The Impact of Oral Nicotine Pouches on Public Health

Overview of Oral Nicotine Pouches and Their Rise in Popularity

Oral nicotine pouches (ONPs) represent a new class of nicotine products that have gained significant traction in the global tobacco market over the past several years. Unlike traditional smokeless tobacco products, such as snus, ONPs contain synthetic nicotine and are marketed as “tobacco-free.” This innovative product category has seen rapid adoption, particularly in the United States, where increasing sales reflect a shift in consumer preferences away from combustible tobacco products. The appeal of ONPs lies in their perceived reduced harm compared to traditional cigarettes and their discreet use, which has made them especially popular among younger demographics.

As seen in various studies, awareness of ONPs among U.S. adolescents and young adults is substantial, with estimates indicating that between 35% and 42% of this population has heard of ONPs. Furthermore, susceptibility to trying these products among tobacco-naïve youth ranges between 9% and 21% (Travis et al., 2024). Given that ONPs are associated with a lower risk profile, they are increasingly considered a viable alternative for current smokers looking to reduce harm while maintaining nicotine use.

Health Risks and Benefits of Using Oral Nicotine Pouches

The health implications of using ONPs are a matter of ongoing research and debate. Proponents argue that ONPs expose users to fewer harmful substances compared to combustible cigarettes and traditional smokeless tobacco. For instance, studies have shown that the chemical composition of ONPs contains fewer potentially harmful compounds than cigarettes and smokeless tobacco, although concerns remain regarding the presence of substances like formaldehyde (Travis et al., 2024).

Despite these potential benefits, health risks associated with ONPs are not negligible. The absence of long-term studies poses challenges in understanding the full spectrum of health impacts. Some studies suggest that while ONPs do not contain tobacco leaf, their nicotine delivery mechanisms can still pose risks, particularly to adolescents whose brains are still developing. Therefore, while ONPs may provide a reduced risk compared to traditional smoking, their safety profile is still being evaluated.

Comparative Analysis of Oral Nicotine Pouches and Traditional Tobacco Products

The comparison between ONPs and traditional tobacco products highlights key differences in both health risks and user experiences. Classic cigarettes are known to contain thousands of harmful constituents and have been definitively linked to various forms of cancer, respiratory diseases, and cardiovascular conditions. In contrast, ONPs, by virtue of being free from combustion, theoretically reduce exposure to many of these harmful chemicals.

In terms of user experience, ONPs are viewed as a more discreet and socially acceptable form of nicotine consumption, providing a compelling alternative for smokers looking to transition away from traditional tobacco. However, the impact of ONPs on smoking cessation efforts remains unclear, highlighting the need for further research into their long-term efficacy and safety.

Demographic Trends in the Use of Oral Nicotine Pouches

Demographic data on ONP usage reveal significant trends, particularly among younger adults and adolescents. The majority of ONP users are reported to be between the ages of 18 and 34, with a higher prevalence among males. This demographic is particularly responsive to flavor offerings, with many users drawn to the variety of flavors available in ONPs. Industry data suggests that marketing strategies targeting youth, including social media campaigns and flavor diversity, are effective in increasing product uptake (Travis et al., 2024).

Furthermore, research indicates that ONPs are most commonly used by individuals with a history of tobacco use, particularly among those who have previously smoked cigarettes or used other forms of tobacco.

Future Research Directions and Regulatory Considerations for ONPs

Given the rapid emergence of ONPs in the marketplace, regulatory oversight is critical to ensure consumer safety and public health. Current regulations surrounding nicotine pouches vary widely by country, with some nations treating them as tobacco products and others as consumer goods or even medicinal products. In the United States, the FDA has yet to issue comprehensive guidelines for ONPs, leaving a regulatory gap that may impact public health outcomes.

Future research should focus on the following areas:

• Long-term health outcomes associated with ONP use.
• Comparative studies on the efficacy of ONPs in smoking cessation vs. traditional nicotine replacement therapies.
• The impact of marketing strategies on youth uptake and dual usage patterns among adults.
• The overall public health implications as ONPs continue to gain market share.

Frequently Asked Questions (FAQ)

What are oral nicotine pouches?

Oral nicotine pouches are small, pre-portioned pouches containing nicotine, which users place between their gum and lip. Unlike traditional smokeless tobacco products, they do not contain tobacco leaf and are often marketed as tobacco-free.

Are oral nicotine pouches safer than cigarettes?

Current evidence suggests that ONPs expose users to fewer harmful substances than traditional cigarettes. However, the long-term health effects of ONPs are still under investigation, and caution is advised, particularly for young users.

Who uses oral nicotine pouches?

ONPs are most popular among younger adults, particularly those aged 18-34, and are often used by individuals with a history of tobacco consumption. Studies indicate that a significant portion of the youth population is aware of ONPs, with a notable percentage expressing interest in trying them.

How do oral nicotine pouches compare to e-cigarettes?

Both ONPs and e-cigarettes are considered alternatives to traditional smoking. ONPs do not involve inhalation and do not produce harmful smoke, while e-cigarettes produce aerosolized nicotine vapor. Each product presents unique health risks and benefits that require further research.

What regulatory actions are being considered for oral nicotine pouches?

Regulatory approaches vary by country. In the U.S., the FDA has not yet established comprehensive guidelines for ONPs, leading to calls for more stringent oversight and research into their health impacts.

References

1. Travis, N., Warner, K. E., Goniewicz, M. L., Oh, H., Ranganathan, R., & Meza, R. (2024). The potential impact of oral nicotine pouches on public health: A scoping review. Nicotine & Tobacco Research

2. Tattan-Birch, H., Hartmann-Boyce, J., Kock, L., Simonavicius, E., Brose, L., Jackson, S., & Shahab, L. (2024). Oral nicotine pouches for cessation or reduction of use of other tobacco or nicotine products. Cochrane Database of Systematic Reviews. https://pubmed.ncbi.nlm.nih.gov/11822881/

3. Śniadach, J., Kicman, A., Michalska-Falkowska, A., Jonczyk, K., & Waszkiewicz, N. (2025). Changes in concentration of selected biomarkers of exposure in users of classic cigarettes, e-cigarettes, and heated tobacco products—A narrative review. International Journal of Molecular Sciences. https://doi.org/10.3390/ijms26051796

4. Karelitz, J. L., Becker, E., Vansickel, A., & others. (2025). Switching behavior and changes in smoking behavior by menthol cigarette preference and menthol heated tobacco product use among adults in the United States who smoke cigarettes: an actual use study. Harm Reduction Journal. https://doi.org/10.1186/s12954-025-01170-7

5. Müller, T. D., Adriaenssens, A., Ahrén, B., Blüher, M., Birkenfeld, A. L., Campbell, J. E., & others. (2025). Glucose-dependent insulinotropic polypeptide (GIP). Molecular Metabolism. https://doi.org/10.1016/j.molmet.2025.102118