Q: While I was waiting at the pharmacy counter the other day, several young people at the checkout beside me came in to purchase Zonnic. I had never heard of this product before, so I asked about it and was told they were nicotine pouches. Why would pharmacies be selling these?
Zonnic is a nicotine pouch product approved by Health Canada as a nicotine replacement therapy intended to help adults quit smoking. The small white pouches are placed between the gum and lip, where nicotine is absorbed through the lining of the mouth. They may be kept in place for up to 60 minutes before being discarded. Unlike cigarettes, vaping products, or chewing tobacco, there is no smoke, vapour, or tobacco leaf involved.
Zonnic was introduced to the Canadian market in 2023 and was initially sold in convenience stores and gas stations in a variety of flavours, including berry frost and tropic breeze. Health Canada and provincial regulators quickly became concerned that the products were appealing to teenagers and young adults who had never previously smoked or vaped.
As concerns grew around youth nicotine use and recreational experimentation, tighter restrictions on the sale of Zonnic were introduced across Canada. Sales were moved exclusively to pharmacies, where the product could be repositioned as a smoking cessation aid, similar to nicotine patches, gum, and lozenges, rather than being marketed as a lifestyle product. Keeping Zonnic behind the pharmacy counter also allows for age verification to prevent sales to minors and reduces the likelihood of youth purchasing the product through self-serve checkouts. In addition, it provides an opportunity for patients to speak with a pharmacist about smoking cessation and appropriate use of nicotine replacement therapies.
At the same time Zonnic was moved to pharmacies, fruit- flavoured varieties were removed from the market. Research has consistently shown that sweet and candy-like flavours are particularly appealing to youth and first-time nicotine users. Initially, chill mint was the only flavour permitted because regulators believed it was less likely to encourage experimentation among adolescents while still remaining acceptable to adults trying to quit smoking. Since then, additional mint-based options such as peppermint and spearmint have become available.
From my perspective as a pharmacist, I am not commonly seeing Zonnic used primarily as a smoking cessation product. Because nicotine pouches are odourless, discreet, and easy to use almost anywhere, there appears to be increasing use among people who did not previously use nicotine products. This is one of the major concerns surrounding nicotine pouches. Researchers at the Ottawa Heart Institute recently reviewed the available evidence and found that while nicotine pouches may help reduce the number of cigarettes smoked per day, there is not enough study evidence to demonstrate whether they improve long-term quit rates. Current evidence suggests these products may be more appropriately viewed as a harm reduction option for smokers rather than a definitive treatment for nicotine addiction, at this time.
From a harm reduction standpoint, nicotine pouches are considered safer than smoking cigarettes because they eliminate combustion. When tobacco is burned, thousands of chemicals are released into the body, including tar, carbon monoxide, and many cancer-causing substances. Cigarette smoking is strongly linked to lung disease, heart disease, stroke, and multiple cancers. Nicotine pouches avoid smoke inhalation entirely, which reduces many of these risks. Compared with vaping, they also eliminate exposure of the lungs to aerosolized chemicals.
However, “safer” does not mean harmless. Nicotine itself remains highly addictive and can lead to long-term dependence. It also has stimulant effects that may increase heart rate and blood pressure. This can be particularly concerning when nicotine is combined with stimulants such energy drinks or certain prescription medications used to treat ADHD. Other commonly reported side effects with Zonnic include nausea, mouth irritation, sore gums, hiccups, and heartburn.
For patients who are motivated to quit smoking completely, varenicline, commonly known by the brand name of Champix, remains one of the most effective treatment options available. Combination nicotine replacement therapy, such as using a nicotine patch together with gum, lozenges, or an inhaler for breakthrough cravings, is also highly effective.
In New Brunswick, pharmacists can assess patients and prescribe medications for smoking cessation. While this assessment service is not currently publicly funded by the provincial government, the cost may be reimbursed through some private insurance plans.