Steps toward Limiting Nicotine Addiction in Youth;
Local, Provincial, and Federal Restrictions on Nicotine Pouches
Date: Thursday, January 18th, 2024
ISSUE/PURPOSE
The recent availability of Nicotine Pouches under the brand name “Zonnic” has triggered widespread concern from health organizations across Canada, including the Canadian Cancer Society, Heart and Stroke, and the Canadian Lung Association, who have issued calls for immediate federal action to regulate their sale to youth (von Stackelberg, 2023). Health Canada has approved the products under their Natural Health Products designation as a Nicotine Replacement Therapy (NRT) which can be used to quit smoking. Each package contains either 10 or 24 pouches with each pouch contains up to 4mg of nicotine, the equivalent of up to 2 cigarettes (Marsh, 2023).
Nicotine is highly addictive and has permanent adverse effects on the developing brains of youth and concerns regarding the nicotine pouches are rooted in their marketing and distribution approach being attractive to young people. An approach which includes attractive colours and targeted promotions, fruity flavouring which includes sweeteners, and a lack of regulations which makes it legal for children and youth to purchase these products. The similarities in purpose, advertising, and the range of flavors offered by nicotine pouches relative to the already popular vaping products poses a significant risk of sparking a trend comparable to rapid uptake of vaping amongst youth.
BACKGROUND
Nicotine pouches were approved for sale in Canada on July 18, 2023 as a Natural Health Product. The nicotine pouches are currently outside the scope of the federal Tobacco and Vaping Products Act (TVPA) and the provincial Smoke-free Ontario Act (SFOA) 2017 which regulate tobacco and vaping products by restricting their advertisement, display, and public use. As a result, the nicotine pouches are currently being sold at convenience stores and gas stations, placed alongside items such as candy and chips. The pouches are sold in vibrant packaging and various sweet and fruity flavours which are attractive to younger populations.
The recent growth in popularity of vaping products serves as an example of the importance of moving quickly to mitigate the risk of these new products (University of Waterloo & Brock University, 2023). Although research on the health effects of using nicotine pouches is still emerging, the effects of using oral NRTs include mouth ulcers, mouth and throat soreness, and coughing (M. Jackson et al., 2023). For youth and young adults who develop a dependence on nicotine, lasting negative impacts on the cognitive abilities, growth, and development can also occur (Stein et al., 1998; Ren & Lotfipour, 2019). Most concerningly, given the highly addictive nature of nicotine, dependence can lead to further use of vaping product, tobacco products, or other drugs (Leslie, 2020).
The Windsor-Essex County Health Unit (WECHU) has consistently engaged businesses, school administrators, students, parents, and municipalities to inform these groups about the health consequences of tobacco and vaping and has worked closely with them to develop policies, and enforce provincial regulations pertaining to smoking and vaping in public areas. The WECHU is committed to working closely with these same partners to better understand the best ways to keep residents, in particular young people, safe from these products however, until such time that a regulatory framework is established at the federal and provincial levels it is possible that the uptake of these products in Windsor and Essex County will escalate in a similar manner to vaping products.
PROPOSED MOTION
Whereas, Health Canada has approved Nicotine Pouches for sale under a Natural Health Product designation which does not provide restrictions on advertising or sale to minors; and
Whereas, there is no evidence to demonstrate the efficacy of Nicotine pouches as a smoking cessation aid; and
Whereas, the emergence of nicotine pouch products produced by Imperial Tobacco Canada, under the brand name “Zonnic” has occurred rapidly without the same regulations applied to other nicotine products; and
Whereas, the marketing and accessibility of Zonnic Pouches raises concerns regarding its appeal to youth populations; and
Whereas, the Nicotine Pouches fall outside existing provincial regulations on tobacco and vaping products; and
Whereas, there are significant concerns regarding the risks to youth and young adults who do not smoke and parallels between nicotine pouch use and vaping.
Now therefore be it resolved that the Windsor-Essex County Board of Health strongly encourages the federal government to take immediate action to close the regulatory gap that permits the sale of nicotine pouches to people under the age of 18; and
FURTHER THAT, the Windsor-Essex County Board of Health strongly encourages the province of Ontario to take immediate action to embed restrictions on the sale, display, and promotion of nicotine pouches under the provincial Smoke-free Ontario Act, 2017; and
FURTHER THAT, the Windsor-Essex County Health Unit works closely with local municipalities to review tobacco/vape-free public place bylaws to include additional nicotine products; and
FURTHER THAT, the Windsor-Essex County Health Unit works closely with local schools and boards to update policies to ensure products like nicotine pouches, and other emerging products that are tobacco or nicotine related are prohibited on school property.
References
Government of Canada, & Health Canada. (2004, July 26). Natural Health Products Ingredients Database. Webprod.hc-Sc.gc.ca. https://webprod.hc-sc.gc.ca/nhpid-bdipsn/ingredReq.do?id=1518&lang=eng
Health Canada. (2023, October 17). Product information. Health-Products.canada.ca. https://health-products.canada.ca/lnhpd-bdpsnh/info?licence=80125630
Leslie, F. M. (2020). Unique, long-term effects of nicotine on adolescent brain. Pharmacology Biochemistry and Behavior, 197(173010), 173010. https://doi.org/10.1016/j.pbb.2020.173010
M. Jackson, J., Weke, A., & Holliday, R. (2023). Nicotine pouches: a review for the dental team. British Dental Journal, 235(8), 643–646. https://doi.org/10.1038/s41415-023-6383-7
Marina von Stackelberg. (2023, November 15). National health groups call on Ottawa to prevent sales of nicotine pouches to children. CBC. https://www.cbc.ca/news/politics/restrictions-nicotine-pouches-1.7028297
Marsh, S. (2023, June 23). How much nicotine is in a cigarette compared to a vape? The Guardian. https://www.theguardian.com/society/2023/jun/23/how-much-nicotine-is-in…
OSDUHS. (2021). The Ontario Student Drug Use and Mental Health Survey (OSDUHS). CAMH. https://www.camh.ca/-/media/files/pdf---osduhs/2021-osduhs-report-pdf.p…
Ren, M., & Lotfipour, S. (2019). Nicotine Gateway Effects on Adolescent Substance Use. The Western Journal of Emergency Medicine, 20(5), 696–709. https://doi.org/10.5811/westjem.2019.7.41661
Stein, E. A., Pankiewicz, J., Harsch, H. H., Cho, J. K., Fuller, S. A., Hoffmann, R. G., Hawkins, M., Rao, S. M., Bandettini, P. A., & Bloom, A. S. (1998). Nicotine-induced limbic cortical activation in the human brain: a functional MRI study. The American Journal of Psychiatry, 155(8), 1009–1015. https://doi.org/10.1176/ajp.155.8.1009
University of Waterloo, & Brock University. (2023). COMPASS: Windsor-Essex County Health Unit.
WECHU. (n.d.). Smoking and Vaping | The Windsor-Essex County Health Unit. Www.wechu.org. Retrieved December 13, 2023, from https://www.wechu.org/school-health/substance-use/smoking-and-vaping#:~…