Nicotine pouches have emerged as a growing public health concern, exposing gaps in the country's tobacco-control framework, including the Cigarettes and Other Tobacco Products Act (COTPA) and the Prohibition of Electronic Cigarettes Act (PECA).
These small, tobacco-free, flavoured sachets, which are placed between the gum and lip to release nicotine, have gained popularity among the young population, especially working men, according to a study by the Indian Council of Medical Research-National Institute of Cancer Prevention and Research (ICMR-NICPR).
A multi-state assessment of points of sale, along with digital audits of online vendors and social media platforms, found nicotine content in these pouches ranging from 2 mg to an ultra-strong 120 mg per pouch.
To be sure, nicotine pouches have no therapeutic value and are not recommended by the World Health Organisation (WHO) as a smoking-cessation aid.
Instead, the WHO and Indian regulations permit only nicotine replacement therapies (NRTs), such as nicotine gums and patches, for quitting smoking. While 2mg nicotine gums are available over the counter, higher-strength gums, as well as nicotine lozenges and patches, require a prescription.
This study is a timely and evidence-based alert to regulators, public health practitioners, and the wider community. Nicotine pouches are not a safe alternative, Dr Shalini Singh, director, ICMR-NICPR, told Mint.
"They are a new vector for nicotine addiction, deliberately engineered to evade our tobacco control laws and targeted squarely at India’s youth. The existing legal framework in India already prohibits these products; what is urgently needed now is uniform, decisive enforcement,” she added.
Widely available
The study identified 68 unique brands, with products primarily available through e-commerce platforms, tobacco shops, hookah retail outlets and gig-based delivery services. International manufacturers accounted for 63.2% of the brands, while domestic manufacturers made up the remaining 36.8%.
The findings, based on data up to 2025, showed these pouches were available in seven out of 10 surveyed cities—Hyderabad, Bengaluru, New Delhi, Mumbai, Kolkata, Chandigarh, Ahmedabad, Chennai, Guwahati, and the North Goa beach belt—with nine out of every 100 surveyed points of sale selling the product.
Hyderabad accounted for the highest share of physical retail outlets selling nicotine pouches at nearly 40%, followed by the North Goa beach belt at around 25% and Bengaluru at 10%.
Furthermore, the study documented 445 unique flavours across eight categories—mint, fruit, alcohol, herbs, spices, coffee, tea, candy, and dessert.
A can containing 15-20 pouches retails for ₹200- ₹1,500, while smaller sachets containing 2-5 pouches are also available.
Interactions with 46 vendors indicated that primary buyers are working men aged 18 to 40 who choose the product because it is marketed as trendy, smokeless and odourless.
E-commerce giant Amazon declined to comment.
Regulatory blind spot
Nicotine significantly increases cardiovascular risks. In India, where the tobacco market is valued at about $62 billion, tobacco use claims an estimated 1.35 million lives annually, according to the Union health ministry.
The country has around 268 million tobacco users, and the economic burden of treating tobacco-related illnesses is estimated at ₹1.77 trillion a year, according to the WHO.
“We witnessed with e-cigarettes aspirational lifestyle marketing, influencer seeding, an array of youth-appealing flavours, and harm-reduction claims that were scientifically unsubstantiated. India must act now, as it did with PECA in 2019, to close this regulatory gap,” said Dr Prashant Kumar Singh, senior scientist and investigator of the study.
The study recommended formulating national measures aligned with the WHO Framework Convention on Tobacco Control to regulate the manufacture, import and sale of these products.
The study said the ICMR-NICPR has advised that the only exception should be unflavored NRTs in 2mg gum form approved by drug regulators for tobacco cessation, with strict prohibitions on sales to minors and marketing by the tobacco industry.
“Nicotine is as addictive as heroin and cocaine. The addiction potential is even higher in young persons…Nicotine is a potent constrictor of blood vessels and sharply raises heart rate and blood pressure, precipitating heart attacks and strokes. It damages the DNA of the genes and prevents their repair. Recent studies have also shown that it can promote cancer growth,” said K. Srinath Reddy, former president at Public Health Foundation of India (PHFI).
Reddy said that while nicotine pouches were first developed as an alternative to nicotine chewing gum for persons whose dental conditions make chewing difficult, it has now become a new tool for promoting addiction to nicotine.
“Tobacco industries see this as a new market to be exploited and have acquired the major stakes in nicotine pouch manufacturing," he said.