Germany: Concerns over teenagers' use of nicotine pouches

Recent results from the DAK-Präventionsradar (National Health Insurance Fund) reveal a worrying trend among German adolescents: around one in seven pupils aged 16 to 17 have already experimented with nicotine pouches. This practice is more widespread among boys than among girls.

Around 12,700 children and adolescents aged 9 to 17 were surveyed about their health behaviour in 2022 and 2023. The survey was conducted in 14 federal states by teachers in 83 schools, representing 927 classes, using questionnaires.[1].

Consumption already very high among students

According to the survey, 5.4% of the children and adolescents surveyed have consumed nicotine pouches at least once (boys: 6.3%, girls: 3.5%). Among 16-17 year-olds, nearly 15 TP3T of the students surveyed said they had already tried these products. Among them, 5 TP3T said they used them regularly.

Health authorities are warning of the dangers of these products. Professor Reiner Hanewinkel of the Institute for Therapie- und Gesundheitsforschung points out that the addictive potential of nicotine is extremely high, especially at a young age. Early consumption can disrupt brain development and the very high levels of nicotine contained in these products can lead to side effects such as headaches, dizziness, heart palpitations and nausea. In addition, the possible presence of carcinogenic substances in these products is a cause for concern.

THE report highlights that nicotine pouches are particularly attractive to young people because of their targeted marketing, often associated with fruity flavours and modern design. This marketing strategy masks the real health risks and the perception of the harmfulness and addictive nature of these products. The data also shows that 60% of the young people surveyed who had tried these products said they had obtained them from friends or acquaintances, while 25% had bought them online, even though these products are normally banned in the country.

Co-consumption of nicotine products by adolescents

The study also reveals that almost all children and adolescents who have already used nicotine pouches have also experimented with other nicotine-containing products such as cigarettes, e-cigarettes or hookahs. From the age of 13, this co-consumption increases significantly.

The results also show that students from disadvantaged socio-economic backgrounds consume even more nicotine pouches. For example, students in general schools (Gymnasium) consume these products less than students or young people in more vocational courses (Haupt – Realschulen).

Toxic products banned from sale in Germany

Public health associations are calling for immediate action to establish strict rules regarding the sale and advertising of these products. "We are facing a new epidemic of nicotine addiction among young people," deplores a DAK spokesperson. Since 2021, nicotine pouches have been subject to the Foodstuffs Act in Germany and can no longer be legally sold due to their high nicotine content. Nevertheless, nicotine pouches are offered for sale in many kiosks across the country and on the Internet.

In 2022, the German Federal Institute for Risk Assessment[2] had analyzed 46 brands of nicotine pouches marketed by twenty different producers and the results showed nicotine levels ranging from 1.79 mg to 47.5 mg/pouch. The analyses had also shown the presence of tobacco-specific nitrosamines, some of which are carcinogenic (NNN, NNK), in trace amounts in 26 of the products tested and quantifiable in 17 of them. A laboratory analysis conducted in France by the National Committee against Smoking and the INC/60 million consumers[3] on 7 different references showed the presence of heavy metals such as arsenic and lead in the products. The two organizations have called for their immediate ban in France, following the example of Belgium and the Netherlands.

©Tobacco Free Generation

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[1] Communicated, Jeder siebte Schüler hat schon Nikotinbeutel probiert, DAK, published December 18, 2024, accessed December 20, 2024

[2] Generation without tobacco, Traces of nitrosamines and high levels of nicotine in pouches, published on August 16, 2022, consulted on December 20, 2024

[3] Communicated, The CNCT and the INC/60 Million Consumers reveal the results of their study: lead and arsenic found in nicotine pouches, CNCT, published on December 10, 2024, consulted on December 20, 2024