E-cigarettes aren’t the only nicotine product that has gained popularity among teens.
A poll of more than 3,500 high school students in Southern California found that flavored gum, lozenges, gummies, and other oral products that contain nicotine but not tobacco were the second most popular nicotine items among teens, after electronic cigarettes.
More than 3% of students surveyed said they had tried these oral products before, and nearly 2% said they had in the last six months. Meanwhile, nearly 10% said they had tried e-cigarettes and more than 5% reported doing so in the past six months.
In addition to gummies and lozenges, oral products included lozenges and nicotine pouches (small bags of powder placed under the lip). The products come in flavors like cherry, mixed fruit and pomegranate, and are labeled “tobacco-free.” But they are not approved or advertised as alternatives to help people quit smoking.
“This is a new type of nicotine product” that has appeared on the market in recent years, said Alyssa Harlow, a postdoctoral fellow at the University of Southern California Keck School of Medicine who conducted the research.
The survey didn’t ask teens why they gravitate toward a particular product, but the resemblance to more familiar types of sugary gummies and lozenges might play a role, Harlow said.
“They come in various sweet flavors and several of these products resemble candy, which can create a sense of familiarity for young people,” he said. “They’re also quite inconspicuous and very easy to hide from authority figures. And then brands are using really modern packaging designs and engaging in social media and digital marketing campaigns.”
Teens who said they had tried oral nicotine products were more likely to have used e-cigarettes or cigarettes than to have avoided other nicotine products, raising questions about whether gummies or lozenges are replacing smoking or vaping.
The Food and Drug Administration attempted to crack down on teen e-cigarette use in June when it ordered Juul to stop selling and distributing their products in the US But a day later, a federal appeals court temporarily blocked the ban, allowing Juul e-cigarettes to remain on the market.
“The discreet and covert nature really feeds into a larger question of whether they are used to supplement e-cigarettes or cigarettes,” said Lauren Czaplicki, an assistant scientist at the Johns Hopkins Bloomberg School of Public Health who was not involved in the study. research.
“In an environment where you may not have the opportunity to smoke cigarettes, vape or e-cigarettes, these would definitely satisfy the need for nicotine and allow you to get away with it, so to speak,” he said.
Or, he said, young people who opt for gummies or lozenges “may like the way they taste and make them feel.”
Nicotine products are risky for teens
The term “tobacco-free” can be tricky, Harlow said. Some products use synthetic nicotine, which is created in a laboratory and therefore not derived from tobacco plants. Other products do not contain tobacco leaves, but include nicotine derived from tobacco.
The FDA in April made it illegal for retailers to sell products that are not made or derived from tobacco, such as those that use synthetic nicotine, to customers under the age of 21. To market such products, manufacturers had to apply and receive authorization from the FDA.
However, teens have still managed to obtain “tobacco-free” nicotine products. In the two weeks leading up to July 13, the FDA issued 107 warning letters to retailers who illegally sold the products to underage customers.
The items are advertised in convenience stores and gas stations, which could make teens more tempted to buy them, Czaplicki said.
“Store sales are pretty common,” he said. “Online sales are also quite common.”
Researchers aren’t sure how the health risks of oral nicotine products compare to those of e-cigarettes. Although gummies and lozenges don’t involve inhaling nicotine, it’s still a drug, so teens shouldn’t use it at all, Czaplicki said.
“Any product that contains nicotine is risky for young people, especially when their brains are developing,” he said.
Nicotine is also addictive, so using it as a teenager could encourage lifelong habits.
“I started smoking when I was 13 and I still have a craving for cigarettes, and I’m a tobacco researcher,” Czaplicki said. “It has a way of activating that addiction pathway that persists into young adulthood and into adulthood.”