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When Health Canada forced nicotine pouches behind pharmacy counters last year, Kaden Desmarais did what many users have done ever since: get creative.<\/p>\n
The 26-year-old from Kelowna, B.C., started buying oral pouches from online sellers \u2014 or driving to nearby Indigenous reserves to buy them there.<\/p>\n
\u201cI think it\u2019s one of the most confusing and braindead laws,\u201d Desmarais told Canadian Affairs via text message.\u00a0<\/p>\n
\u201cWe are legally allowed to import up to 40 tins of 4 mg and under for personal use from other countries, but can\u2019t buy a single tin at a gas station?\u201d<\/p>\n
Desmarais is referring to Health Canada rules<\/a> that require small-dose nicotine pouches to be sold by pharmacists within pharmacies.<\/p>\n These rules were introduced last August, a year after Health Canada first approved Zonnic to be sold as a natural health product and nicotine replacement therapy for adults who smoke. Zonnic, which is sometimes referred to as Zyn, is currently the only nicotine pouch authorized for sale in Canada.<\/p>\n The agency\u2019s rules<\/a> also restrict pouch flavours to mint or menthol, and effectively require them to be under 4 mg to avoid being regulated as prescription drugs.<\/p>\n Desmarais and others say these rules have had the perverse effect of making it easier to buy cigarettes than to buy products to quit smoking, and have led to many buyers seeking out unapproved products elsewhere.\u00a0<\/p>\n \u201cPouches and nicotine shouldn\u2019t be demonized the way they are,\u201d said Desmarais, who started using pouches two years ago after vaping made his lungs feel \u201cheavy.\u201d He says nicotine pouches have helped him cut back on nicotine and manage his ADHD symptoms.<\/p>\n \u201cThe challenge is the accessibility,\u201d said Eric Gagnon, vice-president of corporate and regulatory affairs at Imperial Tobacco Canada, which sells Zonnic.\u00a0<\/p>\n \u201cIt doesn\u2019t make sense in a country like Canada that it\u2019s easier to buy a pack of cigarettes than it is to buy a cessation product approved by Health Canada.\u201d<\/p>\n Pouches as therapy<\/p>\n When it approved the sale of Zonnic in 2023, Canada became one of the first countries in the world to license nicotine pouches specifically for use as a stop-smoking aid.\u00a0<\/p>\n Zonnic\u2019s authorization followed a two- to three-year review process, says Gagnon. \u201cWe had to demonstrate the safety and efficacy of Zonnic as a cessation product,\u201d he said.\u00a0<\/p>\n At first, Zonnic was sold in gas stations and corner stores, alongside other products such as gums and lozenges. And like other nicotine replacement products, pouches were not subject to federal tobacco and vaping legislation, which restricts how products can be advertised and accessed by youth.<\/p>\n The product quickly found an enthusiastic customer base in Canada, says Gagnon. Imperial Tobacco collected \u201cthousands of testimonials\u201d from adult smokers who said they quit with the help of pouches, he says.\u00a0Imperial Tobacco Canada says it also observed cigarette sales falling faster in convenience stores that stocked Zonnic.<\/p>\n But public health groups, such as cancer and heart organizations, were soon warning<\/a> against<\/a> flavoured pouches being sold in convenience stores without age checks.<\/p>\n \u201cHave we not learned our lessons from e-cigarettes?\u201d Cynthia Callard, then-executive director of Physicians for a Smoke-Free Canada, said in a November 2023 press release<\/a>.\u00a0<\/p>\n \u201cGiven the increase in youth vaping<\/a>, 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? How can it possibly be legal to sell to children flavoured nicotine products from a tobacco company?\u201d\u00a0<\/p>\n Health Canada\u2019s August 2024 order forcing pouches to be sold within pharmacies was a response<\/a> to these concerns.\u00a0<\/p>\n Today, the Canadian Pharmacists Association\u2019s guidance<\/a> for pharmacists describes nicotine pouches as short-acting nicotine replacement therapies that may be a low-risk option for smokers who are unable to quit using other methods. The guidance stresses that pouches should not be used by people who do not already smoke.<\/p>\n Gagnon says Imperial Tobacco accepts that pharmacists are \u201cimportant partners\u201d in smoking cessation.\u00a0<\/p>\n But he says the behind-the-counter rule goes too far \u2014 and unfairly targets Zonnic because it is produced by Imperial Tobacco Canada, a subsidiary of global tobacco giant British American Tobacco.<\/p>\n \u201cThe entire NRT category is basically over the counter,\u201d he said. \u201cThe only product that is treated differently<\/a> \u2026 is Zonnic. And probably because it has been distributed by Imperial Tobacco Canada, it was regulated differently.\u201d<\/p>\n Grey markets<\/p>\n Health Canada\u2019s rules are also prompting some Canadians to seek legal \u2014 or illegal \u2014 workarounds.\u00a0<\/p>\n