Popular ‘Nicotine Pouches’ Won’t Help Smokers Quit: Study

Oral nicotine pouches might be marketed as an alternative to cigarettes, but they do little to curb smokers’ nicotine cravings, a new study finds.

The pouches – which contain nicotine powder and other flavorings, but no tobacco leaf – take too long to provide the nicotine “spike” that eases cravings, researchers report in the Nov. 15 issue of journal Addiction.

Current smokers still get a much greater nicotine spike and much sharper relief from craving symptoms when they take a puff than when they use either low- or high-dose nicotine pouches, the results showed.

The spike of nicotine from smoking occurs within about five minutes, said lead researcher Brittney Keller-Hamilton, of Ohio State University’s Cancer Control Program.

By comparison, nicotine pouches take 30 minutes to an hour to hit peak effectiveness, researchers said.

It’s reasonable to see how the instant gratification from cigarette smoking would be more appealing than oral nicotine pouches for smokers deep in the need for a nicotine fix, Keller-Hamilton said.

At the same time, researchers are concerned that the pouches could appeal to young people, increasing nicotine addiction in a younger population while doing nothing to stem cancer risk among smokers.

“Our challenge is to approach regulation of nicotine pouches to limit their appeal among young people while making them more appealing to adult smokers who would see health benefits by switching from cigarettes – which have the most severe health impacts with long-term use – to nicotine pouches,” Keller-Hamilton said in a university news release.

Oral nicotine pouches have become increasingly popular since hitting the market in 2016, researchers said in background notes.

The small pouches are thought to be appealing to smokers because they contain fewer known carcinogens and toxins and can be used indoors where smoking is banned, Keller-Hamilton said.

For this study, researchers examined whether that assumption is true.

They recruited 30 active adult smokers from Appalachian communities in Ohio, and observed each during three sessions where they either smoked the cigarettes they had on them or used oral pouches containing either three or six milligrams (mg) of nicotine.

At regular intervals during each session, researchers collected blood samples to track nicotine levels and had participants complete questionnaires about nicotine cravings.

Ohio State researchers will continue to examine oral nicotine pouches through a new $20 million grant from the U.S. Food and Drug Administration.

They will investigate how the nicotine affects the appeal, addictiveness, and use or oral nicotine pouches, in hopes of better informing oral nicotine pouch regulations and promoting public health, researchers said.

The team also will look at how nicotine factors influence switching between products – for example, from smokeless tobacco or combustible cigarettes to pouches.

“Nicotine addiction is a very real problem for many people, and most current smokers express wanting to quit but often fail because it is so challenging to stop – and to make it stick long term,” Keller-Hamilton said. “For smokers trying to make a healthier choice or stop smoking cigarettes, they should talk with their healthcare providers or call their state’s quit line to find the best smoking cessation options for them.”

More information

The Truth Initiative has more about oral nicotine pouches.

SOURCE: Ohio State University, news release, Nov. 15, 2023