From the Guidelines
Nicotine pouches can potentially cause cardiac problems due to the nicotine they contain, which poses risks to the cardiovascular system, including increased blood pressure, heart rate, and narrowing of the arteries 1. These products deliver nicotine directly to the bloodstream through the gums, which can lead to increased heart rate, elevated blood pressure, and constriction of blood vessels. Regular use may contribute to cardiovascular issues including arrhythmias, coronary artery disease, and increased risk of heart attack or stroke. The cardiovascular effects occur because nicotine stimulates the release of adrenaline, putting stress on the heart and circulatory system. Some key points to consider include:
- Nicotine may also contribute to the hardening of the arterial walls, which in turn can lead to a heart attack 1.
- People with pre-existing heart conditions should be particularly cautious about using nicotine pouches.
- While these products don't contain tobacco or produce smoke like cigarettes, the nicotine itself remains a concern for heart health.
- The intensity of cardiac effects may depend on the nicotine content of the pouch and individual factors such as tolerance, frequency of use, and underlying health conditions.
- Anyone experiencing chest pain, irregular heartbeat, or other cardiac symptoms while using nicotine pouches should seek medical attention immediately. It's also worth noting that there is currently limited evidence regarding the long-term individual health risks posed by novel tobacco products, including nicotine pouches, and their potential public health impact 1. However, given the potential risks, it's essential to prioritize caution and consider the potential cardiac effects of nicotine pouches.
From the FDA Drug Label
Ask a doctor before use if you have a sodium-restricted diet heart disease, recent heart attack, or irregular heartbeat. Nicotine can increase your heart rate. high blood pressure not controlled with medication. Nicotine can increase blood pressure. Stop use and ask a doctor if mouth, teeth, or jaw problems occur irregular heartbeat or palpitations occur
- Nicotine pouches can increase heart rate and blood pressure, which may be problematic for individuals with pre-existing heart conditions.
- Key cardiac concerns associated with nicotine use include:
- Irregular heartbeat or palpitations
- Recent heart attack
- Heart disease
- High blood pressure not controlled with medication
- Based on the information provided, nicotine pouches may have cardiac problems associated with their use, particularly for individuals with pre-existing heart conditions 2 2.
From the Research
Nicotine Pouches and Cardiac Problems
- The available evidence does not specifically address nicotine pouches, but rather nicotine replacement therapy (NRT) in general, which includes products like gum, patches, and lozenges 3, 4, 5, 6, 7.
- Studies suggest that nicotine may contribute to cardiovascular disease, but the doses of nicotine obtained by regular cigarette smoking generally exceed those delivered by NRTs, and the cardiovascular effects of nicotine are more intense when delivered rapidly by cigarette smoking than by NRTs 3.
- Clinical trials of NRT in patients with underlying, stable coronary disease suggest that nicotine does not increase cardiovascular risk, and the risks of NRT are small and substantially outweighed by the potential benefits of smoking cessation 3, 6.
- A meta-analysis of 21 randomised, placebo-controlled trials found that NRT was associated with an increased risk of cardiac disorders, particularly palpitations, but rarely serious cardiac disorders, even in individuals with a cardiovascular history 5.
- Guidelines for health professionals recommend that NRT can normally be recommended to smokers with cardiovascular disease who have tried and failed to quit without such help, but with certain precautions, such as ensuring dosing does not exceed the manufacturer's recommendation and warning patients to stop using NRT if they relapse to smoking 6.