Global tobacco consumption might be falling, but while fewer younger people are finding their way into smoking cigarettes, newer forms of nicotine addiction are still emerging.
Nicotine pouches, a small and discreet cigarette alternative made without tobacco, are increasingly popular among younger people in many countries where sales of these pouches have doubled in recent years, according to analysis.
Although they appear less dangerous that smoking, their large doses of nicotine still make them highly addictive - and bad for your health, scientists are warning. The pouches contain a powder consisting of nicotine salts and some other substances.
Advertised as smoke free, vapour free and tobacco free, many come with different flavours such as peppermint, mango and fruit, making them popular among teens.
The pouches have escaped classification as tobacco products in many countries, and become a regular sight in schools, shops and petrol stations in countries like Austria, Canada and Denmark.
You place them under your upper lip, making them discreet and easy to use anywhere, "at home, at the office, or on-the-go - and you don’t have to stop what you’re doing or step outside to use it," says one brand.
The pouches are similar to what's known as snus, a kind of tobacco pouch of Scandinavian origin and which are also put under the lip, but now banned in most European countries.
Like with snus, the tobacco-free version's ingredients are "packaged in small portions ready for use" and release nicotine for up to an hour, producers say.
But unlike snus, they can appear less harmful at first, since they don't have tobacco in them. And yet some of these pouches deliver so much nicotine that you are taking in more than if you were smoking a cigarette, say scientists.
The researchers tested several brands of pouches saying they contained 6, 20 and 30 milligrams of nicotine and that they also release high levels of nicotine, in some cases even more than cigarettes.
The nicotine pouches analysed are likely to have a high addictive potential, says Tobias Rüther, head of a Munich university Tobacco Outpatient Clinic.
As with cigarette consumption, the pouches with 20 and 30 milligrams of nicotine had effects on the user's heart and circulation. Also, all of the pouches tested caused mouth irritation in all participants.
The potential for addiction could become a serious problem, says Andrea Rabenstein, co-author of the study published in Frontiers in Pharmacology, a trade journal.
Alongside concerns that users of the pouches can develop an addiction to nicotine, the worry is that pouch users may start using other nicotine products or tobacco cigarettes, Rabenstein says.
Smoking increases the risk for several serious diseases such as lung cancer, cardiovascular disease, and chronic obstructive pulmonary disease, the study notes. In Austria, use of the pouches is already extremely widespread in schools, say the scientists.
The pouches are banned in some places including Germany but people are buying them online as they are widely advertised in social media, says the German Tobacco Outpatient Clinic, which worked with Germany's Federal Office for Risk Assessment on the study.
