Nicotine pouches: Are they safer than chewing, smoking or vaping?

Nicotine pouches: Are they safer than chewing, smoking or vaping?

Posted by ART / ITM on Dec 20th 2023

Nicotine pouches

In recent years, the quest for safer alternatives to traditional tobacco products like cigarettes has led to the development of various nicotine delivery systems, including nicotine pouches. As more individuals seek ways to either continue their nicotine use with potentially less risk or find an aid for quitting traditional smoking, understanding the relative safety of these new products becomes crucial. In this article, we delve into the nature of nicotine pouches and compare their safety profile to other forms of nicotine consumption such as chewing tobacco, smoking, and vaping.

What are Nicotine Pouches?

Nicotine pouches are small, teabag-like sachets containing nicotine that is synthesized in a lab or extracted from tobacco plants, along with flavorings and other materials such as plant-based fibers. These pouches are designed to be placed between the gum and the lip, where the nicotine is absorbed through the gums into the bloodstream. Unlike traditional snus or chewing tobacco, nicotine pouches are tobacco-leaf-free, which their manufacturers claim could make them a safer alternative.

Comparing Methods of Nicotine Delivery

1. Nicotine Pouches vs. Smoking

Smoking is the most well-known and studied method of nicotine consumption. It involves inhaling smoke from burning tobacco, which contains thousands of chemicals, many of which are toxic and carcinogenic. According to the Centers for Disease Control and Prevention (CDC), smoking is the leading cause of preventable disease, disability, and death in the United States.

Nicotine pouches, by contrast, do not involve inhalation of smoke or combustion of tobacco, which eliminates the inhalation of tar and carbon monoxide. The absence of these harmful combustion products theoretically makes nicotine pouches a less harmful alternative to cigarettes. However, while the risk of lung diseases such as cancer, emphysema, and chronic bronchitis is reduced, the potential impact of long-term oral nicotine absorption is still under research.

2. Nicotine Pouches vs. Chewing Tobacco

Chewing tobacco contains raw tobacco leaves, which are placed in the mouth and chewed to release nicotine. This method also exposes users to harmful chemicals and is associated with increased risks of several types of cancer, especially oral cancers, as well as gum disease and tooth decay.

Nicotine pouches eliminate the exposure to actual tobacco leaf, which reduces the user's risk of tobacco-specific nitrosamines (TSNAs) – potent carcinogens found in tobacco. This could potentially lower the risk of oral cancers and other health issues associated with chewing tobacco. However, nicotine itself can still contribute to cardiovascular disease and other health issues, and thus the use of nicotine pouches is not without risk.

3. Nicotine Pouches vs. Vaping

Vaping involves inhaling aerosolized liquids (e-liquids) that contain nicotine, flavorings, and other chemicals. While Public Health England maintains that vaping is 95% less harmful than smoking, vapes still pose their own health risks. These include exposure to potentially harmful chemicals not found in tobacco smoke and the risk of lung injuries associated with certain vaping products, as highlighted during the EVALI (e-cigarette or vaping product use-associated lung injury) outbreak in 2019.

Nicotine pouches offer a different mode of use since they do not require inhalation, thus bypassing the lungs altogether. This theoretically reduces the risk of lung-related issues associated with vaping. Nevertheless, the health impacts of the other ingredients in nicotine pouches, and the long-term effects of concentrated nicotine absorption through the oral mucosa, remain areas of active study.

The Pros and Cons of Nicotine Pouches


  • No exposure to smoke or combustion products
  • Lower risk of lung-related health issues compared to smoking and vaping
  • No use of tobacco leaf, reducing risks associated with tobacco-specific carcinogens

Nicotine pouches may represent a safer alternative compared to smoking, chewing tobacco, and possibly even vaping, primarily because they do not involve combustion, use of tobacco leaves, or inhalation of aerosol. However, "safer" does not mean "safe." The use of nicotine in any form is addictive and poses health risks. As with any emerging product, more long-term studies are needed to fully understand the health implications of nicotine pouches.

For those looking to quit nicotine altogether, the best option remains cessation aids approved by health authorities, which are designed specifically to reduce nicotine dependence safely. If considering nicotine pouches as an alternative to smoking or other tobacco products, it's essential to consult with healthcare professionals to understand all potential risks and benefits.