Half a million and counting – will the government see the potential role of nicotine pouches in getting SmokeFree 2030 back on track?

It is estimated there are more than half a million nicotine pouch users in the UK. That’s roughly the equivalent of the population of Manchester, up from zero just four years ago when nicotine pouches first became available in the UK.

The increasingly popular product offers adult smokers and nicotine users an oral, tobacco-free and smoke-free nicotine alternative. Placed under the lip, the pouches allow nicotine to be absorbed through the lining of the mouth.

According to estimates by British American Tobacco UK (BAT UK), there may be more than two million regular nicotine-pouch users in the UK by 2026.

The surging popularity of nicotine pouches is timely news for those committed to delivering on the government’s Smoke Free 2030 target for England.

Independent research commissioned by BAT UK found that practically all nicotine-pouch users in the UK are current or former smokers (99 per cent). The same study also found that most nicotine-pouch users have previously tried, and subsequently failed, to quit using ‘replacement therapies’ such as nicotine gum. Two-thirds found nicotine pouches more effective than nicotine replacement therapies at helping them quit or reduce smoking.

These findings offer extremely promising signs that nicotine pouches can help England go Smoke Free by 2030.

According to the Dr Javed Khan Independent Review on Tobacco Control published in June last year, England will miss its Smoke Free 2030 target by at least seven years on current trends, while its least prosperous communities will not reach the Smoke Free threshold (defined as smoking rates of below 5 per cent) until 2044.

If the example of Sweden is anything to go by, nicotine pouches may be just what’s needed to regain momentum.

In Sweden, oral nicotine – traditional snus, as well as nicotine pouches – has long been popular. Although snus has been widely used since the 1970s, the introduction of nicotine pouches in 2018 has caused smoking rates to decline even faster, with smoking rates of 5.6 per cent reported in November last year – a 51 per cent drop in a decade. According to Statistics Sweden, almost 14 per cent of Swedes used oral products every day last year, a 23 per cent increase on 2012. Sweden is on the brink of becoming the first European country to become officially smoke free.

The June 2022 Khan Review recognised the potential of this new category when it called on the government not to legalise snus, but instead promote ‘safer alternative nicotine products such as nicotine pouches, maximising their value to help smokers to quit’. However, nicotine pouches do not have a specific set of regulations covering them in the same way vaping products do. Instead, they are governed by general consumer product regulations which do not properly regulate the sector. To keep oral nicotine pouches in line with other reduced risk products^[1] and to protect consumers, a bespoke regulatory framework for tobacco-free oral nicotine pouches is urgently needed.

On 17 April, the Committee on Toxicity published its position on nicotine pouches, at the request of the Office of Health Improvement and Disparities, concluding that ‘the use of oral nicotine pouches, as recommended by the manufacturer, as a replacement for combustible cigarette smoking is likely to be associated with a reduction in overall risk of adverse health effects’.

In the absence of regulations, BAT UK, along with two other responsible manufacturers, has adopted a voluntary code of conduct to govern the marketing, packaging and labelling of these products. The code also imposes a nicotine ceiling of 20mg/pouch.

The answer to a recent question to Neil O’Brien, Under-Secretary at Department of Health and Social Care, disappointingly stated, despite previous indications of the contrary, that the government has no timeline for nicotine pouch regulation. Although this would be a missed opportunity in securing the sustainability of the category, we are still optimistic that the government will realise the potential role of nicotine products in reaching Smoke Free 2030.

Smokers are already turning to pouches to help them move away from smoking. It is not too late for the government to seize this golden opportunity to put sensible regulations in place which we believe will give more smokers the confidence they need to switch.

[1] Based on the weight of evidence and assuming a complete switch from cigarette smoking. These products are not risk free and are addictive.