A Pharmacist’s Case for Expanding Nicotine Pouch Access

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Key Points:

• Pharmacist’s Warning: Todd Prochnau criticizes Canada’s behind-the-counter rule for Zonnic, the country’s only approved nicotine pouch.

• Access Problem: Restriction burdens pharmacists and makes unregulated, flavored pouches easier to buy than the approved product.

• Regulatory Context: Health Canada authorized Zonnic in July 2023 but imposed strict limits in Aug. 2024 – flavors restricted to mint/menthol, large addiction warnings, and pharmacy-only sales.

• Backlash: Retailers and convenience store groups argue the rules fuel contraband markets; Couche-Tard and Parkland Corp. launched court challenges.

• Market Imbalance: Cigarette sales fell to $3.85 billion in 2023, but illicit tobacco surged to $1.3 billion; smoke-free alternatives grew only modestly.

• Global Contrast: U.S. FDA has authorized 20 Zyn pouch products in multiple flavors, while Canada restricts options despite harm reduction potential.

• Policy Lesson: Prohibition-style limits don’t curb demand – they drive consumers to illicit markets. Expanding access to safer nicotine alternatives is key to hitting Canada’s smoke-free goals.

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A pharmacist and certified tobacco educator is standing up against the Canadian government’s restrictive policies on federally approved nicotine replacement therapies (NRTs), specifically nicotine pouches. In a recent Calgary Herald opinion editorial, Todd Prochnau criticized Health Canada’s decision to require the only approved nicotine pouch, Zonnic, to be sold exclusively from behind pharmacy counters.

Prochnau argues that the policy undermines smoking cessation efforts by limiting access to a legitimate harm reduction tool. Zonnic is the only nicotine pouch legally marketed in Canada, yet unregulated pouches – often stronger, flavored, and completely unmonitored – remain easier to access than the approved product. The behind-the-counter restriction also creates unnecessary administrative burdens for pharmacists, pulling them away from direct patient care. Prochnau instead advocates for front-of-store sales with age verification, with eventual availability in general retail settings like other NRTs.

Like in the United States, Canada’s regulation of tobacco harm reduction products has been slowed by bureaucratic hurdles. All NRTs are governed under the Food and Drugs Act and the Natural Health Product Regulations (NHPR), requiring Health Canada approval prior to sale. On July 18, 2023, Health Canada authorized Zonnic as an NRT for adults seeking to quit smoking. According to Health Canada’s own guidance, Zonnic can help people reduce cigarette consumption and manage withdrawal symptoms.

But as soon as Zonnic entered the market, health groups including the Canadian Cancer Society, Physicians for a Smoke-Free Canada, and Heart & Stroke, among others, demanded the product be reclassified as prescription-only, warning it would create a new generation of nicotine users. In August 2024, Health Canada responded with a Ministerial Order imposing sweeping restrictions on nicotine pouches: limiting flavors to mint and menthol, mandating large addiction warnings, banning youth-appealing advertising, and requiring all sales to occur behind pharmacy counters. Meanwhile, gums, lozenges, sprays, and patches remained widely available in retail outlets, in multiple flavors.

Former Health Minister Mark Holland defended the order as a way to balance adult cessation support with youth protection. Yet, as history shows, prohibition-style restrictions rarely reduce demand – rather, they push consumers toward illicit and unregulated markets. This is already evident in Canada, where convenience store operators argue the pharmacy-only rule drives demand for illegal products that youth can easily obtain.

In October 2024, major retailers including Couche-Tard and Parkland Corp. filed Federal Court challenges, calling the restriction unconstitutional and counterproductive.

Market data underscores this imbalance. A 2025 industry report found that while cigarette sales fell to $3.85 billion in 2023 (down from $4.5 billion in 2019), smoking prevalence has not declined proportionally. Instead, the contraband market is thriving, with an estimated $1.3 billion in illicit tobacco sales in 2023, which the Convenience Industry Council of Canada warns is “eight times more profitable than the illicit drug trade.” At the same time, sales of regulated smoke-free alternatives, including vapes and nicotine gum, rose modestly by 2.8 percent to $216.7 million.

This mirrors developments in the United States. Despite the FDA’s authority over e-cigarettes since 2016, the agency has authorized only 39 e-cigarette products – all tobacco or menthol-flavored – while denying millions of others, many already long on the market. As a result, the vast majority of sales are technically unauthorized: by 2024, 86.3 percent of retail e-cigarette sales in the U.S. came from unauthorized products, according to Truth Initiative. Yet during this same period, youth vaping rates fell to a 10-year low, while adult vaping increased – showing that adults seek these products despite regulatory bottlenecks.

Nicotine pouches may be headed for a similar fate. Canada now restricts them to mint and menthol only, a policy that ignores their harm reduction potential. By contrast, in January 2025, the U.S. FDA authorized 20 Zyn nicotine pouch products across multiple flavors, including citrus and coffee. This approach recognizes that flavored alternatives are critical for helping adults transition away from combustible cigarettes.

If Canada is serious about achieving the World Health Organization’s goal of reducing smoking below 5 percent by 2035, it must embrace innovation in tobacco harm reduction rather than stifle it. That means expanding – not limiting – access to safer alternatives.

As Prochnau concludes, this debate is not about hooking a new generation on nicotine but about giving adults the tools they need to quit smoking: “It’s about harm reduction, broader access to Health Canada-approved NRT products, and efficient use of pharmacists’ time.”

Nothing in this analysis is intended to influence the passage of legislation, and it does not necessarily represent the views of Tobacco Harm Reduction 101.