Nicotine pouches are now restricted to pharmacies. Former smokers say that's making it harder to quit
Federal government has banned pouches from convenience stores and completely recalled fruity flavours
Flavoured nicotine pouches are now only available for purchase in Canada from a pharmacist — but some former smokers say the new national regulations also make it harder for adults to reach a product that was helping them quit cigarettes.
"I think the government should be doing whatever they can to limit youth from getting addicted to nicotine, whether it's nicotine pouches, vaping products or tobacco products in general," said 29-year old Zach Laing, a former cigarette smoker who uses the pouches.
"The legislation here … is just taking it a little bit too far," the Edmonton man said.
As of Wednesday, the federal government has banned the sale of the pouches in convenience stores, gas stations and online. It has also now completely recalled all fruity flavours — only mint is available for purchase from behind a pharmacy counter.
The move has been applauded by multiple national health organizations, from the Canadian Dental Association to the Heart and Stroke Foundation.
They've argued that unlike other nicotine replacement therapies already on the market such as gum or patches, the pouches were being advertised and sold in a way that targeted youth — including those who had never smoked before.
Health Canada approved the pouches last summer, sold under the brand name Zonnic, to help people stop smoking, also known as cessation. The small white packets are placed between a person's cheek and gums. That method releases what doctors say is the nicotine equivalent of smoking multiple cigarettes, but without the cancer-causing chemicals.
"To me it always felt like the nicotine pouches were sort of the lesser of two evils," Laing said. "I've had a nicotine addiction for the last decade and I don't think that's necessarily something that's going to change anytime soon for me."
Laing, who has asthma, said he tried chewing tobacco, cigarettes and vaping before he started using the pouches.
"Right away, I really liked them. I mean, they didn't make me feel ill like tobacco products would at times," he said.
Pouches also come with health risks
Todd Prochnau, an Alberta pharmacist who specializes in helping patients quit smoking, said there was an advantage to having pouches in convenience stores.
"That is where people are purchasing their cigarettes, so it allows them to perhaps make a less harmful decision," he said.
Prochnau said patients need as much access as possible to any nicotine replacement product that is going to help them stop using cigarettes.
"The difference in harm is so significant that without having those products accessible, these patients are going to continue to smoke cigarettes, which is ultimately a flip of a coin if it will end up killing them or not," he said.
The pouches still carry significant health risks, from damaging gum tissues to increasing blood pressure and heart rate. Health Canada says nicotine is highly toxic and powerfully addictive, especially to children and teenagers whose brains are still developing. Even small amounts can increase the risk of nicotine addiction in the future.
Prochnau also warns there could be unintended consequences of pulling the flavoured pouches. He points to research that found adults in the U.K. who vape prefer a variety of flavour options.
"Often, adult smokers trying to quit will pick fruitier flavours, or flavours that are not mint or not tobacco flavour," he said.
However, the same research also found that children are more likely than adults to choose sweet flavours, and less likely to choose mint or menthol.
Prochnau warns restricting access and flavours could encourage people to seek out other pouches illegally, where they won't be subject to the same safety controls.
"There is a large, call it a black market or illicit market, of these nicotine pouches. They're quite readily available online or in some stores that are selling them illegally."
Imperial Tobacco, which makes Zonnic, has launched a campaign arguing this will happen.
"I remind everybody that we are the only approved nicotine pouch in Canada," said Eric Gagnon, vice-president, of corporate and regulatory affairs at Imperial Tobacco Canada, in an interview with CBC News last week.
Health Canada vows to crack down
A spokesperson for Health Minister Mark Holland said Health Canada will work to identify and seize unauthorized nicotine pouches, including online and at the border.
"We want to help adults quit smoking. That is why smoking cessation aids which have an established history of appropriate use, such as gums, lozenges, sprays and inhalers, will continue to be available in a wide range of retail locations with a variety of flavours," spokesperson Matt Kronberg wrote in a statement.
The pouches need tighter controls, Kronberg wrote, because of the "elevated risk of youth appeal."
Rob Cunningham, a senior policy analyst with the Canadian Cancer Society who works in the area of tobacco control, said the pouches will still be readily available for adults who want them.
"Nowadays we have pharmacies everywhere. It's going to be practically quite easy for people to access these products," he said.
"We can't expect a gas station attendant to provide smoking cessation advice that we can from a health professional."
Cunningham said it's a historical accident that cigarettes are sold in convenience stores. When nicotine replacement therapies such as gums and patches were introduced, they were sold in pharmacies, too.
"The tobacco industry's preferred approach is in convenience stores and in gas stations because it provides access to people who are never smokers," he said.
As smoking rates have declined, the tobacco industry has come up with new products to get young people addicted, creating a potential group of lifetime customers, he said.
According to Statistics Canada, nearly three-quarters of a million Canadians who were never smokers now vape, a number that's rising. Canada now has one of the highest youth vaping rates in the world.
"Can we really believe that Imperial Tobacco as a cigarette company wants smokers to quit? Of course not," Cunningham said. "They say that they don't want young people to use these products, but they said the same thing in the 1960s."
Cunningham said Imperial Tobacco opposed the Canadian restrictions "very aggressively" for that reason.
"This has implications not only for Canada but globally," he said. "They did not want this measure to get adopted."
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