Pakistan is currently grappling with a significant public health challenge of a dual nature: the persistent presence of communicable diseases alongside the rapid rise of non-communicable diseases (NCDs). This double burden strains Pakistan’s already fragile healthcare infrastructure and jeopardizes the well-being of its citizens.
Amidst this complex scenario, a new threat has emerged and is spreading at an alarming rate: tobacco-free nicotine pouches. Marketed with deceptive appeal, these products pose a significant and often underestimated risk to individual health.
### What Are Nicotine Pouches?
Nicotine pouches are small sachets placed between the gum and lip, widely advertised as a modern and discreet way to consume nicotine. Unlike traditional tobacco products, these pouches contain nicotine powder extracted from tobacco leaves or synthetically manufactured. Their appeal is enhanced by a variety of flavors and the absence of smoke or spit, which are often associated with other tobacco products.
Marketed as tobacco-free or tobacco leaf-free, nicotine pouches have seen a significant surge in popularity recently. This has led to a common misconception among the public that they are harmless.
### The Health Risks of Nicotine
Nicotine is a highly addictive substance with a range of detrimental health effects. It is a potent psychoactive compound that leads to addiction—a chronic, relapsing brain disease characterized by compulsive drug-seeking and use despite harmful consequences.
This addiction is particularly concerning when it begins in youth, as it can disrupt brain development. The human brain continues to develop until a person’s mid-twenties, and early exposure to nicotine can impair cognitive functions such as attention and learning. Moreover, early nicotine use may increase the likelihood of addiction to other substances later in life.
Clinical trials have extensively documented the health risks linked to nicotine. Its use has been associated with several cardiovascular issues: nicotine can increase heart rate and blood pressure, placing added strain on the heart. Long-term use can contribute to the hardening of artery walls, increasing the risk of heart attacks and strokes—conditions that already account for a major portion of the NCD burden in Pakistan. The proliferation of nicotine pouches threatens to worsen this crisis.
### Impact on Oral Health
Nicotine pouches also raise serious concerns regarding oral health. Placing the pouch directly against the gums can lead to irritation and inflammation. Prolonged and repeated use may cause gum recession, a condition where gum tissue pulls away from the teeth, exposing the roots and increasing the risk of dental caries and tooth loss.
While research into the long-term impact on oral cancer is ongoing, the potential for chronic irritation and inflammation of oral tissues remains a significant health risk.
### Regulatory Challenges and Marketing Concerns
The market for nicotine pouches in Pakistan is largely unregulated. Because they are marketed as tobacco-free, these products bypass many of the regulations and taxes that apply to traditional tobacco items. This regulatory gap has created a space for aggressive marketing campaigns, particularly on social media, targeting young adults and adolescents.
The appealing flavors and discreet nature of nicotine pouches make them especially attractive to younger demographics, fueling the creation of a new generation of nicotine users and perpetuating the cycle of addiction. Alarmingly, a recent study highlighted the high use of nicotine pouches among young adults in Pakistan, many of whom remain unaware of the associated health risks.
### The Public Health Implications
The lack of robust regulation, combined with deceptive marketing, directly contributes to Pakistan’s double burden of disease. As NCDs such as cardiovascular diseases and certain cancers continue to rise, the introduction of easily accessible and addictive nicotine products threatens to exacerbate the situation.
This growing public health problem places immense pressure on Pakistan’s healthcare system and economy, draining valuable resources that are desperately needed for other critical health initiatives.
### Legislative Efforts and the Way Forward
In response to these challenges, the National Assembly passed the NIH (National Institute of Health) bill on August 12. The bill emphasizes the urgent need to establish a national cancer registry to accurately assess the disease burden and implement a national action plan for cancer prevention and management strategies.
Through this legislation, the structure and governance of the National Institute of Health will be strengthened, aiming to improve the institution’s performance. The approval of the bill marks a significant step towards healthcare reform and institutional improvement in Pakistan.
### Call to Action
To safeguard public health—especially that of the younger population—it is imperative for the government and regulatory authorities to take immediate and decisive action against nicotine pouches.
Including these products within the taxation framework can substantially curb their widespread use. Moreover, the sale and distribution of nicotine pouches must be subjected to strict regulatory controls.
The most effective and direct way to address this emerging threat is through a comprehensive ban on the sale of nicotine pouches. Such a step would prevent a new wave of nicotine addiction and associated diseases from sweeping across the country.
By eliminating this silent scourge, Pakistan can protect future generations and make tangible progress toward reducing the double burden of disease that challenges the nation.
**The time for action is now.**
https://www.thenews.com.pk/tns/detail/1345109-the-double-burden-of-disease