Red Ribbon Week 2023: SERAC Puts Spotlight on Oral Nicotine
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This month, we’re preparing for Red Ribbon Week, an annual nationwide campaign to prevent underage alcohol, tobacco, and drug use. This is a great opportunity for families and communities to talk about how these substances can impact young people. Something that often gets overlooked in these discussions is nicotine, which may seem less risky compared to other drugs. But we know that despite declining cigarette use in younger generations, nicotine dependence has barely loosened its grip on the population. Younger people are simply getting hooked on different products—such as oral nicotine.
As oral nicotine pouches continue to gain popularity across the country, they’ve emerged as a problem particularly among youth. In SERAC’s 2021-22 School Health Survey, more Connecticut high school students reported using non-cigarette tobacco products than those who used cigarettes. A fall 2020 study also found that 13% of 15-24-year-olds had used nicotine pouches in the past 30 days. This trend warrants attention, and SERAC is taking a closer look at how these products are used, how they differ from other products on the market, and what makes them dangerous.
About Red Ribbon Week
Taking place from October 23 through October 31 each year, Red Ribbon Week is the nation’s largest and oldest drug prevention campaign. It was created in 1988 by the National Family Partnership with a mission “to lead and support our nation’s families and communities in nurturing the full potential of healthy, drug-free youth.” Red Ribbon Week encourages people of all ages to come together and take a stand against substance use.
To emphasize how making positive choices contributes to individual health and happiness, the campaign’s theme for 2023 is “Be Kind to Your Mind. Live Drug Free.™”
What Are Oral Nicotine Pouches, and Why Are They Popular with Teens?
Oral nicotine pouches are small fiber pouches prefilled with nicotine powder (rather than tobacco leaf), along with flavorings, sweeteners, and filling agents. The pouches are placed between the gum and lip, allowing the nicotine to be absorbed orally. The level of nicotine varies by product and brand; while they are generally comparable to other smokeless tobacco products, increasingly high-nicotine products are hitting the market.
Like lozenges, gum, and other smokeless nicotine products, pouches are growing in popularity among young people. Since they don’t produce smoke or ash, these products can be used discreetly, which appeals to teens trying to hide their nicotine use from parents and teachers.
Yet there’s another reason behind the popularity of oral nicotine pouches. Because they are not yet subject to the stringent FDA regulations which govern the sale and marketing of most tobacco products, many brands are using marketing tactics that directly appeal to young people, including:
- Flavors: Nicotine pouches are available in a variety of sweet and fruity flavors like berry, cinnamon, and citrus. Nationwide studies have found that the vast majority of young tobacco users prefer flavored options; flavors are a strong determinant of how likely a young person is to try a tobacco product. (Hence the federal ban on flavored cigarettes, which has not yet been extended to vape cartridges and smokeless tobacco products.)
- Packaging: Most nicotine pouches come in containers that look similar to those containing candy or mints, with bright, eye-catching colors and graphics designed to appeal to young people.
- Marketing Claims: With no smoke to inhale, nicotine pouches and other smokeless products may seem less harmful than traditional cigarettes, especially to young people who don’t know about nicotine’s health risks. Some brands take advantage of this misconception by claiming to be a smoking cessation product (although they do not meet FDA criteria for this use).
What Makes Nicotine So Dangerous for Kids?
Because their brains are still developing, teens and adolescents are more susceptible to nicotine addiction than any other age group—and they’re also the most vulnerable to its harmful effects on the mind and body. While it may seem less “risky” than other substances, researchers have named this drug the third most addictive substance on earth, behind only heroin and cocaine. Two-thirds of Americans who ever give smoking a try will become dependent during their lifetime, and the risk is highest among those who first experiment with nicotine during youth.
How Do I Know If My Child Is Addicted to Nicotine?
While oral nicotine pouches might be new, the signs and symptoms of nicotine addiction are not. If your child has developed a dependence on nicotine, they’ll experience withdrawal symptoms when not using it. Here’s what to be on the lookout for:
- Changes in mood: Nicotine use puts young people at an increased risk for mood disorders and suicidality, so take note if your child seems depressed. Cravings may also cause them to feel anxious, irritable, or angry for no apparent reason.
- Changes in sleep: Because nicotine is a stimulant, those who use it might stay up later than usual, have trouble falling asleep, or sleep restlessly.
- Changes in academic or sports performance: Nicotine can reduce impulse control, attention, learning, and memory, negatively impacting schoolwork as well as teamwork.
- Changes in appetite: Nicotine is an appetite suppressant, so some users might eat less and lose weight. However, withdrawal can cause strong cravings, so you might also notice your child eating more.
- Jaw clenching and teeth grinding: A common side effect of stimulants, this can lead to temporomandibular joint disorder (TMJ), which makes it difficult to chew, talk, and open the mouth.
Of course, these are just the symptoms you can see. Nicotine can also cause significant physical harm which may be invisible until it’s too late, such as damage to the heart and blood vessels which increases the risk of heart disease and stroke. That’s why prevention and early intervention are so important. If you notice any of the above symptoms, have an open, honest conversation with your child—and check out these resources for quitting.