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Opinion | Michigan must regulate nicotine pouches before new generation lost to addiction
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When a 17-year-old sat in my exam room recently, he didn’t look like someone in the grip of nicotine addiction. He was a focused high school senior and aspiring pilot – the kind of patient you don’t worry about. But as we talked through his daily routine, a different picture emerged: he was using 15 to 20 nicotine pouches every single day.
The nicotine load from that volume rivals two to three packs of cigarettes. He had no idea. But because these small sachets are smokeless, spitless, and tobacco-free, they’ve inherited a healthier veneer.
Data now backs the increasing trends I’m seeing in my clinic. According to the University of Michigan’s 2025 Monitoring the Future Study, pouch use among 10th graders nearly doubled in a single year, from 1.9% to 3.4%. Among high school seniors, use has risen to nearly 6%. While e-cigarettes remain the most used nicotine product among teens, pouches are closing the gap because they have one critical advantage: they remain invisible. Tucked under the lip, they leave no smell, no smoke, and no visible trace. Teachers cannot see them, parents remain unaware, and doctors don’t yet know to ask.
The smokeless nicotine industry has let social media do its marketing. Search #Zynfluencer and you’ll find what amounts to an unpaid sales force of young people modeling pouches as a productivity hack and a cleaner alternative to vapes and cigarettes. My patients then assume these products are risk-free.
While nicotine may provide a momentary buzz, there are serious long-term consequences to the developing brain and body. Nicotine disrupts the formation of neural circuits governing attention, learning, and impulse control. It’s a known gateway to other substance use, and it increases the risk of psychiatric illness. Persistent use drives up blood pressure and raises the danger of heart attacks and strokes. These risks multiply when a teen is consuming a three-pack equivalent of nicotine every day.
Michigan is beginning to respond. Governor Whitmer’s latest budget proposal includes a tax on smokeless nicotine products, which is a meaningful deterrent for a product that retails under $6 a can. The Detroit City Council went further last year, banning nicotine pouch use in professional sports arenas. These are real signals of political will, but our leaders need to move beyond stadium prohibitions and tax proposals.
At the state level, Michigan needs to act on two fronts. First, move pouches behind the pharmacy counter. They are currently sold at gas stations and convenience stores with few barriers to purchase. Requiring a pharmacist-mediated sale doesn’t prohibit adult access. Instead, it makes it a deliberate transaction rather than a reflexive one, and it puts someone with clinical training in the room when a purchase is being considered.
Second, close the online sales loophole. Teenagers can purchase nicotine pouches through online retailers with age verification systems that amount to little more than a checkbox. Some international vendors sell “super pouches” with dangerous levels of nicotine, upwards of 20 times the standard product bought off the shelf. Michigan must require robust third-party age verification and hold online retailers accountable when they fail.
At the federal level, there is cause for cautious optimism and reason to press further. Earlier this month, the Food and Drug Administration (FDA) paused its pilot program for fast-tracking nicotine pouch applications, given concerns about the risks to young people. The agency initially authorized nicotine pouches last year as a lower-risk alternative for existing tobacco users, not as a cessation tool and certainly not as a product for adolescents who have never smoked. Yet, the industry has marketed them as something broader than what the FDA ever sanctioned. Congress should mandate a clear regulatory line – who these products are for, and who they are not – and hold the agency to it.
My patient is a teen with a plan: finish school, earn his pilot’s license, and take flight. Nicotine dependency is not a minor detour from that plan but an anchor that may hold him down for decades. He deserves to enter adulthood with a mind and body that work for him, not against him. So does every Michigan teen who picks up a pouch thinking there’s nothing to worry about.
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