Nicotine pouches the next battle for youth health

New nicotine products are continuing to infiltrate the Australian market and there is not enough research to understand their side effects, AMA Queensland Vice President Dr Nick Yim told ABC radio.

Transcript: AMA Queensland Vice President, Dr Nick Yim, ABC Sunshine Coast, Drive with Annie Gaffney, Thursday 8 February 2024

Subjects: Nicotine pouches

ANNIE GAFFNEY: Gone are the days of us winning the war against nicotine consumption. It seems smoking rates are headed down; well, they were until the spectre of vapes, the new market that's been exploited and school aged kids came along. Now there's another delivery system being marketed to kids by influencers. These are called nicotine bags or pouches. They look just like snus, the Scandinavian tobacco bags, but these things are marketed as tobacco free.

Influencers on TikTok, Snapchat, Instagram, they're all selling these products as a way to kick the vape habit for the new year. Dr Nick Yim is Vice President of AMA Queensland. He's a GP based Hervey Bay doctor. Nick, good afternoon. Great to have you back with us, how concerning is this trend?

DR NICK YIM: Good afternoon Annie. It just seems like every single week or every month we're talking about nicotine and the new products that are available. I think it's really concerning these new nicotine products are coming onto the market, and must I say, illegally. It's just not safe, it's something that is really concerning for our community.

ANNIE GAFFNEY: These pouches are marketed as tobacco free, so what are the health risks?

DR NICK YIM: I think the key thing here is many of these pouches, from what we have seen overseas, do contain high levels of nicotine. As we all know, nicotine is highly addictive and there's not enough research done into the other chemicals in these pouches and what other damage they can cause. This is similar to the vaping issue that we're having at the moment, made three or four years ago when it first was introduced.

ANNIE GAFFNEY: Many of these products being sold to kids via websites and are made by manufacturers like Philip Morris and British American Tobacco. Do you think Big Tobacco is being held accountable for its role in getting a new generation addicted to their poisonous products?

DR NICK YIM: With these products, we are seeing all the multiple flavours that are coming through, similar to the vapes. So, these pouches are flavoured, and with those pretty colours and flavours they are clearly targeting children and young adults, which is very, very concerning.

ANNIE GAFFNEY: The way these pouches work is you're holding them literally between your gums, your teeth, your lips, and sort of sucking away on them. What could that do if they do contain nicotine? Let's talk about what's happening in the mouth before the nicotine even gets into your bloodstream.

DR NICK YIM: Besides the toxicity from nicotine, obviously nicotine can cause addiction. So it's something where the biological need for nicotine and seeking it out can affect sleep, concentration, it can generate higher levels of anxiety and stresses especially for that child or young adult. Obviously, there's the other element of the other chemicals involved in these pouches, and we just don't know what that can do long term for the developing body.

ANNIE GAFFNEY: These kind of oral nicotine products have been banned and illegal in Australia since the early 90s. So how surprised are you that we are now seeing – it's like whack-a-mole, isn't it, Nick? You know, we ban one thing and up pops another product.

DR NICK YIM: Absolutely. It just feels like we're continually chasing our tail. I think one thing that we've spoken about previously on your show is all about education. If people are addicted to vaping or tobacco smoking, those of you who want to quit smoking, there are very, very good evidence-based products available to quit. The best available advice is actually speaking to your GP or your local pharmacist for options available.

ANNIE GAFFNEY: It seems like we're playing the long game when it comes to trying to stop these various products being advertised and sold to kids. What more can be done in your view? Because it's already patently evident that anything that's taken off the streets at the moment in the way of vapes, for instance, is just the tip of the iceberg, isn't it?

DR NICK YIM: Absolutely. So, it comes down to, there’s not just one thing to help prevent this issue. We have seen how quickly vapes have taken hold of our community, especially our young adults and our children in schools. We as a community; obviously healthcare professionals, the community, parents, educators, et cetera, we must stay vigilant of all the other products that are going to be potentially entering our market and being exposed to our children.

ANNIE GAFFNEY: If you wanted to have nicotine pouches as a way to quit vaping, for instance, or smoking, you'd actually need a prescription from the doctor to do that. I know I asked this the last time we spoke, Nick, but have you had many people actually coming in and asking for vape prescription products because they're addicted to vapes and they want to, you know, give them up slowly, I suppose?

DR NICK YIM: Yes. We have probably seen a very, very slight increase across the community in Hervey Bay. But overall, as I mentioned previously on your show, the gold standard is obviously nicotine replacement therapies. So, we've got nicotine gum, patches, lozenges, and we do need to incorporate our support services such as Quitline and the support networks in place. So, there's not just one methodology. We've already got the gold standard, and we know to use vaping as a quit tool, that it is not first line, it’s not even the second line, it's very much down the track.

ANNIE GAFFNEY: Good to speak with you, Nick. Thank you.

DR NICK YIM: Always a pleasure.

ANNIE GAFFNEY: Dr Nick Yim, Vice President of the Australian Medical Association in Queensland. He's a Hervey Bay-based GP and we've been talking about nicotine pouches.

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