Maybe you’ve never heard of Zyn until now. Maybe it has started creeping into your social media feeds in the form of funny videos where wives joke about their husband’s addiction to the nicotine pouch brand. Or maybe you’ve seen the recent headlines about how Zyn is reaching our kids directly, via influencers, on TikTok and Instagram. In any case, it’s becoming clear that nicotine pouches are part of the landscape of being a teenager right now, and experts want parents to know a few things about them.
Zyn is one of many brands of nicotine pouches: little packets of powdered nicotine you insert straight into your mouth, rather than smoking a cigarette or vaping. Some are flavored like mint, mango, even strawberry kiwi, depending on the brand.
As kids who grew up learning that cigarettes are bad for you — being shown side-by-side photos of normal lungs and a smoker’s lungs in school — now that we’re parents, we may not realize how harmful nicotine itself can be, even when all those other components in a cigarette are stripped away. And that teenagers are particularly vulnerable to the damage it can cause.
“The adolescent brain is different from the adult brain. It is still in formation and any changes you make during adolescence to the brain really can have permanent effects,” says Dr. Lindy McGee, M.D., pediatrician at Texas Children’s Hospital and assistant professor of pediatrics at Baylor College of Medicine. She specializes in smoking and vaping prevention. “When I encounter patients who are using these products, it is not infrequent that the parents are using these products as well, and then they just kind of think it’s not that big of a deal. It is just not the same. An adult using this product is not the same as a teenager using this product.”
Here’s what McGee says parents need to know about nicotine pouches.
Teenagers are more likely to become addicted to nicotine than adults.
“Teenagers are much more likely to become addicted to substances than adults are. We know from studies that 88% of adult daily smokers started before the age of 18, and almost nobody becomes a daily smoker if you start for the first time after the age of 25,” says McGee. “It’s because the teenage brain is wired for risk-taking behavior and the reward system. Talk to almost any adult who struggles with addiction and I would say with the exception of painkillers, everyone started their addictive substances before the age of 25.”
Nicotine can interfere with brain development, and make symptoms of depression and anxiety worse in teens.
Using nicotine while the brain is still forming disrupts normal development, McGee says, and can permanently affect the parts of the brain that control attention and learning. Studies have also confirmed that teens who use substances, including nicotine, are more likely to experience poor mental health than peers who don’t.
“Nicotine can make feelings of depression and anxiety more intense. We’re looking at the mental health crisis we see in teenagers right now. There was a study just released that showed significant dose-dependent relationships between nicotine use and worsening psychiatric symptoms, including thoughts of suicide. That’s very concerning to me as a pediatrician and as a mother of two teenagers.”
Nicotine use increases the risk of cardiovascular disease.
Nicotine activates your sympathetic nervous system, what we think of as our fight-or-flight response, McGee explains. That means it increases your heart rate and blood pressure, and the workload on your heart overall. Over time, after many exposures to nicotine and constantly working harder, your heart will “remodel itself,” she says, which can lead to abnormal heart rhythms and even heart failure.
“That’s part of the reason why smokers have increased risk of cardiovascular disease, not just lung disease, because of the nicotine’s effect on the heart.”
Studies show that smoking and smokeless tobacco use use are both associated with high rates of peripheral artery disease as well.
The pouches could cause gum disease.
Nicotine pouches haven’t been around long enough to know a ton about how they’ll affect oral health, but it’s well-established that the where nicotine enters the body, it takes a toll on the entry point.
“Any delivery system for nicotine, so that could be cigarettes or vape or dip or these pouches, can have direct effects on organs where they’re being targeted. Cigarettes and vapes can have direct effects on the lungs. We know that dip has a direct effect on the mouth, can increase cancers, and we are starting to hear reports about gum damage in relation to these pouches,” says McGee.
“Zyn-fluencers” include prominent public figures, like Tucker Carlson.
Carlson has mentioned Zyn in numerous podcast appearances and interviews, enough so that it has earned him the nickname “Tucker Carlzyn,” The New York Times reports. Comedians Burt Kreischer and Tom Segura tried nicotine pouches on their podcast 2 Bears, 1 Cave, where Segura says he uses one in the morning, one on the way to a workout, and has fallen asleep with them in his mouth before. Other TikTokers show refrigerators filled completely with Zyn cartons, while others explain which flavors of nicotine pouches pair well with which beverages, saying a coffee-flavored Zyn with a cup of Joe in the morning “is what being a man is all about.”
You should talk to your kids about influencers and nicotine pouches now.
We need more policies protecting children online, McGee says, but there is something parents can do right now to keep their kids safe. “As soon as kids are being exposed to media, they need to be having discussions with the adults in their lives about the way the media is trying to manipulate them. Whether that be your For You page in TikTok, taking you to the next thing and the next thing and the next thing, or influencers showing you products and getting you to buy products. It’s a much more effective way of advertising than the way we think about traditional advertising. Just like you teach your kid not to talk to strangers or not to run across the street, you need to teach them digital safety as well.”
This might look like parents watching videos with their kids and just asking a few questions aloud. “‘Oh, hey, I see that guy is using these products. How does that make you feel about the products? Do you think he could be getting paid to show them in a good light?’” McGee says.
Not only will this line of questioning help your kid think critically if nicotine pouches come across their social media feeds, but they’ll be ready for the next nicotine product too, whatever form it takes, even if they hear about it long before you do.
Tervo-Clemmens, B., Gilman, J. M., Evins, A. E., Bentley, K. H., Nock, M. K., Smoller, J. W., & Schuster, R. M. (2024, January 29). Substance Use, Suicidal Thoughts, and Psychiatric Comorbidities Among High School Students. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2023.6263
Van’t Hof, J. R., Wang, W., Matsushita, K., Heiss, G., Folsom, A. R., Widome, R., & Lutsey, P. L. (2023, May). Association of Smokeless Tobacco Use With Incident Peripheral Artery Disease: Results From the Atherosclerotic Risk in Communities Study. American Journal of Preventive Medicine, 64(5), 728–733. https://doi.org/10.1016/j.amepre.2023.01.001
Dr. Lindy McGee, M.D., pediatrician at Texas Children’s Hospital and assistant professor of pediatrics at Baylor College of Medicine