The Centers for Disease Control and Prevention's (CDC) recent Notes from the Field in the 2024 National Youth Tobacco Survey (NYTS) has shed new light on youth usage trends concerning e-cigarettes and nicotine pouches. While comprehensive data on traditional tobacco use is still pending, there are important insights to discuss about these modern nicotine products. 

One key takeaway from the report is that youth vaping, which has been a major focus of public health campaigns, continues to decline. At the same time, there has been a slight uptick in the use of nicotine pouches, including popular brands like Zyn and On!. However, it's important to put these numbers in perspective: only 1.8 percent of U.S. middle and high school students reported using oral nicotine products in 2024, which is only a small increase from the 1.5 percent who reported using them in 2023. When compared to the 5.9 percent of students who reported vaping, it's clear that nicotine pouch use among youth is still much lower. 

To give further context, the percentage of U.S. youth using oral nicotine products in 2024 was 106.5 percent less than the number of youth who were vaping. This sharp contrast between youth vaping and nicotine pouch use raises questions about why nicotine pouches are increasingly being vilified by public health groups. And while nicotine pouches receive criticism, there seems to be little attention given to alcohol use among teenagers. In 2023, 22 percent of U.S. high school students reported drinking alcohol, which is far more dangerous for teenagers, yet no one is pushing for alcohol bans or extreme regulatory measures to address this issue. 

The Public Health Response: Misplaced Concerns? 

Despite the relatively low usage rates of nicotine pouches among youth, many public health trade associations continue to target these products, amplifying concerns about their use without acknowledging the critical fact: nicotine pouches are significantly less harmful than combustible cigarettes. In fact, nicotine pouches, unlike traditional tobacco, do not involve combustion, the main cause of the serious health issues linked to smoking. Smoking rates in Sweden have dropped by 55%, thanks to progressive policies supporting alternative nicotine products.  New research from The Lancet reveals that going smoke free like Sweden would increase life expectancy around the world and prevent millions of premature deaths by 2050. The research comes as Sweden is on the brink of becoming the first country to achieve a smoking rate of less than 5%, the threshold at which a country can officially be designated “smoke free”.  The data confirms that oral nicotine products can be part of a harm reduction strategy for adult smokers who are looking for safer alternatives.  

Public Health England (PHE) has repeatedly emphasized that vaping and other non-combustible nicotine products, including nicotine pouches, are far less harmful than smoking combustible tobacco. In their 2018 evidence review, PHE stated that e-cigarettes (which are similar to nicotine pouches in terms of harm reduction) are "at least 95% less harmful" than smoking. 

Unfortunately, this balanced view is often missing from public health discourse. For example, the American Lung Association (ALA) recently published a blog post titled “ZYN 101: What to Know About Big Tobacco’s Latest Addiction.” In this post, the ALA frames modern oral nicotine products as a new threat without addressing their reduced harm compared to cigarettes.  

This kind of fear-based messaging may fuel unnecessary panic about nicotine pouches while overlooking their potential role in helping adult smokers reduce or quit their cigarette use. 

Why We Should Be Talking About Harm Reduction 

The demonization of nicotine pouches in public discourse runs counter to harm reduction strategies, which aim to provide safer alternatives for those who are unable or unwilling to quit nicotine entirely. Harm reduction is a proven public health approach that has been widely used in other areas, such as drug and alcohol addiction. Yet, when it comes to nicotine, many public health groups still push for total abstinence, even when safer alternatives exist. 

By ignoring potential harm reduction and focusing on youth use, the public health narrative is increasingly sidelining adult smokers who might benefit from switching to products like nicotine pouches. For many adults, nicotine pouches offer a satisfying alternative that eliminates the harmful effects of smoke inhalation, making them a crucial tool in reducing smoking-related deaths and diseases. 

A Call for Balanced Discourse 

The CDC's 2024 report underscores the need for a balanced, data-driven discussion about nicotine products and youth use. While youth nicotine pouch use is worth monitoring, it’s clear that the real concern lies with far more harmful and dangerous behaviors—like underage drinking or cigarette smoking—where public health efforts would have a far greater impact. 

At the same time, we cannot ignore the fact that nicotine pouches are a valuable for millions of adult smokers. As policymakers, public health professionals, and the media continue to shape the narrative around nicotine, it’s crucial that they recognize the role these products play in helping people transition away from smoking. 

A true public health approach balances harm reduction for adults with responsible regulation, ensuring that both groups receive the attention and support they need.