The World Health Organization (WHO) today issues a strong warning over the rapid global expansion of nicotine pouch products, which are being aggressively marketed to adolescents and young people. WHO notes that regulation in many countries is limited or absent, raising concerns about youth nicotine addiction and related health risks.

The report comes in the lead-up to World No Tobacco Day (31 May), which this year will focus on tobacco and nicotine addiction and the tactics used by industry to hook a new generation of users.

Nicotine pouches are small sachets placed between the gum and lip that release nicotine through the lining of the mouth. They typically contain nicotine, flavourings, sweeteners and other additives. Retail sales of nicotine pouches reached over 23 billion units in 2024, increasing by more than 50% from previous year.

“The use of nicotine pouches is spreading rapidly, while regulation struggles to keep pace,” said Dr Vinayak Prasad, Unit Head of the Tobacco Free Initiative for WHO. “Governments must act now with strong, evidence-based safeguards.”

WHO’s first global report on the topic entitled, Exposing marketing tactics and strategies driving the growth of nicotine pouches, was developed in response to requests from countries seeking authoritative guidance from WHO on nicotine pouches and how governments should respond. The global market of nicotine pouch products was worth nearly US$ 7 billion in 2025.

WHO emphasizes that nicotine itself is highly addictive and harmful, particularly for children, adolescents and young adults whose brains are still developing. Nicotine exposure during adolescence can affect brain development, including impacts on attention and learning. Early nicotine use can increase the likelihood of long-term dependence and future use of other nicotine and tobacco products. Nicotine use also increases cardiovascular risk.

Regulatory gaps leave youth exposed

Nicotine pouches often fall through regulatory cracks:

• around 160 countries have no specific regulation;
• 16 countries ban their sale; and
• 32 countries regulate them in some form, including:
  • 5 restricting flavours
  • 26 restricting sales to minors
  • 21 banning advertising, promotion and sponsorship.

Governments are seeing the use of these products spread quickly, especially among adolescents and young people who are being aggressively targeted by deceptive tactics,” said Dr Etienne Krug, Director of Department of Health Determinants, Promotion and Prevention at WHO. “These products are engineered for addiction and there is a strong need to protect our youth from industry manipulation.”

Marketing tactics designed to attract young users

The report highlights widespread industry tactics to appeal to younger audiences, including:

• sleek, discreet packaging;
• flavours such as bubble gum and gummy bears;
• influencer marketing and heavy promotion on social media;
• sponsorship of concerts, festivals and sports events, including Formula 1;
• aspirational lifestyle branding; and
• messaging that encourages discreet use in schools and smoke-free settings.

Some packaging mimics sweets or popular candy brands, increasing risks to young children.

The report warns that all of these tactics are designed to normalize nicotine use, lower perceptions of risk and draw a new generation of users into nicotine addiction.

Call for urgent action

WHO urges governments to adopt comprehensive regulation covering all tobacco and nicotine products, including nicotine pouches. Recommended measures include:

• bans or strong restrictions on flavours;
• advertising, promotion and sponsorship bans, including on social media and use of influencers;
• strong age-verification and retail controls;
• clear health warnings and plain packaging;
• caps on the amount of nicotine allowed;
• taxation to reduce affordability and deter youth use;
• surveillance of use patterns and industry tactics; and
• strong enforcement of policies.

Nicotine pouches should not be considered risk-free. Yet, some products are being sold in multiple strength tiers marketed as “beginners”, “advanced” and “experts” with nicotine amounts labelled at up to 150 mg.

WHO urges young people to recognize and reject industry tactics designed to make nicotine use seem normal. Urgent, coordinated action today can help protect a new generation from nicotine dependence.

Notes to editors

The report builds on the report of the WHO Study Group on Tobacco Product Regulation and WHO’s report to the Framework Convention on Tobacco Control. It responds directly to Member State requests for evidence and policy guidance on nicotine pouches.

Relevant reference sections

Chapter 4 – WHO study group on tobacco product regulation. Report on the scientific basis of tobacco product regulation: ninth report of a WHO study group. Geneva: World Health Organization; 2023 (WHO Technical Report Series, No. 1047). Licence: CC BY-NC-SA 3.0 IGO.

FCTC/COP10/6 (pages 16 and 17) – Progress report on technical matters related to Articles 9 and 10 of the WHO FCTC (Regulation of contents and disclosure of tobacco products, including waterpipe, smokeless tobacco and heated tobacco products). July 2023

About WHO

Dedicated to the well-being of all people and guided by science, the World Health Organization leads and champions global efforts to give everyone, everywhere an equal chance at a safe and healthy life.

We are the UN agency for health that connects nations, partners and people on the front lines in 150+ locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues and expanding access to medicines and health care. Our mission is to promote health, keep the world safe and serve the vulnerable.

“Together for health. Stand with science”, the theme of World Health Day 2026 marks a year-long campaign to highlight science as the foundation for protecting health and well-being worldwide.

Dear people of Tenerife,

Greetings from Geneva. It is Tedros again.

Our work in Tenerife is done. And it was done with grace.

Last Monday, I stood at the port of Granadilla de Abona and watched the last of the passengers from the MV Hondius board the vehicles that would carry them home. I watched health workers in protective equipment move with calm professionalism. I watched Spanish officials coordinate with quiet precision. And I watched and felt your support and solidarity.

And I thought of the letter I wrote to you just days ago, and how everything that your Spanish Government and the World Health Organization promised came to pass, exactly as described.

More than 120 people from 23 countries have safely disembarked and are now being cared for and monitored by public health professionals while in transit or upon arrival in their home countries. They arrived in fear and uncertainty. They left carrying something they could not have expected to find in Tenerife: the dignity of being cared for by strangers from your community, and people around the world, who chose to help. The risk assessment held. The protocols worked. The corridor held. Science and solidarity operated in coordination, as they must, as they can, when we trust each other.

But I do not want this moment to be remembered only as a logistical success. What happened here in Tenerife was something rarer than competence. It was moral courage, the willingness of an entire island, an entire nation, to say: these are human beings, and we will not turn away from them.

The government of Prime Minister Sánchez honoured its obligations under international law and then went beyond them, with warmth, speed and care. Ministers Mónica García, Fernando Grande-Marlaska, and Ángel Víctor Torres led with great commitment. The port authorities of Granadilla executed a complex operation flawlessly. The health teams who boarded that ship, who stood at the port gates, who rode in those vehicles: they did their jobs not because it was easy, but because it was right.

To Captain Jan Dobrogowski and his 26-member crew still onboard of the MV Hondius and sailing now to the Netherlands: you held your passengers together through weeks of grief and confinement. History will not forget that.

To you, the people of Tenerife, who opened your island not with applause or fanfare but with quiet, steady acceptance: I want you to know what that means to the world. You may never meet the passengers and crew who transited your port. But those 150 people and their families know that somewhere in the Atlantic, there was an island community that said “yes.” That community was you.

We live in a time when it is easy to close doors, to turn inward, to let fear harden into hostility. Tenerife chose differently. You have written something into the record of how humanity responds to crisis, and the WHO will carry that record forward.

Three people died in connection with the outbreak on the Hondius. Their families are grieving. The conclusion of this operation does not erase that grief, and I do not want it to. Behind every public health response there are real lives, real losses and real families who will carry this forever.

We also learned of the loss of a member of the Guardia Civil of Tenerife, who died of a heart attack while serving during this operation. He was here because of duty and commitment to his community. I extend my deepest condolences to his family, his colleagues, and to the entire Guardia Civil. His service will not be forgotten.

The best immunity we have is solidarity. Tenerife has proven this, not as a slogan, but as a way to work, and to live.

I will confess something personal. Last Monday, before the last group of passengers departed, I walked through part of your city, alone. The island was going about its day, and I found Tenerife to be genuinely beautiful: the place, yes, but above all the people. The warmth I encountered from some people who recognised me, even in the briefest exchanges, stayed with me.

I wish I had come under different circumstances, on a WHO conference perhaps, or better still, simply with my family to rest. That is a wish I intend to honour. I look forward to returning to Tenerife as a visitor, not as a crisis responder, to see it the way it deserves to be seen, slowly and without urgency, with my family beside me.

On behalf of the World Health Organization, on behalf of the passengers now home, and on behalf of those families around the world who watched this island with hope: thank you. From the depth of my heart, thank you.

I also want to thank my colleagues from WHO headquarters and from our Regional Office for Europe in Copenhagen, who stood with me in Tenerife, and those who supported us tirelessly from afar. This was a team effort in every sense of the word.

But for us, the job is not yet done, until every passenger and crew is out of quarantine and reunited with their loved ones.

With profound respect, admiration and gratitude,

Tedros

Editor’s note

The statement has been corrected to reflect that the three people confirmed to have died as a result of the hantavirus outbreak did not all die on the ship. Only two people died onboard, while the third died upon arrival in South Africa.

The World Health Organization (WHO) has validated Tunisia as having eliminated trachoma as a public health problem. This is a major milestone in the country’s public health journey, coming after decades of sustained national effort.

“I congratulate Tunisia on this historic public health achievement,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Eliminating trachoma shows what long-term political commitment, strong primary health care and teamwork can do. Tunisia has proven that even the world’s leading infectious cause of blindness can be overcome.”

Trachoma is closely linked to limited access to water, sanitation and hygiene, and hits vulnerable populations hardest. In the early to mid-20th century, trachoma was endemic in Tunisia, affecting at least half of the population, especially in its southern regions.

“I congratulate Tunisia on the elimination of trachoma as a public health problem. This is a major achievement that reflects sustained and consistent national commitment over many years and shows what is possible when a country remains focused on addressing preventable causes of blindness,” said WHO Regional Director for the Eastern Mediterranean Dr Hanan Balkhy.

For decades, Tunisia ran a comprehensive and sustained response to trachoma that turned a once-heavy health burden into a success story. The country adopted and scaled up the WHO-recommended SAFE strategy: Surgery for advanced cases,Antibiotics to clear infection,Facial cleanliness to reduce spread, andEnvironmental improvement, particularly better access to water and sanitation. Tunisia also ran nationwide screening and treatment campaigns, integrated eye care into primary care and school health programmes, and worked with communities to promote good hygiene.

“Validation marks a historic achievement for Tunisia and reflects our country’s long-standing commitment to public health, prevention and equity,” said Dr Mustapha Ferjani, Minister of Health of Tunisia. “This milestone is the result of decades of coordinated national efforts, with the dedication of generations of health-care professionals, local communities who worked tirelessly to expand access to care, strengthen prevention and improve eye health across the country. Tunisia remains committed to sustaining these gains and protecting future generations.”

Tunisia’s achievement followed a long campaign led by the Ministry of Health, supported by WHO and partners, anchored in strong public health policies and social development. Strong health system foundations, including wide access to primary health care and significant progress in water and sanitation coverage, helped reduce transmission and push disease prevalence down.

A robust post-validation surveillance system is now in place to detect any return of disease at an early stage. This system includes provision for ongoing case management and training of health professionals.

“The validation of elimination of trachoma as a public health problem in Tunisia reflects the impact of sustained collaboration between the Ministry of Health and WHO in achieving public health gains across the country,” said Dr Ahmed Zouiten, Acting WHO Representative in Tunisia. “This milestone stands as a strong demonstration of how science, evidence-based programming and coordinated technical support can overcome neglected tropical diseases every time and everywhere.”

Tunisia joins a growing number of countries working toward the elimination of neglected tropical diseases, a key component of the health-related Sustainable Development Goals.

Editor’s notes

Neglected tropical diseases and trachoma elimination efforts

Trachoma is caused by the bacteriumChlamydia trachomatisand spreads through close contact with infected individuals, contaminated surfaces, and flies that carry eye and nose discharge. Repeated infections can lead to scarring of the eyelids, turning eyelashes inward, and ultimately causing blindness if untreated.

Neglected tropical diseases like trachoma are associated with devastating health, social and economic consequences. Their burden is mainly felt among impoverished communities in tropical areas.

Public health targets for the control, elimination and eradication of these conditions were set in the road map for neglected tropical diseases 2021–2030.

In 1996, WHO launched the WHO Alliance for the Global Elimination of Trachoma by 2020 (GET2020), creating a network of governments, nongovernmental organizations and academic institutions dedicated to the fight against trachoma. WHO continues to support endemic countries to accelerate progress towards the global target of eliminating trachoma as a public health problem worldwide; 2030 is the new target date.

Elimination of trachoma as a public health problem is defined as: (i) a prevalence of trachomatous trichiasis (TT) “unknown to the health system” of < 0.2% in ≥15-year-olds; and (ii) a prevalence of trachomatous inflammation-follicular (TF) in children aged 1–9 years of < 5%, in each formerly endemic district; plus (iii) the existence of a system to identify and manage incident cases of TT.

Other countries validated by WHO as having eliminated trachoma as a public health problem are: Algeria, Australia, Benin, Burundi, Cambodia, China, Egypt, Fiji, Gambia, Ghana, India, Iraq, Islamic Republic of Iran, Lao People’s Democratic Republic, Libya, Malawi, Mali, Mauritania, Mexico, Morocco, Myanmar, Nepal, Oman, Pakistan, Papua New Guinea, Saudi Arabia, Senegal, Togo, Vanuatu and Viet Nam.

Trachoma is the first neglected tropical disease to be eliminated in Tunisia. Following recognition of national trachoma elimination there, Tunisia becomes the 14^th country in the WHO Eastern Mediterranean Region to have eliminated at least one neglected tropical disease. It is the 31^st country in the world to be validated as having eliminated trachoma as a public health problem.

The world is falling short on health targets, with progress uneven, slowing, and in some areas reversing, according to the World Health Statistics 2026 report, published today by the World Health Organization (WHO).

While there have been meaningful improvements in global health over the past decade, with millions benefiting from better prevention, treatment and access to essential services, persistent and emerging challenges mean that the world remains off track to achieve any of the health-related Sustainable Development Goals (SDGs) by 2030.

The notable progress outlined in the report includes: