1.媒體來源:
CNN
2.記者署名:
泰勒·尼西奥利（Taylor Nicioli）
3.完整新聞標題:
尼古丁袋正變得越來越受歡迎 以下是健康專家擔憂的原因
Nicotine pouches for your mouth are becoming increasingly popular. Here’s
why health experts are concerned
4.完整新聞內文:
Zyn 是一種無煙尼古丁袋，去年逐漸變得越來越受歡迎。該公司表示，該產品面向已
使用菸草或尼古丁產品的成年人。Shelby Knowles/Bloomberg/Getty Images
CNN
—
在過去的一年裡，一種相對新的無煙和無菸的尼古丁產品吸引了一波新用戶：放置在牙齦
上並在使用時幾乎無法察覺的口腔尼古丁袋。
美國於 2014 年推出的領先品牌 Zyn 在 2023 年出貨了 3.5 億罐，每罐約 15 個口袋，
與去年相比增長了 62%，菲利普·莫里斯國際公司在 2 月份宣布。
儘管該產品的目標是已經使用尼古丁的成年人，但一些健康專業人士和研究人員擔心，這
種關注可能會吸引一大批全新的用戶，尤其是年輕人。
菲利普·莫里斯國際公司的一位發言人在一封電子郵件中表示，Zyn 不使用社交媒體影響
者進行市場營銷，並且針對美國受眾的 Facebook 和 Instagram 上的公司社交媒體帖子
已經進行了 21 歲及以上的年齡閘門設置。然而，美國各地的大學都看到了 Zyn 在校園
中的使用量增加，而社交媒體上出現了一種新型的非官方尼古丁影響者 —— “
Zynfluencer”。
參議院多數黨領袖查克·舒默最近呼籲聯邦貿易委員會和食品和藥物管理局監管機構調
查 Zyn 的市場營銷策略和健康影響。他在一月份的新聞發布會上說：“我要向父母發出
警告，因為這些尼古丁袋似乎把目光鎖定在年輕孩子身上 —— 青少年，甚至更小的孩
子 —— 然後使用社交媒體來吸引他們。”
以下是專家對該產品健康風險的看法。
尼古丁口袋是否比電子煙更好？
菸草是已知的致癌物，可以引起多種癌症。根據美國癌症協會的說法，吸煙是肺癌的主要
原因。Zyn 及其他品牌的尼古丁袋，如 Rogue、On! 和 Velo，將其口袋市場定位為吸
煙和使用菸草的代用品。
儘管使用尼古丁袋不需要像吸煙或使用電子煙那樣吸入化學物質，但內布拉斯加醫學
院的肺部疾病和胸外科護士執業者 Kecia Christensen 目前不建議使用袋產品作為戒
菸的手段。
“這些公司正試圖推出無菸草相關的尼古丁形式，讓人們嘗試戒除尼古丁成癮……我認為
，這類產品的問題在於，除非它們完全受到 FDA 的監管，否則我告訴我的患者的是，‘
我不確定這些東西中究竟含有什麼，’” Christensen 說道，她也是一名註冊的戒菸治
療專家。
誰應該擔心肺癌？醫生解釋
根據公司的說法，菲利普·莫里斯國際公司向 FDA 提出的授權申請自 2020 年以來一直
在等待審批。然而，FDA 官員允許這種無菸草尼古丁產品在申請審查期間繼續上市。
Christensen 表示，雖然需要進一步研究該產品，如果尼古丁口袋的尼古丁含量逐步減少
到比抽菸或咀嚼菸草時攝入的尼古丁量更少，則對於最終想要完全戒除菸草和尼古丁使用
的人來說，尼古丁袋可能有助於抑制渴望。
數字可能有所不同，但克里斯滕森通常告訴患者，一支香煙中的尼古丁含量約為每支 5
到 10 毫克，實際吸入的尼古丁量可能少於這個數字。尼古丁袋的尼古丁含量各不相同
；每個口袋中的尼古丁含量最常見為 3 或 6 毫克，但有些品牌的口袋中的尼古丁含量甚
至高達 28 毫克。
尼古丁成癮與心理健康
根據克里斯滕森（Christensen）的說法，很多試圖戒除菸草的患者最終會通過電子菸而
不是菸草，有時甚至比吸煙更容易成癮。這是因為電子煙更容易使用，通常在室內使用，
而不是在戶外吸煙休息時間，她說。尼古丁袋甚至更加隱蔽，一個小袋尺寸為 0.6 英
寸 × 1.1 至 1.3 英寸（14 毫米 × 28 至 32 毫米），類似於一塊口香糖，幾乎可以
在任何地方放入口中，而其他人都不會知道。
研究建議，與幫助減肥不同，吸煙會導致更多的腹部脂肪。
依賴尼古丁會導致渴望和戒斷症狀，如煩躁、頭痛、頭暈和疲勞。根據國家癌症研究所的
說法，研究人員發現，長期使用可能與心臟病、血管疾病、生殖紊亂等有關。根據 FDA
的說法，尼古丁不會導致癌症或肺部疾病。
克里斯滕森表示，當尼古丁使用與應對壓力、焦慮或抑鬱的方法相關聯時，戒斷尼古丁成
癮尤其困難。
“心理健康與尼古丁成癮密切相關，”她補充說。 “人們重新吸煙或再次咀嚼的最大原
因是因為他們生活中發生了不好的事情，你知道，他們有一些新的壓力或有人去世了或失
業了或他們正在離婚，然後他們開始吸煙，因為他們無法應對那些情緒，或者他們認為沒
有吸煙就無法應對。”
此外，克里斯滕森補充說，對於從青少年時期開始使用尼古丁的人來說，這種習慣尤其難
以戒除。
尼古丁口袋用戶將口袋放在牙齦上最多一個小時，這可能導致口腔疼痛或牙齦刺激。但截
至目前，對口腔產品的完整影響還不清楚，仍需要進一步研究了解尼古丁使用如何可能與
牙齦疾病或蛀牙相關聯，紐約州立羅切斯特大學伊斯曼口腔健康學院診斷科系主任兼教授
任延方（Yanfang Ren）表示。他曾參與了一項於 2017 年 12 月進行的研究，該研究部
分由菲利普·莫里斯國際公司資助，研究了煙霧對牙齒顏色的影響。
對於那些希望戒除煙草和尼古丁，過上更健康的生活方式，莫蘭建議咨詢初級健康護理提
供者，以及利用梅奧診所尼古丁依賴中心提供的在線資源。美國疾病控制與預防中心（
CDC）也提供在線資源來幫助那些打算戒煙的人。
Zyn, a smokeless nicotine pouch, has been increasing in popularity over the
past year. The product is intended for adults who already use tobacco or
nicotine products, according to the company. Shelby Knowles/Bloomberg/Getty
Images
CNN
—
A relatively new nicotine product with a tobacco-free and smokeless design
has drawn in a wave of new users in just the past year: oral nicotine pouches
that sit at the gums and are nearly undetectable when in use.
The leading brand Zyn, introduced in the United States in 2014, shipped 350
million cans, about 15 pouches per can, in 2023 — a 62% increase compared
with the previous year, Philip Morris International announced in February.
While the product is aimed at adults who already use nicotine, some health
professionals and researchers are worried the attention could attract an
influx of brand-new users, especially among younger people.
Zyn does not use social media influencers to market, and the company’s
social media posts on Facebook and Instagram for US audiences are age-gated
to 21 and older, a spokesperson for Philip Morris International said in an
email. Yet colleges across the United States have seen a rise in Zyn usage on
campus, while social media has a new type of unofficial influencer for
nicotine — a “Zynfluencer.”
Senate Majority Leader Chuck Schumer recently called for Federal Trade
Commission and Food and Drug Administration regulators to investigate Zyn’s
marketing strategies and health impacts. “I’m delivering a warning to
parents, because these nicotine pouches seem to lock their sights on young
kids — teenagers, and even lower — and then use the social media to hook
them,” he said in a January press conference.
Here’s what experts have to say on the health risks of the product.
Are nicotine pouches better than vaping?
Tobacco is a known carcinogen that can cause several types of cancer.
Cigarette smoking is the primary cause of lung cancer, according to the
American Cancer Society. Zyn, among other brands of nicotine pouches such as
Rogue, On! and Velo, markets its pouches as an alternative product to smoking
and using tobacco.
While using a nicotine pouch does not entail inhaling chemicals as with
cigarettes or vape pens, Kecia Christensen, a nurse practitioner in pulmonary
disease and thoracic surgery at Nebraska Medicine, does not recommend the use
of pouch products as a means to quit smoking at this time.
“It’s good that these companies are trying to come up with
nontobacco-related forms of nicotine for people to try to wean their
addiction. … The problem, I think, with products like this is that until
they are completely regulated by the FDA, what I tell my patients is, ‘I don
’t really know for sure what’s in those things,’” said Christensen, who
is also a certified tobacco treatment specialist.
Unrecognizable young woman enjoying a cigarette outdoors. Focus is on the
cigarette.
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Philip Morris International’s application for FDA authorization has been
pending since 2020, according to the company. However, FDA officials have
allowed the nontobacco nicotine product to stay on the market while the
application is under review.
While more research on the product is needed, Christensen said, the nicotine
pouches could potentially help curb cravings for those looking to ultimately
stop tobacco and nicotine use altogether if the amount of nicotine is
incrementally decreased to be less than what a person was taking in with
cigarettes or chewing tobacco.
The numbers can vary, but Christensen often tells patients to think of one
cigarette as having 5 to 10 milligrams of nicotine each, with the actual
amount inhaled probably less than that. Nicotine pouches have varying degrees
of nicotine strength; 3 or 6 milligrams per pouch is most common, but some
brands have pouches that contain upward of 28 milligrams.
Nicotine addiction and mental health
Oftentimes, patients who are trying to quit tobacco instead get addicted to
nicotine through vaping, sometimes even more so than with cigarettes,
according to Christensen. That’s because vapes are easier to use and are
often used indoors rather than outside on smoke breaks, she said. Nicotine
pouches are even more discreet, with a small pouch measuring at 0.6 inches by
1.1 to 1.3 inches (14 millimeters by 28 to 32 millimeters), similar to a
piece of chewing gum, that can be popped in the mouth virtually anywhere
without anyone else knowing.
Rather than help weight loss, the study suggests smoking leads to more
abdominal fat.
A dependency on nicotine causes cravings and withdrawal symptoms such as
irritability, headaches, dizziness and fatigue. Researchers have found
long-term usage may be connected with heart disease, vascular disease,
reproductive disturbances and more, according to the National Cancer
Institute. Nicotine does not cause cancer or lung disease, according to the
FDA.
Addiction to nicotine can be particularly tough to break when the usage is
associated with coping methods for stress, anxiety or depression, Christensen
said.
“Mental health is really wrapped pretty tightly up with nicotine addiction,
” she added. “The biggest reason why people relapse and start smoking again
or chewing again is because something bad happens in their life, you know,
they have some new stress or somebody dies or they lost their job or they’re
getting a divorce, and then they start smoking again, because they can’t
handle those emotions, or they don’t think they can without smoking.”
And the habit can be particularly difficult to kick for those who have been
using nicotine since they were teenagers, Christensen added.
More adolescent e-cigarette users report vaping within five minutes of waking
up, new study finds
Zynfluencers and Zyn users
Zyn does not have official social media influencers, but the hashtag “
Zynfluencer” has hundreds of posts on TikTok and Instagram, and “Zyn” has
upward of tens of thousands.
“Nicotine products should only be used by legal-age adults, which means
those 21-plus. The latest CDC (US Centers for Disease Control and Prevention)
and FDA data show that underage nicotine pouch use has remained low while
providing many adult smokers with a better alternative than continued smoking,
” Philip Morris International said in a statement to CNN.
The data from Swedish Match, a tobacco company that makes Zyn and acquired by
Philip Morris International in February 2023, also shows that most of the
social media audience is “previous consumers of traditional oral, vaping and
cigarette products with others coming from other nicotine product categories,
” the company noted.
How to convince, scare or bribe your kids not to vape
The advertisements for Zyn use terms such as “smoke-free,” “spit-free”
and “odor-free” and can contain imagery of the products being used in
places a cigarette or an e-cigarette wouldn’t be allowed, said Meghan Moran,
an associate professor of health, behavior and society at Johns Hopkins
Bloomberg School of Public Health in Baltimore. The discreetness is cause for
concern when it comes to the attractiveness to people under 21, she added.
“When you think about young people who are not already using tobacco and who
we don’t want to use tobacco, a product being discreet is potentially very
attractive, because younger folks, teenagers, often find themselves in
situations such as, you know, school, maybe home with the parents, where if
it were discovered that they were using a tobacco product, there would likely
be repercussions,” Moran said.
What’s more, the Zyn nicotine pouches come in a variety of flavors,
including cool mint, wintergreen, coffee and cinnamon, that could be
appealing to younger people.
In October, 1.5% of middle school and high school students reported using
nicotine pouches in the previous 30 days, according to the 2023 National
Youth Tobacco Survey conducted by the FDA and CDC.
“The FDA remains concerned about any tobacco product that may appeal to
youth,” said Brian King, director of the FDA’s Center for Tobacco Products,
in a statement. “As always, we are committed to holding those accountable
who sell unauthorized tobacco products, including those labeled, advertised,
and/or designed to encourage youth use.”
For those not used to nicotine, high amounts can cause vomiting and nausea
(or “nicotine sickeness”), Christensen said. Nicotine products can also “
harm the developing adolescent brain,” according to FDA and CDC research.
A man sits outside and holds a slim menthol cigarette between his fingers.
Close-up with focus on the cigarette.
Zyn and mouth soreness
Nicotine pouch users hold the pouch to their gum for up to an hour, which may
cause a sore mouth or gum irritation. But the full effects of the oral
product are not known as of yet, with more research needed to understand how
nicotine usage might be associated with gum disease or cavities, said Yanfang
Ren, a professor and chairman of the department of diagnostic sciences at the
University of Rochester Eastman Institute for Oral Health in upstate New York.
“If you put something, anything in the mouth for a long time, potentially
you might have some irritation to the gum — but to what extent, that’s
something we really don’t know yet,” Ren said. He was a part of a December
2017 study that looked at the effect cigarette smoke had on the color of the
teeth that was partially funded by Philip Morris International.
For those looking to quit tobacco and nicotine altogether for a healthier
lifestyle, Moran recommends visiting a primary health care provider, as well
as using resources provided online by the Mayo Clinic Nicotine Dependence
Center. The CDC also has online resources to help those aiming to quit
smoking.
5.完整新聞連結 (或短網址)不可用YAHOO、LINE、MSN等轉載媒體:
https://reurl.cc/lg3kZ9
6.備註:
我是世衛菸草減害專家 王郁揚，
台灣衛生福利部跟董氏基金會對這產品完全避而不談，
更離譜的是，
政府就趁全體國民都不清楚發生什麼事的時候，修菸害防制法時，
就把「類菸品」的定義，除了符合電子菸的定義，也符合尼古丁袋/菸鹼袋，
因此在台灣，尼古丁袋已經被納入類菸品全面禁止
狗屁黑箱的菸害防制法，嚴重危害國民健康，這些拿的菸捐亂搞的單位，噁心！
延伸閱讀：
一、
【菸鹼袋Nicotine Pouches分享】類菸品包山包海 尼古丁袋也被納入嚴格禁止 ft. WHO
FCTC菸草減害專家 王郁揚
https://www.youtube.com/watch?v=DgPr-GWxdDA
二、
觀點投書：黑箱菸害防制法，危害台灣人民健康
https://www.storm.mg/article/4879143?mode=whole
三、
加熱菸禁不禁？台灣菸害防制的新難題｜NOWnews
https://www.youtube.com/watch?v=1vISgLHPcfc