What are E cigarettes and Nicotine Pouches?

“Nicotine use among young people has increased in recent years driven largely by the variety of flavours, disposable Vapes and growing availability of smokeless nicotine products such as synthetic nicotine pouches which are often called snus.”
Written by Martina Blake, HSE National Lead for the Tobacco Free Ireland Programme

E cigarettes are electronic devices which contain a battery and produce an aerosol by heating an e liquid. This aerosol usually contains nicotine, flavourings, volatile organic compounds and ultrafine particulate matter. There have been reports in Ireland of the distribution of so-called “spice vapes” (i.e., vapes containing synthetic cannabinoids), as well as illicit vaping products purported to contain THC, where the composition and strength may be unknown. Concerns have also been raised internationally about vapes containing other harmful substances, including synthetic opioids or sedatives. THC is a controlled drug in Ireland and falls within the scope of the Misuse of Drugs Act 1977.

Nicotine pouches (sometimes called Snus) contain a lab-made, tobacco-free form of nicotine combined with plant-based fillers, flavorings, sweeteners, and pH balancers. Alkaline minerals (such as sodium carbonate or sodium bicarbonate) are added to raise the pH level of the mouth. This makes it significantly easier for your body to absorb the nicotine. The pouch is designed to be placed between the lip and the gum and the nicotine is absorbed into the bloodstream through the gums which is a vascular area. There have also been instances of legal loopholes being exploited by chemically manipulating nicotine derivates, to market vapes and other products as “nicotine-free”.

The industry is constantly innovating and introducing new nicotine products to the market – some of which include nicotine gel type products (which is rubbed on the skin), a new nicotine lozenge and a type of sweet as well as nicotine oral strips and toothpicks. These are available in other jurisdictions but not commonly seen in Ireland to date.

Nicotine use among young people has increased in recent years, driven largely by the variety of flavours, disposable vapes, and the growing availability of smokeless nicotine products, as well as delays and gaps in legislation regulating the availability and marketing of these products.

Although most young people do not vape, many are first exposed to vaping as early as the start of secondary school and vaping has become increasingly normalised. Young people are more vulnerable to the harmful effects of nicotine, including addiction with nicotine itself impacting on memory concentration, mood and impulse control. Kids, teens and young adults are biologically more prone to addiction than adults are. Nicotine addiction develops much more quickly in a child or adolescent’s brain because the brain is still undergoing massive structural changes and possesses heightened synaptic plasticity. This allows nicotine to hijack the brain’s reward centers and permanently alter its neural wiring faster than it would in an adult.1, 2 This explains why people starting young face lower quit success rates and more severe withdrawal symptoms.

Some of the physical and mental health effects of nicotine are listed below.

increased heart rate
increased blood pressure
sleep problems
heart problems are caused because nicotine causes vasoconstriction and a narrowing of the arteries and increases the risk of blood clots
problems with attention, learning and impulse control in young people
mental health difficulties, such as anxiety.

The HSE Tobacco Free Ireland Programme and National Communications Department carried out extensive research with both young people and influential adults to help develop a communications campaign to address this problem. This included in person focus groups with parents, teachers, older siblings and sport coaches as well as a survey of more than 300 parents and their children.

Many parents told us they felt “out of their depth” and were “unsure about the risks of vaping or pouches” and whether their children were experimenting.

From our discussions with young people at around age 14, vaping is seen as something “everyone does” rather than a rebellious act with more than 70% of young people reporting they are exposed to vapes in schools or shops. 1 in 4 had vaped and 1 in 10 had tried nicotine pouches.

Social pressures drove experimentation as did bright packaging and sweet flavours. Many young people we spoke to had contradictory understandings of the risks. Parents and teachers reported uncertainty about the range of products, their harms and how to talk to young people about them. Fortunately, they also expressed openness to conversations about Vapes and other nicotine products and a desire for clearer information.

These insights helped shape the first phase of our campaign, which focused on helping parents find trusted accessible information on vaping and snus and giving them tools to start conversations with young people. The HSE has developed website content and booklets outlining nicotine products, health risks, warning signs and conversation tips. The Tobacco Free Ireland Programme issued a letter to all primary and Post primary schools highlighting rising nicotine use and the work was supported by a public information campaign. The second stage launched in March 2026 focused on young people, while continuing to support adults, using content creators to bring the vaping conversation directly to their established communities on TikTok and Instagram. So far results have been encouraging with over 11 million video views across all content and channels within one month of launch.

The HSE provides safe, effective and clinically sound stop smoking services, which are free and easy to access across the country. These services have been designed for people who smoke cigarettes. We think that these supports may also help those people who wish to stop vaping. There is no funded vaping cessation service yet (bids for funding have been made to the department of health). Within stop smoking services if capacity allows, behavioural support and advice is provided to those who wish to stop vaping however, state funded medicines to support those who want to stop vaping is not currently provided. See advice for the public on how to quit vaping. https://www2.hse.ie/living-well/quit-smoking/other-products/quit-vaping/

There are ongoing studies internationally examining what works in terms of vaping cessation. There is emerging evidence that that the same behavioral supports and medicines which work for smoking cessation may be effective for vaping cessation these include varenicline, and nicotine replacement therapies for example. https://tobaccocontrol.bmj.com/content/35/3/382.full.pdf

Nicotine replacement therapy (NRT) is a group of safe and effective medicines to help people stop smoking. NRT may help to relieve cravings and withdrawal symptoms when you stop vaping. Pharmacists can play a key professional group that play an important role in supporting and advising on nicotine cessation.

AS A QUICK REFERENCE GUIDE IN CALCULATING E CIGARETTE DEPENDENCE

Ask:

When do you have your first vape? Within the first hour of waking may indicate high dependence.

How many times per day do you vape? Assume one time consists of around 15 puffs or lasts around 10 minutes. The higher the amount of vaping the higher the dependency.

Dual Use

If the client indicates dual use of vaping/pouch use plus tobacco smoking assume that there is high dependence and start on highest patch plus short acting product.

About Martina Blake

Ms Blake has a background in general nursing and has worked in the area of Health Promotion and Public Health since 1999. She has worked in Tobacco Control leadership roles since 2008; initially drafting the first five year strategic plan for Tobacco Control for the Irish Health Service (HSE). She currently holds the role of ‘National lead for the Tobacco Free Ireland Programme’ in the Irish health service. She has implemented standardised programmes and processes within stop smoking services, introduced robust and systematic analysis of performance data, developed performance indicators and minimum operating standards as well as overseeing successive award winning mass media campaigns. Evaluation and research is an underpinning principle in all of the work of the Tobacco Free Ireland programme and Ms Blake and her staff commission research, complete it in house and publish their work routinely. She has successfully negotiated increased funding to strengthen tobacco control and increase the investment in the delivery of stop smoking services in Ireland. During her tenure to date, funding has been secured, which has helped to triple the number of staff working in stop smoking service delivery as well as securing an additional circa 2 million euros to implement free stop smoking medication to all who require access to it through the quit service.

Martina holds a higher diploma in Social Personal and Health Education from South East technological University Waterford, a certificate in Health Care Management from the University of Limerick and an MSc in Health Promotion/Public Health from the University of Ulster Jordanstown. She is a busy mum of three teenagers, a scout leader and in her spare time she likes to read, bake and go for long walks.

To order free leaflets for your store – log on to www.healthpromotion.ie

References

Yuan M, Cross SJ, Loughlin SE, Leslie FM. Nicotine and the adolescent brain. J Physiol. 2015 Aug 15;593(16):3397-412. doi: 10.1113/JP270492. Epub 2015 Jun 23. PMID: 26018031; PMCID: PMC4560573.
Ball J, Christie G, Hoek J, Waa A, Edwards R. Youth vaping addiction: How it happens and why it matters. Public Health Expert Briefing. 2024 Jan 23. https://www.phcc.org.nz/briefing/youth-vaping-addiction-how-it-happens-and-why-it-matters.