches on the street, told APP that demand is surging. “A 20-pouch tin costs around Rs 250 to 300. Brands like Velo, Zyn, and Loop are popular — mint, coffee, berry, whatever you want,” he said. “People buy them every day.”

Each pouch contains 3–14 milligrams of nicotine, absorbed through the soft tissues of the mouth. While one pouch lasts about an hour, many users consume an entire tin daily.

“It costs me Rs 300 a day, but I can’t stop now,” said Murtaza, alias Sherry, a barber from Pandorian, Islamabad. “It gives a stronger kick than cigarettes, and no one even notices, not even at work.”

Health experts caution that the absence of smoke does not make these products safe. “They cause gum irritation, swelling, and mouth sores,” said Dr Farah Malik, a dental surgeon in Islamabad. “Long-term use damages soft tissues, leading to gum disease, oral infections, and even tooth loss.”

Some users face graver consequences. Subhan, a private driver from Rawalpindi, began using nicotine pouches to quit smoking. Within months, he became addicted. “I used one every hour,” he said. “Later, doctors told me I had pancreatic cancer. Surgery cost me over Rs 2.5 million, and I’m still on chemotherapy.”

Dr Ateeq ur Rehman, a cancer specialist in Islamabad, noted that pancreatic cancer has a survival rate below 10 percent when detected late. While no direct link between nicotine pouches and pancreatic cancer has been established, he warned that prolonged nicotine exposure harms major organs. 

“Nicotine is toxic,” he said. “It raises blood pressure, affects the heart, liver, and pancreas, and disrupts cell function. Continuous intake — even through smokeless products — increases the risk of chronic disease and possibly cancer.”

Pakistan’s tobacco laws ban cigarette sales to anyone under 18, but nicotine pouches escape regulation because they are not classified as tobacco products. “It’s a dangerous loophole,” said a senior official at the Tobacco Control Cell.

 “These contain pure nicotine — the same addictive chemical as in cigarettes — yet children can buy them freely.”

Globally, regulators are beginning to respond. In the United Kingdom, health groups such as Action on Smoking and Health have called for strict packaging and age limits. In the United States, the Food and Drug Administration is reviewing rules following a surge in teenage use.

Doctors and educators in Pakistan warn that without awareness campaigns and clear laws, the problem could escalate rapidly. “It’s like naswar or cigarettes — the addiction starts quietly but becomes hard to escape,” said Dr Malik. “This one just hides behind a modern image.”

A recent national survey of 14,232 children aged 10–16 found that 3.4 percent of boys and 2.7 percent of girls reported having used nicotine pouches, a higher share than those who reported smoking cigarettes. Nearly one-third of respondents said they would accept a nicotine pouch if offered by a friend, and roughly one in three said they found it “easy” to buy such products.

A separate point-of-sale survey revealed that although nicotine-pouch outlets comprised just 7.9 percent of stores across nine Pakistani districts, nearly 12 percent displayed dedicated advertising, and many placed products within children’s reach.

 The findings highlight how easy availability and social normalisation are driving early uptake among youth — a worrying indicator of how widespread this “modern alternative” has become.

As cases of tobacco-related illness rise, experts fear that this new form of “smokeless addiction” could spread unchecked unless authorities act decisively to curb access and educate the public.