Can Nicotine Pouches Cause Cancer? Does Zyn Cause Cancer?

Understanding What Nicotine Pouches Are

Nicotine pouches are small, white packets containing nicotine, flavorings, sweeteners, and plant-based fillers. They do not contain tobacco leaf or stem material, which differentiates them from traditional smokeless tobacco products like snus. Users place the pouch between the gum and upper lip, where nicotine is absorbed through the oral mucosa.

Despite lacking tobacco leaf, these products still deliver nicotine extracted from tobacco plants. That means they share many of the same concerns associated with other nicotine delivery systems, including dependence and potential health effects.

Is Nicotine Itself a Carcinogen?

One of the most common misconceptions is that nicotine is the direct cause of cancer. According to the International Agency for Research on Cancer (IARC), nicotine is not classified as a carcinogen[1]. Similarly, the U.S. Surgeon General has concluded that there is insufficient evidence to classify nicotine itself as cancer-causing[2].

However, some studies suggest that nicotine may play an indirect role in cancer progression. It has been shown to interfere with apoptosis (programmed cell death) and promote angiogenesis (the formation of new blood vessels), which can theoretically support tumor growth[3]. While these biological mechanisms raise concerns, they do not conclusively prove that nicotine alone initiates cancer in humans.

Chemical Composition and TSNAs

Although nicotine pouches lack tobacco leaf, they may still contain tobacco-specific nitrosamines (TSNAs)—a group of known carcinogens formed during the curing and fermentation of tobacco. These compounds can appear in trace amounts if the nicotine used in the pouches is not fully purified.

A 2022 laboratory analysis conducted by the Centers for Disease Control and Prevention (CDC) found that 26 out of 44 tested nicotine pouch products contained detectable levels of TSNAs[4]. These findings suggest that nicotine pouches are not entirely free of carcinogenic compounds, although the concentrations are significantly lower than those found in cigarettes or moist snuff.

It’s also worth noting that other potentially harmful substances, including formaldehyde, acetaldehyde, and acrolein, have been detected in some pouch products[5]. These chemicals are not exclusive to nicotine products and can also be found in processed food, air pollution, and household items, but their presence contributes to the overall toxicological profile.

Does Zyn Cause Cancer?

Zyn is currently one of the most widely used nicotine pouch brands, and it has been subject to increased scrutiny by researchers and regulators. In January 2025, the U.S. Food and Drug Administration (FDA) granted marketing authorization for 20 Zyn products under its premarket tobacco product application (PMTA) process[6].

The FDA’s scientific review found that Zyn pouches contain significantly lower levels of harmful and potentially harmful constituents (HPHCs) than traditional cigarettes and even many smokeless tobacco products[7]. Most notably, TSNAs were either absent or present at very low levels, and genotoxicity tests (which assess whether a substance can damage DNA) returned negative results[8].

While this sounds promising, the FDA explicitly stated that approval does not mean Zyn is safe. Rather, the agency concluded that the products present a lower risk compared to more harmful tobacco products. Long-term cancer data is not yet available because Zyn and similar products have only been on the market for a relatively short time.

Oral Health Effects and Local Irritation

There is some emerging evidence that nicotine pouches, including Zyn, can cause local irritation of the oral mucosa. Case studies have documented gum recession, lesions, and inflammation in users who place pouches in the same area consistently[9]. However, these effects are typically reversible once use is discontinued.

In contrast, traditional smokeless tobacco products are strongly associated with conditions like oral leukoplakia and cancers of the mouth and throat. There is currently no strong epidemiological evidence linking nicotine pouch use to oral or systemic cancer, but the lack of long-term studies means this risk cannot be ruled out.

Comparative Risk: How Do Nicotine Pouches Stack Up?

Public health experts generally agree that nicotine pouches pose less cancer risk than combusted tobacco or traditional smokeless products. However, they are not risk-free. Here’s a summary comparison:

This chart emphasizes that while nicotine pouches may represent a harm-reduction strategy for smokers, they should not be considered harmless or safe for non-smokers or youth.

Regulatory and Public Health Perspective

Regulators such as the FDA and public health bodies are taking a cautious approach. While nicotine pouches are likely safer than traditional tobacco, concerns remain about:

• Long-term safety data gaps
• Youth and non-smoker uptake
• Flavored products and marketing practices
• Unknown impacts of chronic oral exposure

Several U.S. states have proposed bans or restrictions on flavored nicotine pouches, and ongoing surveillance is planned to monitor adverse events, toxicology, and usage trends.

Conclusion: What We Know and Don’t Know

At present, the answer to the question “can nicotine pouches cause cancer?” is not definitively yes or no. Based on current evidence:

• Nicotine pouches contain far fewer carcinogens than cigarettes or smokeless tobacco.
• Zyn products show a reduced toxicological profile, including very low levels of TSNAs.
• There is no conclusive evidence linking Zyn or any nicotine pouch to cancer.
• However, long-term data is lacking, and low-level exposure to carcinogens may still pose risks.

If you are currently using nicotine pouches to quit smoking, they may be a safer alternative—but not entirely safe. If you don’t use nicotine at all, there is no health benefit to starting.

Sources and References

1. International Agency for Research on Cancer. Monographs on the Evaluation of Carcinogenic Risks to Humans.
2. U.S. Surgeon General’s Report on the Health Consequences of Smoking (2014).
3. Schaal C, Chellappan SP. Nicotine-mediated cell proliferation and tumor progression. J Oncol. 2014.
4. CDC. Nicotine Pouch Market Analysis, 2022. National Center for Chronic Disease Prevention and Health Promotion.
5. Shahab L, et al. Nicotine, carcinogen, and toxin exposure in long-term users of nicotine replacement therapy. Nicotine Tob Res. 2017.
6. FDA. FDA Permits Marketing of 20 ZYN Nicotine Pouch Products, January 2025.
7. FDA Premarket Tobacco Product Application Technical Project Lead Review for ZYN.
8. Philip Morris International. Modified Risk Tobacco Product Application for ZYN.
9. Ghosh A, et al. Oral lesions and periodontal health in users of nicotine pouches. J Oral Pathol Med. 2023.