The nicotine use vocabulary expands beyond vaping and smoking as cigarette companies push flavored oral pouches that have no tobacco. Brands such as Zyn, On!, Rogue and Velo have gained popularity in recent years. No spitting is required, so they're less visible than vaping – something that appeals to young users, even though buyers are supposed to be over 21. Another draw is the choice of flavors, such as citrus, cinnamon, spearmint and peppermint -- sold for $5 or $6 in round tins with 15 little white rectangles. TikTok and Snapchat videos help propel the products' popularity. Pouches are marketed as a cleaner, more discreet way to consume nicotine – especially indoors. Sales have doubled annually since 2019, researchers say, with Zyn accounting for nearly 60% of purchases.

Due to the absence of tobacco leaf, the federal Food and Drug Administration (FDA) doesn't classify the new category as a smokeless tobacco product. But the fingernail-size packets, placed under the lip and informally called "gum pillows" or "lip cushions," have nicotine powder -- a stimulant drug that speeds up messages between the brain and body. As the microfiber pouch sits in the mouth while nicotine salts melt, it provides a "rush" that users say helps them stay alert and stop using cigarettes. "It makes you feel like you're walking on a cloud," Alec Cellini of South Boston told a local TV station.

Some health experts and government officials call for protections to prevent youth consumption and addiction. "These nicotine pouches seem to lock their sights on young kids, teenagers and even lower, and then use the social media to hook them," says Sen. Charles Schumer, D-N.Y., who wants the FDA and Federal Trade Commission to consider tighter legal restrictions beyond the age limit that's loosely enforced – if at all. Many studies show that the younger people are when they try nicotine the first time, the more likely they'll get addicted. Nearly 90 percent of adults who smoke daily started the habit before age 18, a recent New York Times opinion article says.

Across our northern border, where teens can buy Zonnic brand pouches legally, the Canadian Cancer Society and Canadian Lung Association urge "immediate action" by the government to reclassify them as a prescription product or suspend their sale. "Most people who become addicted to nicotine do so during their adolescence," says Cynthia Callard, executive director of nonprofit group in Ottawa called Physicians for a Smoke-Free Canada. "Given the increase in youth vaping, how is it possible that Health Canada would allow a new category of nicotine product on the market, sold by a tobacco company, with massively inadequate regulations in place?" Chill Mint, Tropic Breeze and Berry Frost are among Zonnic flavors.

Teen says: "Nobody had heard about Zyn until very early 2023. Now, a lot of high schoolers have been using Zyn. It’s really taken off." – Greyson Imm, 18, of Prairie Village, Kansas

Tobacco firm says: "It's important to put less harmful alternatives to smoking on the market. We're selling this product like any other [smoking] cessation product." – Eric Gagnon of Imperial Tobacco Canada

Professor says: "It's on TikTok, it’s on Snapchat, whatever – all social media -- and it's not stigmatized, whereas cigarettes have become kind of taboo." -- Dr. Rebecca Toland, assistant professor of health sciences at Columbus State University in Georgia