Despite the harm, young people are using nicotine pouches. Experts say it’s giving them déjà vu

The Dose20:56What do I need to know about recreational nicotine products?Read transcribed audio.They come in brightly-coloured tins with flavours like tropic breeze and berry frost, and in most of the country, they’re sold at convenience stores. If you don’t look closely, you might mistake them for gum or candy. Nicotine pouches, under the brand Zonnic, are the latest nicotine product to be approved for sale in Canada. Earlier in March, Health Minister Mark Holland vowed to crack down on their sale to young people. Despite the product’s claim that it’s a nicotine replacement therapy and not intended for those under 18, experts say youth are fast becoming their main market — and that raises troubling questions about how young people’s health could be affected.Health Canada approved Zonnic last July as a smoking cessation aid under the country’s natural health product regulations, with no restrictions on how it’s advertised, where it’s sold, or at what age someone can buy it.”If they could reach the counter, a toddler could wander in and buy some,” said David Hammond, a public health professor at the University of Waterloo who researches tobacco control, referring to patchwork regulations and enforcement across the country. An advertisement for Zonnic on a Canadian convenience store counter next to candy. Imperial Tobacco, the company that sells Zonnic, says it has removed parts of its advertising campaign featuring young people and placed the 18+ age label more clearly on its package. (Canadian Cancer Society)The pouches can cause a host of health problems for young people, experts say, and the current lack of regulations is creating a sense of déjà vu for those who study tobacco control, including Laura Struik, an assistant professor in the school of nursing at UBC Okanagan.  “The tobacco industry is very good at releasing kid-friendly, nicotine-based cessation products — and these nicotine pouches are no exception,” said Struik. Eric Gagnon, vice-president of corporate and regulatory affairs at Imperial Tobacco Canada, says Imperial requires any retailer selling Zonnic to keep it behind their counter and request ID. Quebec and B.C. have changed the regulations so nicotine pouches can only be sold behind the counter at pharmacies, and Health Canada has announced it will explore regulatory options to protect youth. What are the health concerns? Zonnic pouches — small bags filled with nicotine powder that users place against their gums — contain up to four milligrams of nicotine. They’re often sold 10 to a package, which is roughly the amount of nicotine in a pack of cigarettes, Dr. Nicholas Chadi told Dr. Brian Goldman, host of CBC’s The Dose.David Hammond, a public health professor at the University of Waterloo, says the original marketing campaign for nicotine pouches looked a lot like the one for e-cigarettes several years ago. (Turgut Yeter/CBC)”You can become addicted to nicotine after only a few days or weeks of use if you’re a young person,” said Chadi, a pediatrician and researcher at CHU Sainte-Justine hospital in Montreal who specializes in adolescent and addiction medicine. “Your brain is a little bit more vulnerable to the effects of different substances.”Nicotine’s effect on the brain There is more and more research into how nicotine affects the developing brain, said Chadi, which includes impacts on memorization, emotional regulation and sleep. “More and more studies are showing that young people who use nicotine also may be more likely to have mental health issues,” Chadi said. Nicotine is one of the most addictive substances there is, says Dr. Nicholas Chadi, a pediatrician and researcher at CHU Sainte-Justine hospital in Montreal who specializes in adolescent and addiction medicine. (CHU Sainte-Justine (Véronique Lavoie))Nicotine can limit impulse control and inhibit cognitive processing and decision making, said Struik. “It not only alters the way that your brain communicates, but [early use] also enhances the addictive potential of nicotine,” she said. The younger someone starts using nicotine, the harder it is to quit, Struik said. Oral health and cancer concernsThere are also concerns around users’ gum health, experts say. “When you’re using these pouches, you’re inflaming your gums, you’re inflaming your oral cavities,” said Struik.”That can result in a whole host of risks: mouth cancers, throat cancers.”The pouches contain other ingredients that haven’t been tested for efficacy, said Chadi, so it’s unclear if they could have potential negative health effects. “We really know very little about these emerging synthetic nicotine products,” Chadi said. WATCH / Health Minister vows to regulate nicotine pouchesMarketing of nicotine pouches must stay ‘away from our kids,’ says health ministerSome of the pouches have been found to contain tobacco-specific nitrosamines, said Struik, carcinogens found in tobacco and tobacco smoke. “These are cancer-causing chemicals,” said Struik. “So there is that risk for seeing future cancer rates go up.”We’ve been here before Experts say it’s baffling that these pouches are being sold in corner stores without age regulations, given what happened with e-cigarettes several years ago. Some provinces have since banned non-tobacco flavours of e-cigarettes. In 2018, Canada introduced a new Tobacco and Vaping Products Act that allowed e-cigarettes to be sold to anyone 18 and older. Five years later, Canada had some of the highest teen vaping rates in the world. Hammond points to marketing practices and the availability of new products as contributing factors to increased vaping among youth after the legislation changed.The advertising of nicotine pouches looks similar to what we saw with e-cigarettes, experts say. “If you look at the original social media campaign [for the pouches], it’s all about young people and partying and using it whenever you can. This doesn’t look like a therapeutic product,” said Hammond. These are the same tactics the tobacco industry used to market cigarettes, he noted. Laura Struik, an assistant professor in the school of nursing at UBC Okanagan, says the younger someone starts using nicotine, the harder it is to quit. (Submitted by Laura Struik)Earlier this month, a spokesperson for Imperial Tobacco, the company that makes Zonnic, told CBC News that after speaking with Health Canada, the company has voluntarily removed parts of its advertising campaign featuring young people and placed the 18+ age label more clearly on its package.How to talk to your kids Chadi and Struik both say parents and caregivers should be having open conversations with their children about nicotine pouches. “We can’t just go into it with, ‘These are bad for you; don’t do it,'” said Struik.Instead, she suggests staying curious and asking your teen or preteen what they’ve heard about the products or whether friends are using them. Struik even bought some vaping devices to show her 10-year-old daughter what they are and how they look. “A lot of parents don’t even know what these devices or these pouches even look like,” she said. Having those conversations “can go a long way in terms of building that trust.”

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