The U.S. Food and Drug Administration (FDA) has taken a significant step in the evolving landscape of tobacco harm reduction by authorizing the marketing of 20 ZYN nicotine pouch products. The agency released this decision following comprehensive scientific review under the PMTA pathway, marking the first time FDA has authorized nicotine pouches. This move, while bringing to light debates concerning public health, could fundamentally shape the future of nicotine consumption and alternatives to tobacco use in the United States.
ZYN nicotine pouches are innovative products designed as alternatives to traditional tobacco. Unlike cigarettes or smokeless tobacco, these small synthetic fiber pouches contain nicotine but no tobacco. Users place them between the gum and lip, where nicotine is absorbed into the bloodstream. Available in various flavors, including cinnamon, citrus, and cool mint, ZYN offers two nicotine strengths- 3 milligrams and 6 milligrams.
This new product category targets adult smokers who would like to switch to less harmful alternatives compared to traditional tobacco. FDA's authorization marks a landmark moment for this emerging segment of the tobacco market in the United States.
The FDA decision anchors from the Family Smoking Prevention and Tobacco Control Act of 2009, which obligates all new tobacco products to comply with strong public health standards. The agency review found that the ZYN pouches involve substantially lower risks compared to cigarettes and smokeless tobacco products, such as snuff or snus.
The pouches contain far fewer harmful constituents associated with cancer and other life-threatening diseases. In addition, studies submitted by the manufacturer showed that many adult smokers and users of smokeless tobacco switched entirely to ZYN, indicating its potential as a harm-reduction tool.
"These nicotine pouch products meet that bar by benefiting adults who use cigarettes or smokeless tobacco products," said Matthew Farrelly, Ph.D., director of the FDA's Office of Science at the Center for Tobacco Products.
This is a clear FDA warning: ZYN is not risk-free, nor is it "FDA-approved." Although the agency said that low use levels of nicotine pouches among youths remain at 1.8% of middle and high school students in the United States who reported using any tobacco product, according to the 2024 National Youth Tobacco Survey, the agency emphasized preventing youth exposure.
The FDA did this by applying stringent marketing restrictions, including the following:
- Ban mass-market advertising on TV and radio.
- Require actors/models in ads to appear at least 35 years old.
- Avoid themes, characters, or imagery appealing to youth.
The agency will also closely monitor marketing practices and suspend or withdraw authorizations if products no longer meet public health standards.
ZYN pouches don't contain any tar and the carcinogenic chemicals present in cigarette smoke and in the majority of smokeless tobacco products. Unlike snus, a popular form of pasteurized tobacco widely used in Scandinavian countries, ZYN contains no tobacco at all. In fact, that positions it like the nicotine gum or lozenge, releasing controlled doses of nicotine to eliminate craving.
For decades, tobacco companies have been looking for alternatives to traditional cigarettes, as smoking rates in the U.S. and around the world have declined. E-cigarettes became popular in the early 2010s but were later criticized for underage vaping. ZYN nicotine pouches could be a safer alternative, but critics fear they may follow the same path if youth use increases.
ZYN, marketed by Philip Morris International acquisition target Swedish Match through 2022 for a cost of $16 billion. While Philip Morris invests massively into nicotine pouches, huge demand from customers bolsters the business segment in the most phenomenal way in U.S. tobacco. Already nicotine pouches emerge as a pace-setter that could set to be at the core of industry's future prospects.
Also Read: 3 Science-Backed Methods To Quit Smoking For Good
However, controversies run rampant in the history of tobacco alternatives. For example, e-cigarette giant Juul Labs was sued for marketing to minors, settling in 2023 for $462 million without admitting wrongdoing. Critics are now beginning to scrutinize ZYN flavored products, including citrus and peppermint, arguing they may attract younger users.
That benefit, however – the FDA seems poised to acknowledge adult smokers will use nicotine pouches – underscores much-needed responsible marketing and rigorous oversight. Public health advocates caution, however, there is no such thing as winning when it has to be over youth uptake first and close to long-term effects on health.
Supporters say that ZYN is a genuine substitute for smokers looking to quit or reduce their reliance on devastating tobacco products. Indeed, as Brian King, Ph.D., FDA's Center for Tobacco Products director, noted, "It is imperative that the maker of these products does so responsibly so that youth will not take up their use".
The FDA's approval of ZYN nicotine pouches is part of a larger effort to regulate and innovate within the tobacco industry. Over the past decade, the agency has received applications for nearly 27 million products, authorizing only those that meet rigorous health standards.
This also goes with recent suggestions to limit nicotine content in cigarettes, marking a step toward harm reduction and prioritization of public health. However, challenges remain, but the ZYN authorization is reflective of a growing recognition of alternative nicotine products' role in reducing tobacco-related disease and mortality.
The FDA's approval of ZYN nicotine pouches marks a turning point in tobacco harm reduction. As a less harmful alternative to cigarettes and smokeless tobacco, ZYN has the potential to benefit adult smokers while reducing risks to public health. However, the success of this initiative will depend on strict regulatory oversight, responsible marketing, and continued vigilance against youth use.
Smoking cessation is one of the best heart-healthy lifestyle choices you could ever make and minimize the risk for developing conditions like A-Fib. While quitting smoking might not be an easy task, its benefits can be felt at once and significantly. Here is how to quit smoking successfully.
Set a quit date and be firm about it. This will give you ample time to mentally and physically prepare for the transition.
Share your decision with your family, friends, or support group. This will make it easier for you because you have people to motivate and hold you accountable.
Consider using nicotine patches, gum, or lozenges to manage withdrawal symptoms and reduce cravings. Seek the advice of a healthcare professional.
Identify situations or emotions that make you want to smoke, such as stress, boredom, or social settings. Develop healthy coping strategies, like journaling or engaging in a hobby, to navigate these triggers.
Engage in regular exercise. Exercise not only diverts your mind from excessive hunger and craving but also improves moods and overall well-being.
Drinking water will help to flush out nicotine from your system, and the level of your craving will decrease.
People often smoke when their stress is too high. Try to engage in some relaxing activities like yoga, meditation, or deep breathing.
Tobacco Product Use Among Middle and High School Students — National Youth Tobacco Survey, United States, 2024
E-Cigarette and Nicotine Pouch Use Among Middle and High School Students — United States, 2024
Credits: Canva
In a controversial move that has rattled the U.S. medical community, federal health officials have severed ties with more than half a dozen major medical organizations from participating in government vaccine advisory workgroups.
The decision, communicated via email on Thursday, disinvites top experts from these groups from contributing to the workgroups that support the Advisory Committee on Immunization Practices (ACIP), a key body that guides the nation’s vaccination policies.
Organizations affected include the American Medical Association (AMA), the American Academy of Pediatrics (AAP), the Infectious Diseases Society of America (IDSA), and several others, many of whom have historically played a critical role in shaping vaccine guidelines.
“This is deeply concerning and distressing,” said Dr. William Schaffner, a renowned vaccine expert from Vanderbilt University who has been involved with ACIP workgroups for decades. “Removing these organizations will likely create conflicting messages about vaccine guidance. Patients might hear one thing from the government and another from their personal doctors.”
For years, the ACIP has relied on a structured system where experts from various medical and scientific fields evaluate vaccine data and help draft recommendations. These recommendations, once approved by the Centers for Disease Control and Prevention (CDC), often inform clinical practice and determine insurance coverage.
But according to an email obtained by Bloomberg and confirmed by federal officials on Friday, the medical organizations are now being sidelined on the grounds that they are “special interest groups” and are assumed to carry a “bias” due to the populations they serve.
Dr. Schaffner defended the former system, highlighting how professional organizations offered practical insights on how recommendations could be realistically implemented in clinical settings. Importantly, all members were subject to conflict-of-interest vetting, ensuring objective guidance, he added.
This latest shake-up follows an earlier, unprecedented move in June when U.S. Health Secretary Robert F. Kennedy Jr. abruptly dismissed the entire ACIP panel, accusing it of being too closely aligned with vaccine manufacturers. Kennedy, a former leader in the anti-vaccine movement, has since appointed several known vaccine skeptics to the new committee.
Among the organizations removed from the workgroup process are the American Academy of Family Physicians, American College of Physicians, American Geriatrics Society, American Osteopathic Association, National Medical Association, and the National Foundation for Infectious Diseases.
In a joint statement released Friday, the AMA and several of the disinvited organizations denounced the decision, calling it “irresponsible” and “dangerous to our nation’s health.” The statement warned that excluding their medical expertise “will further undermine public and clinician trust in vaccines.”
The groups urged the administration to reverse the decision, emphasizing the importance of transparency and collaboration in public health decision-making.
Several of the ousted organizations had previously criticized Kennedy’s overhaul of the ACIP. Last month, three of them joined a lawsuit challenging the government’s decision to halt COVID-19 vaccine recommendations for most children and pregnant women, a policy shift that has been widely criticized by public health experts.
Meanwhile, newly appointed ACIP member Retsef Levi, a professor of business management with no formal medical background, defended the administration's direction on social media. Levi wrote that future workgroups would “engage experts from an even broader set of disciplines,” and claimed that membership would be based on “merit & expertise, not organizational affiliations with conflicts of interest.”
The Department of Health and Human Services (HHS) has not yet disclosed which experts will replace the disinvited members or when the new workgroups will begin operating.
Credits: Canva
The United States Centers for Disease Control and Prevention (CDC) is assessing a potential travel notice for China following a sharp rise in cases of chikungunya, a mosquito-borne viral infection that has sparked public health alarms in southern China, as reported by the Independent and the South China Morning Post.
Nearly 5,200 infections have been reported in the Guangdong province since early July, with most of them concentrated in the city of Foshan. Health officials there have since escalated their emergency response to a level III alert, which signals a “relatively major” public health threat in China’s four-tier system.
While the CDC has not yet published a formal advisory, a spokesperson told The Independent that the agency is “aware of the reported chikungunya outbreak in Guangdong Province in China and is currently assessing the size and extent of the outbreak.”
Chikungunya is a viral infection transmitted by the bite of an infected Aedes mosquito, the same mosquito species responsible for dengue and Zika. Symptoms typically include sudden onset of fever and joint pain, but may also include headache, muscle pain, swelling, and rash.
Although most cases are mild and self-limiting, some infections can lead to prolonged joint pain or, in rare cases, long-term complications. Serious outcomes are more likely among those with pre-existing health conditions. There are no antiviral treatments available, so prevention, particularly mosquito control and bite avoidance, remains the primary approach.
Vaccines against chikungunya have recently become available and are recommended for travelers to high-risk areas, although they are not yet widely accessible.
According to local health authorities in Foshan, around 95% of reported cases have been mild, with patients recovering within a week. However, the outbreak’s rapid spread has raised concern among international health bodies.
The outbreak in China follows a global pattern of chikungunya resurgence. The World Health Organization (WHO) issued an alert last week warning of the risk of the virus repeating its global spread from two decades ago. Diana Rojas Alvarez, a medical officer with WHO, said that nearly 5.6 billion people across 119 countries live in areas where the virus could potentially spread.
Chikungunya was first identified in 1952 in Tanzania and has since been detected in more than 110 countries, including major outbreaks in India, Italy, and the Americas. The virus is not spread from person to person; instead, it is carried by mosquitoes that have fed on infected individuals and then pass it to others.
The concern is not just local: international travel plays a key role in how the virus crosses borders. Infected travelers returning to or visiting countries with mosquito populations capable of transmitting the virus can trigger new outbreaks.
The first case in this outbreak was reported in Foshan’s Shunde district on July 8 and was believed to be imported. Since then, local and national health authorities have moved quickly to contain the spread.
Measures taken include the use of drones to detect rooftop water accumulation, the release of larva-eating fish into lakes, and widespread public awareness campaigns. Residents have been urged to eliminate standing water, install window screens, and wear protective clothing.
Hospitals in affected areas have increased bed capacity for confirmed cases and designated specialized treatment centres. Border controls have been stepped up in Hong Kong to prevent imported cases from mainland China, with expanded testing capabilities introduced at key entry points.
The CDC’s travel health notices are used to inform travelers about global disease risks and provide precautionary guidelines. The warning system has four levels, ranging from “practice usual precautions” (Level 1) to “avoid all travel” (Level 4).
As of now, China has only a Level 1 travel health notice for measles. However, the CDC has issued Level 2 notices for chikungunya in several countries including Bolivia, Kenya, and Madagascar in recent months.
If the CDC decides to escalate China’s status, it would be a significant development, both in terms of travel planning and diplomatic perception.
The potential issuance of a travel notice also comes against the backdrop of complex US–China relations. While the CDC’s move would be grounded in public health data, the optics of a travel warning could have broader implications.
On Thursday, Chinese foreign ministry spokesperson Guo Jiakun responded to the reports, saying that China is in communication with the WHO and “making every effort to ensure a safe environment for travelers.”
The WHO has not issued any travel restrictions related to the outbreak but continues to monitor the situation closely.
With mosquito-borne diseases on the rise globally, driven by climate change, urbanization, and increased mobility, health experts advise travelers to stay informed and take preventive measures.
“Mosquito control is key,” said an official from the Hong Kong Centre for Health Protection. “Simple actions like using insect repellent, sleeping under mosquito nets, and avoiding stagnant water can go a long way in preventing infection.”
As global health agencies monitor the chikungunya outbreak in China, travelers to affected areas should remain vigilant and stay updated with official advisories. Prevention remains the best protection in the face of a disease with no cure.
Credits: Canva
August is known as the Hair Loss Awareness Month and the first Saturday of this month is known as the International Alopecia Day.
Hair loss is a common concern, affecting over 85% of men, 55% of women, and between 15–38% of adolescents at some point in their lives. For those with advanced or long-lasting alopecia, the emotional and social impact can be profound.
Baldness has been linked to significant declines in mental health and quality of life, with higher rates of anxiety, depression, stress, and reduced self-esteem.
It is a term used for hair loss that affects the scalp or even the entire body, temporarily or permanently. Alopecia can happen due to variety of reasons, including heredity, hormonal changes, and medical conditions, or as simple as normal aging.
The day aims to form a community of those who experience this autoimmune disease.
International Alopecia Day was initiated by American activist Lynn W. Walker in 2011. She herself lives with a diagnosis of alopecia totalis and created this day to unite people with similar experiences, reduce stigma, and highlight beauty and strength regardless of the presence of hair.
This year's theme as per Alopecia UK is, 'Strength in Numbers', which urges more and more people to join the International Alopecia community and to do away with the shame of hair loss and form a support group, across the world.
As per the National Library of Medicines, US, alopecia refers to the loss or absence of hair in areas where it normally grows. It can be localized or widespread, temporary or permanent, and affects people of all ages and genders. As a symptom with diverse underlying causes, alopecia is generally categorized into two main types: nonscarring (the most common) and scarring (cicatricial).
For many patients, hair loss leads to significant emotional distress and a reduced quality of life. Accurate diagnosis requires a thorough history, physical examination, and targeted investigations to identify the root cause and guide effective treatment. Managing alopecia can be challenging, but this overview outlines key assessment and treatment approaches for the most common forms to support better outcomes.
There are several main types of alopecia, including:
alopecia areata: an autoimmune disease that causes hair loss, often in small, round patches on the scalp, but it can occur anywhere on the body
alopecia totalis: complete loss of scalp hair
alopecia universalis: hair loss over the entire body
androgenetic alopecia: hereditary baldness
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