Key messages:
- Nicotine pouches, a tobacco-free product, are becoming increasingly popular globally.
- Nicotine pouches are likely to be a ‘lower-risk product’ as compared to tobacco smoking due to their lack of combustion.
- Nicotine pouches may be an option in tobacco harm reduction and smoking cessation.
- Oral health effects from the use of this product are unknown.
Nicotine pouches are tobacco-free products that users place between the lip and gingiva. This relatively new product began to be sold predominately in Europe, USA, and Japan around 2019. Nicotine pouches deliver nicotine through the oral mucosa, where it is absorbed via mucous membranes and enters the bloodstream. They provide a source of nicotine without the main constituent of carcinogen-associated tobacco. Other ingredients include flavourings and sweeteners.
This review article describes the composition of nicotine pouches, patterns of use, and possible oral and general health effects.
Nicotine is the main active ingredient and is probably the main reason most people use these products. Nicotine pouches may be a ‘lower-risk product’ relative to tobacco smoking due to their lack of combustion and absence of tobacco. However, there is currently a lack of evidence to evaluate the health effects and their use as a smoking cessation tool.
The impact of nicotine pouches on oral health is currently lacking. Thus, further research is required. However, they may have similar effects as orally administered smokeless tobacco products, and their prolonged and regular use may increase the risk of oral problems, such as periodontal disease.
Globally, there is concern with the introduction and marketing of nicotine pouches. Some suggest they may be a ‘gateway’ to cigarette smoking due to the combination of addictive nicotine, pleasant flavours, and attractive packaging, which might appeal to nonsmokers or young people. More data are required to assess the popularity of these products among young people, who appear to be the target of marketing strategies.
Due to their increasing popularity, oral health professionals must be aware of nicotine pouches and their potential impact on oral and overall health. Further research is required.
