Global sales of nicotine pouches have increased by an estimated 660% since 2020 and are projected to reach US$25 billion by 2028, according to a new report from tobacco industry watchdog STOP, which warns that aggressive marketing by major tobacco companies could fuel a new wave of nicotine addiction.

The report, Understanding Nicotine Pouches: Current Evidence and Industry Activity , examines market trends, scientific research and tobacco industry practices surrounding the rapidly growing nicotine pouch sector. Its release follows a recent World Health Organization review of nicotine pouch regulation and marketing.

According to STOP, the market is dominated by Philip Morris International (PMI), British American Tobacco (BAT) and Altria, which together account for more than three-quarters of global nicotine pouch sales. The companies are using established production, distribution and marketing networks to drive growth, particularly in the United States, Sweden, Denmark, Pakistan and Austria.

Youth Marketing Concerns

STOP warns that nicotine pouch makers are using tactics known to appeal to young people, including flavored products, social media campaigns and marketing that links nicotine use to friendship, success and active lifestyles.

In the United States, an estimated 85% of youth nicotine pouch users prefer flavored products, mainly mint and fruit varieties. The report also highlights growing expansion into lower- and middle-income countries with young populations, including Kenya, Nigeria and the Philippines.

Regulatory Gaps and Industry Lobbying

The report says nicotine pouch growth has been aided by weak or nonexistent regulation in many countries. Tobacco companies have reportedly lobbied governments against stricter rules, while promoting potential economic benefits such as tax revenues and investment.

STOP also notes that companies have cited regulatory developments in the United States, including the FDA’s authorization of PMI’s Zyn brand, in efforts to influence policy discussions in other markets.

Questions Over Health Risks and Smoking Cessation

Researchers found insufficient evidence that nicotine pouches are effective tools for quitting tobacco or nicotine use. Instead, many consumers use them alongside cigarettes, e-cigarettes or heated tobacco products.

While the long-term health effects remain unclear, studies have identified potential short-term risks, including gum damage. The report also raises concerns about increasingly high nicotine strengths and the risk of nicotine dependence, particularly among young people.

Warning of a New Addiction Epidemic

Dr. Sophie Braznell, co-author of the report, said major evidence gaps remain regarding the health impacts of nicotine pouches and warned against relying on data from tobacco companies or studies focused on other products such as snus.

Jorge Alday, Director of STOP at Vital Strategies, said nicotine pouch marketing resembles strategies used before the rise of youth vaping and warned that the products could contribute to a new generation of nicotine addiction if left unchecked.

The report concludes that rapid market growth, increasing nicotine levels and youth-oriented marketing are laying the groundwork for a potential new public health challenge worldwide.