How nicotine pouches are leaving children with serious health problems

How nicotine pouches are leaving children with serious health problems,

Clare Nichols thought she was just doing what ‘everyone else was doing’ when, at the age of 15, she tried her first nicotine pouch.

Within two years, the highly addictive drugs had done irreparable damage to her health.

Her blood pressure soared, damaging her heart and taking her to the brink of cardiac arrest.

The legal pouches also caused serious gum disease, with the loss of two teeth, and shattered her ability to concentrate, sending her school results into freefall.

‘I honestly thought it was harmless,’ says Clare, now 21 and a history student at Liverpool University. ‘But I had no idea what it was doing inside my body.’

A nicotine pouch is a small bag placed under the tongue or against the lip to provide a hit many times stronger than a cigarette. It often leads to light-headedness, nausea and vomiting.

Clare grew up in Lytham St Annes, Lancashire, a sporty teenager who loved running and netball. Her parents were health-conscious and trusting.

But by 14, she had already started using vapes. ‘Everyone at school was, and I didn’t want to feel left out. People bought them for me: older kids, friends’ brothers. The corner shop never asked for ID. It was just what you did. The flavours, the colours – it all seemed so innocent.’

More dangerous still was the craze for nicotine pouches that spread through Snapchat and other social media. Clare was one of the first to try them.

A nicotine pouch is a small bag placed under the tongue or against the lip to provide a hit many times stronger than a cigarette

‘At 15, everyone was talking about these little white pouches that gave you a head rush,’ she says.

Currently, nicotine pouches are unregulated and can be sold legally to under-18s.

Clare adds: ‘You could order them online – delivered straight to your house. It was cheaper, easier and stronger than vaping.

‘They came with star ratings for strength – from one to six. I went straight for six. I liked the buzz. But over time, the buzz got shorter, and I needed more to feel it.’

What started as one or two pouches a day quickly spiralled. By the age of 16, Clare was using eight to ten pouches daily, spending £60 a week.

‘I’d buy packs of 30 and they’d last three days. I’d do it in class, after school, before bed. Nobody ever caught me. It was so easy to hide.’

At first, Clare ignored the bleeding. But within months, her gums were swollen and painful.

‘My mouth was constantly sore,’ she says. ‘My gums bled when I brushed. Then one morning, I woke up and one side of my mouth was throbbing.’

At 16, she was diagnosed with advanced gum disease. Two of her back teeth were so badly infected they had to be removed.

‘I remember crying in the dentist’s chair. I was 16 and losing teeth. I couldn’t believe what I’d done to myself.’

The infection spread into her bloodstream, causing her blood pressure to skyrocket.

‘One night, my chest started pounding like a drum. I was shaking, sweating – it felt like a heart attack.’

Clare was then rushed to A&E, where doctors recorded dangerously high blood pressure and irregular heart rhythms.

She says: ‘They asked if I’d been taking anything. I said no; I was too embarrassed to admit it. I thought they’d think I was stupid.’

She later learned that her heart had twice shown the early signs of cardiac arrest. ‘They said I was lucky, another few minutes and it could’ve been serious.’

By her GCSE year, Clare’s schoolwork had collapsed.

‘I couldn’t focus without the pouches. I was snappy, tired and constantly craving that hit. My grades fell apart. I was angry all the time.’

Her parents thought she was struggling with anxiety or depression. ‘They didn’t know it was addiction. None of us did.

‘It’s such a new thing – there are no warning signs, no smell, nothing obvious.’

Hers is just one case among tens of thousands of teenagers who are risking heart problems, as experts warn of an ‘epidemic’ rise in the use of super-strength nicotine pouches, dubbed ‘the new vape’.

Latest figures indicate a rise of up to 60 per cent in the use of the pouches in the last year – just as figures from Action on Smoking and Health (ASH) show vaping figures seem to be plateauing.

Packages of Velo, Fre, Alp and Zyn nicotine pouches. The pouches come in a variety of flavours, are unregulated and can be sold legally to under-18s

Drug education charity the DSM Foundation regularly polls more than 4,000 youngsters around the UK. In surveys that asked school-age children on perceived use of the pouches among their peers, they found that use has risen from 46 to 61 per cent in just six months – leap-frogging cannabis for the first time since it started the surveys in 2017.

When asked if it’s ‘OK to use nicotine pouches’, the percentage saying ‘yes’ rose from 22 to 35 per cent.

Fiona Spargo-Mabbs, director and founder of the charity, says: ‘It’s worrying how quickly this seems to have happened. Kids are swapping vapes for nicotine pouches without any real understanding of what risks they might have, and how incredibly strong some can be.

‘We only introduced nicotine pouches into the survey last year because it was coming up in the “other” category for the first time. Since then it’s been consistently towards the top of our list of most commonly used drugs.’

The Government is currently planning to ban the sale of the pouches to under-18s in the new Tobacco and Vapes Bill. But Spargo-Mabbs says by the time that comes into force next year (or possibly later), ‘a whole generation of kids could be addicted, permanently damaged’.

A single pouch, often fruit-flavoured, can contain as much nicotine as 15 cigarettes. And it usually comes in a tin of 30 that costs as little as £5.

‘It’s a whack-a-mole situation, with the big tobacco companies always one step ahead of the Government when it comes to keeping kids hooked,’ says Spargo-Mabbs.

‘Way more kids are addicted to nicotine now than before vapes, and that figure’s rising by the day.

‘If the Government bans one form of nicotine without providing ways to help kids come off it, these companies have an open goal. They’ll just create another nicotine product to fill the void.’

Use of the pouches has been glamorised by footballers including Leicester striker Jamie Vardy, who admitted to using them, and Aston Villa’s Victor Lindelof, who has said he used ‘snus’ (similar to pouches but containing tobacco). Marcus Rashford was also photographed holding what appeared to be snus pouches in St Tropez last summer.

Before Euro 2020, Gary Lineker warned of their dangers after trying a pouch and vomiting for several hours.

Last September Steve Pope, a psychotherapist and addictions counsellor based in Lancashire, started his first ever support group for under-16s addicted to nicotine pouches.

‘Nicotine’s one of the most addictive, damaging substances there is, and the levels in these pouches is off the charts,’ says Pope. ‘I personally know four kids under 16 who’ve been hospitalised with heart issues in the past year because of nicotine pouches.

‘Your heart rate goes through the roof, your blood pressure surges, it can trigger asthma, eczema, gastrointestinal problems, they can even cause your teeth to fall out. Add in high-caffeine and sugar energy drinks and I’m in no doubt these pouches can be fatal.’

Pope has also worked with a number of professional football clubs including Glasgow Rangers, Tottenham, Manchester United, Blackpool and Burnley, and says it’s because nicotine isn’t on the list of banned substances that players so often get their high from pouches.

In surveys that asked school-age children on perceived use of the pouches among their peers, they found that tobacco-pouch use has risen from 46 to 61 per cent in just six months

‘Kids see people like Jamie Vardy with a pouch and think it’s safe, or even that it’ll increase their performance, when the opposite is true,’ he says.

‘It’s the ultimate false endorsement: you can get your high and still be a hero.’

Pope says referrals to clinical practice of under-16s hooked on the pouches has risen by 60 per cent since 2021 – and that’s only those whose use has become so problematic they seek professional help.

‘I’ve got one 11-year-old who’s in our support group who started when he was eight.

‘Every adult who’s ever tried to quit smoking cigarettes knows how hard it is. How do you expect a youngster to give up a nicotine product that’s ten times stronger without support?

‘They’re “sanitised” by professional sportsmen, they’re easy to use without being spotted because unlike vapes there’s no vapour or smoke, and they’re in fruity flavours. We’re only beginning to see the true fallout from this epidemic, driven by multi-billion-dollar companies looking for new revenue streams as tobacco sales decline.’

High nicotine levels also affect concentration and sleep quality in youngsters, which can be detrimental to their schooling, says Pope.

‘There’s evidence to show high nicotine intake as a child can permanently affect concentration, increase impulsivity and exacerbate ADHD, so all these kids’ futures are hanging in the balance – and other research shows some pouches contain carcinogenic substances, yet consumers are rarely told this.

‘Cigarette packets are plastered with health warnings; nicotine pouches carry almost none, and the NHS still has no definitive long-term data because the products are so new.’

Pope suggests he’s ‘in no doubt’ that these pouches are the ‘perfect gateway’ into nicotine and potentially other addictions. ‘It’s exactly the same multi-billion-dollar tobacco companies who killed us with cigarettes for decades who’ve pumped tens of millions into these pouches, and the UK Government is completely blind to what’s happening,’ he says.

Dr Rosemary Hiscock, from the Tobacco Control Research Group at the University of Bath, says there is clear evidence that tobacco companies are actively promoting nicotine pouches to young people.

These include hosting ‘pop-up’ events in large shopping centres, using giveaways and competitions, and partnering with music, food and beer festivals to showcase their nicotine pouches.

‘This has been going on for years without anyone really noticing because everyone was so focused on cigarettes and then vapes. But now it seems to be really bearing fruit for them – pouches are everywhere,’ Dr Hiscock says. She also agrees that high levels of nicotine can be especially harmful in youngsters.

‘There are clear clinical trials to show nicotine damages developing brains of mice and rats, and there are clear indications there are similar effects in humans,’ she says.

And the only effect of using the pouches for sport is a negative one, she adds.

‘The farmers who grow the tobacco used in pouches regularly experience something called “green tobacco sickness” – nausea and vomiting as a result of just handling it. This is a very damaging substance, and the idea of children putting high concentrations of it directly into their mouths is extremely worrying.’

For Clare, weaning herself off nicotine took months. After meeting Steve Pope through a school wellbeing programme, she decided to quit, despite horrific withdrawal symptoms.

‘Steve understood straight away,’ she says. ‘He said I had an addictive personality and he didn’t judge me. We started meeting once a week.

‘It was horrible at first. The headaches, the cravings, the fatigue. I’d cry and say I couldn’t do it. But Steve kept reminding me how strong I was.’

She’s now been nicotine-free for four years and today, Clare’s energy has returned. She goes to the gym regularly and is thriving at university. Her complexion has cleared, her blood pressure is normal and she hasn’t touched a vape or pouch since she was 17. ‘My dentist told me if I hadn’t stopped, I could’ve lost all my teeth by 24. That was the shock I needed.’

She still lives with the consequences: two missing molars and a lingering fear of what the nicotine might have done to her heart.

‘When I see people doing it now – especially younger teens – I want to grab them and say: “Please, don’t.”

It’s not harmless. It’s addictive, it wrecks your gums, your energy, your heart – and your confidence.’

Clare now shares her story in talks at schools near her home town. ‘It starts with curiosity, but it ends with addiction. You think: “What can go wrong?” – until it does.’

She pauses, her voice softening. ‘I’m lucky to be here. It took losing teeth, nearly losing my life, to realise how dangerous these things are.

‘But if my story makes even one person stop before they start, then it’s worth it.’

Clare now also shares her story at Pope’s sessions of the Nicotine Pouch Harm-Reduction & Recovery Group.

‘She’s become one of the strongest youth voices in our group on nicotine pouch addiction and early harm,’ he says. ‘When I was helping Clare, I had just a handful of kids needing help with pouches. Now I’ve got waiting lists.’

Hazel Cheeseman from ASH agrees the pouches are currently ‘near ubiquitous’, but believes changes to the Tobacco and Vapes Bill ‘should see an end to such marketing, and create an age of sale of 18’.

A spokesman for British American Tobacco UK, which owns the VELO brand of nicotine pouches, said: ‘We are clear that VELO is for adult smokers and nicotine users only and a tobacco-free alternative to cigarettes.

‘We have repeatedly called on the UK Government to introduce specific regulation for nicotine pouches to ensure robust product quality, responsible marketing, and minimum age of sale requirements and hope it will do this as part of the Tobacco and Vapes Bill.’