Are nicotine pouches safer than smokeless tobacco products?

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Last updated: May 24, 2025 • View editorial policy

From the Guidelines

Nicotine pouches are likely a safer alternative to smokeless tobacco, but their long-term health effects are still unclear and they are not without risks. The key difference between nicotine pouches and traditional smokeless tobacco products is the absence of tobacco leaf in nicotine pouches, which means they do not contain tobacco-specific nitrosamines and other carcinogens linked to oral cancer, pancreatic cancer, and other health problems 1. Some of the key points to consider when evaluating the safety of nicotine pouches include:

  • They contain nicotine, which is highly addictive and can cause cardiovascular effects like increased blood pressure and heart rate
  • They lack the tobacco leaf found in products like snuff or chewing tobacco, which reduces the risk of exposure to certain carcinogens
  • The long-term health effects of nicotine pouches remain unclear as they are relatively new products
  • Governments should introduce and enforce strong systems for thorough premarket assessment of any novel products, including nicotine pouches, to ensure their safety and prevent industry from making unsubstantiated health claims 1. For those already using tobacco products, nicotine pouches may represent a harm reduction option, but the safest choice is to avoid all nicotine products entirely. Anyone considering nicotine pouches should understand they're not FDA-approved for smoking cessation, and consulting with a healthcare provider about evidence-based quitting methods is recommended.

From the Research

Comparison of Nicotine Pouches and Smokeless Tobacco

  • Nicotine pouches are considered to be a safer alternative to smokeless tobacco, as they contain lower levels of toxic compounds 2.
  • A study found that nicotine pouches had lower levels of 10 harmful and potentially harmful constituents (HPHCs) compared to Swedish snus, a type of smokeless tobacco 2.
  • Another study suggested that oral nicotine pouches likely produce less harm to individual users than conventional tobacco products, including smokeless tobacco 3.

Toxicant Levels in Nicotine Pouches

  • Nicotine pouches were found to have lower toxicant profiles and estimations of relative toxicant exposure compared to smokeless tobacco and other tobacco products 2.
  • The levels of 22 compounds measured in nicotine pouches were not quantifiable, indicating that they may be safer than other tobacco products 2.
  • However, more research is needed to determine the health effect profile of nicotine pouches under naturalistic use conditions 4.

Public Health Implications

  • Nicotine pouches may be a viable harm reduction option for individuals who switch completely to using them from conventional tobacco products 3.
  • However, widespread adoption of nicotine pouches among otherwise nicotine-naive individuals may reduce their net public health benefit 3.
  • Further research is needed to understand the full range of factors associated with nicotine pouch susceptibility and use, as well as to determine the potential public health impacts of nicotine pouches 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.