Nicotine pouches are smokeless alternatives to tobacco. They contain nicotine salts that dissolve through the gums. Marketing claims that nicotine pouches are lower risk than tobacco.
Nicotine pouches are a newer way to consume nicotine, so
This article rounds up the available studies into whether nicotine pouches are harmful and discusses other products that may help people quit nicotine altogether.
There is not enough research available on the effects of nicotine pouches to say whether they are harmful.
In theory, nicotine pouches are less harmful than burning and inhaling tobacco. Nicotine is highly addictive, but it is the other chemicals in tobacco that increase a person’s risk of cancers, lung problems, and heart disease. Even smokeless tobacco can increase a person’s risk of mouth cancer.
The
A 2022 study of 44 nicotine pouch products and two nicotine-free pouches found that 26 of the samples contained cancer-causing chemicals known as tobacco-specific nitrosamines (TSNAs). The same study advised that 29 of the products did not clearly state how much nicotine they provided or gave vague descriptions.
As nicotine pouches are a new product, their long-term side effects are unclear. However, the
Some nicotine products also deliver a similar amount of nicotine to other smokeless tobacco products, such as snus or snuff, at a similar speed. While a
Nicotine is a stimulant drug. When a person ingests nicotine in a pouch, cigarette, or other delivery system, it enters the bloodstream and moves to the gland that pumps out a stress chemical called adrenalin. This
It also activates the reward system in the brain, releasing a feel-good chemical called dopamine. Over time, nicotine
This means that stopping nicotine can lead to feeling sick — a condition known as nicotine withdrawal. These withdrawal symptoms can peak within a few days and last for several weeks.
The modern tobacco market has seen a huge increase in the availability of smokeless products that claim to help people manage nicotine addiction by reducing smoking.
However, the research for many has limits or is short term. Also, smokeless tobacco products still contain
E-cigarettes
E-cigarettes and vapes provide nicotine in the form of an e-liquid vapor instead of tobacco smoke. According to the National Institute for Drug Abuse (NIDA), around 4.7% of people in the United States reported vaping nicotine within the previous 30-day period.
In 2021, researchers conducted a
However, vaping’s long-term effects are unclear based on current research. E-cigarettes
- lung disease and lung damage
heart attacks asthma attacks
Snus, snuff, and dip
This is a type of tobacco that people place in the mouth in the same way as nicotine pouches, in its moist form, or sniff, in its dry form. Dipping tobacco, or “dip,” is another form of moist snuff.
While snus still exposes users to some potentially harmful chemicals in tobacco, a
Snus may help people move away from smoking, although not tobacco or nicotine use, according to a
Chewing tobacco
This is tobacco that people chew in different forms, such as loose leaves, twists, or plugs. While people may chew tobacco to reduce how much they smoke or cut out smoking altogether, chewing tobacco is still a
The safest option is to go nicotine free and cut out all forms of tobacco, even for people who do not smoke it.
Some nicotine replacement therapy products have a sturdy evidence base showing that they may be effective. According to the American Cancer Society (ACS), these may help a person become
- Patches: These are wearable on the skin, steadily releasing a small amount of nicotine.
- Gums: Chewing these releases nicotine while it dissolves in the mouth.
- Lozenges: People looking to quit smoking can suck on these like hard candy. Lozenges release nicotine slowly as they dissolve.
Stronger inhalers and nasal sprays are available with a physician’s prescription.
People often combine this with other
- telephone chatlines, such as
800-QUIT-NOW that provide free, confidential coaching - free texting programs, such as SmokefreeTXT
- free apps, such as
quitSTART , and online resources, including smokefree.gov andCDC.gov/quit - medications, including bupropion and varenicline
- cognitive behavioral therapy (CBT), which can help people identify and avoid their triggers for smoking or relapsing
- motivational interviewing, a patient-focused technique that lets patients identify gaps between their desire to quit and current behavior pattern
It is best to speak with a clinician about evidence-based options instead of resorting to an unproven product that suggests a supportive role in smoking cessation in its marketing.
Nicotine pouches contain nicotine salts that dissolve into the gums. However, there is very little evidence available to confirm its long-term health risks.
Even though nicotine pouches contain fewer harmful chemicals than smokeable tobacco, they still contain cancer-linked TSNAs and carry a risk of several side effects, including nausea, hiccups, and mouth irritation.
No available evidence supports nicotine pouches or other smokeless tobacco products as smoking cessation aids. Those who need support in quitting smoking can supplement nicotine with NRTs to reduce withdrawal while using proven interventions to help with the psychological and emotional aspects of quitting.