To be clear they commonly use snus which is tobacco product, not just nicotine pouch. It shares many of the health issues associated with smoking tobacco and also has it's own ones (e.g. related to gum health).
As an ex snusare and ex smoker, this is a pretty wild claim to make my friend
The other primary risks are things which tie more to nicotine in general (like stroke & various effects on pregnancy including increased risk of stillbirth).