Nicotine Pouch Usage and Impact
Conexiant
June 18, 2024
While oral nicotine pouches may present a less harmful alternative for cigarette users, there is concern about their potential to become a new form of nicotine dependence, especially among youth who did not currently use tobacco or nicotine products.
A comprehensive review of 62 studies related to the use of oral nicotine pouches was conducted by researchers at Georgetown University's Lombardi Comprehensive Cancer Center and colleagues and published in the journal Nicotine and Tobacco Research.
The researchers' analysis, based on 45 academic and 17 industry-funded studies, mostly from the U.S., found that as of 2023, 1.5% of surveyed youth reported currently using oral nicotine pouches, while lifetime use among young people was under 2.5%. Between 35% and 42% of U.S. adolescents and young adults had heard of the products, and 9% to 21% of tobacco-naïve youth surveyed were not opposed to trying them.
U.S. adult usage estimates varied widely across surveys, with 0.8% to 3% currently using the products and 3% to 16% having used them at some point in time as of 2023. Due to rising nicotine pouch sales in 2024, usage has likely increased, noted investigators.
While oral nicotine pouches contained fewer harmful chemical compounds at lower levels compared to cigarettes and smokeless tobacco, with the exception of formaldehyde, there was a wide range of total nicotine content across different brands, nicotine strengths, and flavors.
Oral nicotine pouches are often marketed as tobacco-free; however, this descriptor may be associated with the perception that pouches are less harmful than other tobacco products. The FDA has not authorized oral nicotine pouches for marketing as a modified-risk product or approved them as a cessation aid.
The authors concluded that as more evidence on oral nicotine pouches became available, particularly from independent studies, it would be essential to conduct further analyses comparing industry and non-industry-sponsored research findings and to critically assess the quality and risk of bias.
All authors declared no conflict of interest.