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Why are nicotine pouches making Canadian headlines?
Health experts across Canada are drawing attention to nicotine pouches as they hit the market, urging the federal government to immediately regulate the product due to their accessibility to children.
Under the Natural Health Product Regulations, Health Canada approved the sale of flavoured nicotine pouches from Imperial Tobacco Canada under the name Zonnic earlier this year.
Imperial Tobacco Canada calls its product "a new option to help" people quit smoking that contains no tobacco. However, experts from health organizations nationwide say there's a regulatory gap that allows these nicotine pouches to legally be sold to consumers of any age in Canada.
Action on Smoking and Health, the Canadian Cancer Society, the Canadian Lung Association, Heart & Stroke, Coalition québécoise pour le contrôle du tabac and Physicians for a Smoke-Free Canada are urging health ministers to reassess the situation.
For one, the group suggests reclassifying the nicotine pouches as a prescription product or to suspend their sale until that regulatory gap can be closed. The group also wants Health Canada to pause authorizing any more nicotine pouch products until there are more regulations.
Why are health experts raising concern?
On top of a lack of an age restriction on purchasing nicotine pouches, the Canadian Cancer Society (CCS) says Imperial Tobacco Canada is "aggressively marketing" the product. While they're available in convenience stores and gas stations, the CCS says in-store promotions for the pouches can be found near racks of candy and chocolate bars.
Cynthia Callard, executive director of Physicians for a Smoke-Free Canada, says little is known about the health effects of nicotine pouches.
"The problem with these products is they are introduced without any disclosure or testing, or any sense of what the public health impact is," she notes during a media conference on Tuesday.
"We don't know, in the same way, we didn't know how dangerous cigarettes were 100 years ago. Waiting for a whole generation to use these products before we have available epidemiology is not useful."
Are nicotine pouches only a concern in Canada?
In November 2020, the Government of Canada issued a safety alert for nicotine pouches, noting no products had been authorized by Health Canada for "safety, efficacy and quality." Even though Zonnic has been approved for sale, an update to the safety alert notes any other nicotine pouch could present serious health risks unless authorized.
In the United States, they're regulated by the Food and Drug Administration and subject to age restrictions, a nicotine health warning and pre-market assessment.
Some countries, including Brazil, Iran and Thailand, regulate nicotine pouches under tobacco products.
"Worldwide countries are scrambling to address this new product, some are banning its recreational use and others are strictly regulating," Canadian Lung Association president and CEO Terry Dean said during the media release.
What are the alternatives to nicotine pouches?
Nicotine pouches resemble the Swedish-style snus minus the tobacco leaf, where the user puts it in their mouth between the upper lip and gum.
Currently, the long-term health effects of using nicotine pouches are unknown. Nebraska Medicine notes some side effects include gum irritation, sore mouth, hiccups, nausea and nicotine addiction. Experts also suggest smokers use approved products like nicotine patches, gum, lozenges, nasal spray or inhalers to wean off nicotine.
People addicted to nicotine can also adopt lifestyle changes, like meditation, trying new hobbies, drinking plenty of water, eating healthy foods and practicing mindfulness.
Executive director of Physicians for a Smoke-Free Canada Cynthia Callard says it's "absolutely incomprehensible" these flavoured nicotine pouches are allowed to be sold without regulations.
"The Canadian public will not tolerate these new developments and this regulatory gap," she says in a Canadian Cancer Society media release.
Callard also urges ministers take "immediate action" to prevent nicotine addiction among youth.
E-cigarette deja vu
"Have we not learned our lessons from e-cigarettes?" Callard adds, noting a rise in youth vaping makes it hard to understand why Health Canada would approve this product without regulations.
Data released earlier this year by Health Canada shows the country has some of the highest teen vaping rates in the world. Among the more than 61,000 students surveyed between grades 7 and 12, eight per cent vaped daily, with that number closer to 12 per cent for respondents between grades 10 and 12.
A study released in September also found nearly 50 per cent of young Canadians have tried vaping.
Appeals to kids, teens
Canadian Cancer Society senior policy analyst Rob Cunningham explains at the media conference it "boggles the mind" that Health Canada has approved this product, one he adds are "clearly appealing to youth."
"With attractive flavours such as 'Tropic Breeze,' 'Chill Mint' and 'Berry Frost,' and with colourful, small packages that might as well hold candy, of course youth will want to buy them," he says in a release. "The devastating result is that youth will become trapped into nicotine addiction."
An 'unfortunate' situation
Eric Gagnon, vice president for legal and external affairs at Imperial Tobacco Canada, tells Global News it's "unfortunate" people are targeting the nicotine pouches since the company showed Health Canada it can help adults quit smoking.
He notes that if more regulations were to be added, "adult smokers are going to be the ones who are going to pay the price." Moreover, he says the company made it "clear" the product is supposed to be behind the counter and that buyers should be verified as adults.