Do Nicotine Pouches Really Help Quit Smoking?

Nicotine pouches are popular. Estimates suggest the product market for nicotine pouches will reach $33 billion by 2026. Many Americans want to quit smoking (or vaping) but don’t know how. Some replace this habit of smoking with alternatives, such as nicotine pouches. But do nicotine pouches help to quit smoking? Here, we discuss the role of nicotine pouches in quitting smoking.

What are nicotine pouches?

Oral nicotine pouches are smokeless tobacco products often manufactured by large tobacco companies. Traditionally, smokeless tobacco was called ‘snus’ and marketed in a pouch with salt and food-grade flavorings. The U.S. Food and Drug Administration (FDA) categorizes oral pouches as “ground, cut, leaf or powdered tobacco regularly available in moist or chew gum snuff often packed in a pre-portioned pouch.”

In recent years, companies have been marketing tobacco-free pouches as an alternative to smoking. These pouches contain nicotine from synthetic sources. Young adults buy these pouches due to their attractive flavors like mint, citrus, or fruit. Estimates suggest that over 50% of young adults have tried these flavored oral pouches. The contents of these tobacco-free pouches are placed between gums and teeth. The chemicals gradually dissolve and are absorbed into the bloodstream.

Are nicotine pouches a safer alternative to smoking, vaping, or chewing tobacco?

When people try to quit smoking, they may experience withdrawal symptoms. These include:

• Tremors
• Lower heart rate
• Increased appetite
• Depression
• Anxiety
• Lack of focus
• Insomnia

These withdrawal symptoms appear within 24 hours and may last up to 4 weeks. To better manage these symptoms, smokers use nicotine replacement therapy (NRT). NRT is a short-term intervention where smokers replace nicotine (cigarettes) with likely safer alternatives, such as snus, vaping, or chewing gum. Nicotine pouches are considered a likely safer alternative to smoking cigarettes. But are they really? As compared to cigarettes, nicotine pouches have less toxic effects on the bronchial cells. However, nicotine pouches are still able to cause inflammation in the lungs.

Some companies sell tobacco-free nicotine pouches that are marketed as a safer alternative to smoking. But many times, people do not use these products as suggested. In a survey study, teenagers and young adults have reported using nicotine pouches along with cigarettes or e-cigarettes. Using nicotine pouches and cigarettes simultaneously is harmful to health as it increases nicotine dependency and, thereby, nicotine addiction. Sometimes, these pouches are consumed by people who have never smoked. In such nicotine-naïve individuals, nicotine pouches can have similar effects to that of a cigarette.

Are nicotine pouches effective for quitting smoking?

There is no consensus regarding the effectiveness of nicotine pouches. Researchers have noted that nicotine pouches are not different from other products, such as nicotine patches, lozenges, etc. They are effective for quitting smoking when smokers are motivated to quit. However, they are ineffective when people are ‘just trying out.’

Large tobacco companies that manufacture nicotine pouches sponsor research studies about the effectiveness of nicotine pouches. Since these manufacturers have already advertised these products as ‘effective for quitting smoking,’ it creates a conflict of interest. Furthermore, aggressive marketing strategies and social media have influenced how young adults may respond as research participants.

Are nicotine pouches an FDA-approved method to quit tobacco?

Since 2022, the FDA has provided oversight for the manufacturing and distribution of non-tobacco nicotine products, including nicotine pouches. The FDA also warns the public that these products may contain other harmful chemicals that cause cancer. Retailers cannot sell these products to individuals below 21 (legal age).

Risks of nicotine pouches

Nicotine pouches are less addictive as compared to cigarettes, but they still contain nicotine. They can cause an inflammatory response in cells and are ultimately cytotoxic. Nicotine pouches are associated with diseases such as:

• Parkinson’s disease
• Cancer
• Birth defects
• Type II diabetes
• Periodontal diseases
• Oral submucosal fibrosis
• Cardiac diseases

Can nicotine pouches be addictive?

Yes. Nicotine pouches often contain alarmingly high amounts of nicotine. For instance, some brands contain nicotine up to 32–50 mg/pouch. When consumed in such high amounts, nicotine causes temporary cardiovascular or gastrointestinal symptoms. But more importantly, it has the potential to be addictive. Although the FDA requires clear labeling about nicotine content, some brands mislabel their nicotine pouches.

What to do if you swallow a nicotine pouch?

Accidental swallowing of a nicotine pouch can be dangerous, depending on the type of pouch. Extra-strong pouches have high doses of nicotine, which can give rise to intoxication symptoms, e.g., sweating, vomiting, convulsions, etc. Keep nicotine pouches away from infants and children. Contact your doctor immediately and provide detailed information about the nicotine pouch (brand) consumed.

In summary, nicotine pouches were found to be less addictive and, thereby, effective as a short-term intervention. But at present, their long-term safety data is not available. Nicotine is cytotoxic. Using nicotine pouches can also lead to diseases such as cancer, type II diabetes, Parkinson’s disease, and birth defects. Consult your doctor and join smoking cessation support groups to manage nicotine withdrawal.