Are Nicotine Pouches Safe?

Nicotine pouches are a type of oral nicotine product made up of small white pouches that can be placed between your lip and your gum. These small white pouches contain a combination of nicotine, flavors and other ingredients that allow for the absorption of nicotine through the lining of your mouth.

Nicotine pouches are different from cigarettes, chewing tobacco and e-liquids. They do not make smoke or vapor.

Available in a range of flavors including mint, fruit and candy-like, these small white pouches are becoming an extremely popular item with young adults and children alike.

Nicotine pouches do not have harmful tobacco chemicals that come from burning tobacco. However, nicotine pouches are still not safe.

Rather than comparing nicotine pouches with cigarettes, it is more accurate to compare them with all nicotine-containing vaping products.

Many people falsely assume that because nicotine pouches do not contain aerosol and are “no smoke” products, there must be no health effects from their use.

Nicotine in any form:

• Contains an addictive drug, which can have very serious effects on your life and health when use becomes long term
• Increases heart rate and blood pressure
• Can cause local (dental) damage, including gum recession and other damage to soft tissues of the mouth
• Can cause long-term health problems, including serious cardiovascular disease
• Can lead to lifelong dependence on nicotine

“The absence of smoke does not mean there are no health effects from nicotine,” says Dr. Posadas. “If you’ve never used tobacco or nicotine before, nicotine pouches are not a safe product for you to start using.”

Nicotine can act very quickly as it travels to the brain in a matter of seconds. There, it releases the neurotransmitter dopamine, which can give users feelings of extreme euphoria or pleasure.

The brain normally releases the chemical for things that feel good, but for users of nicotine, the brain will become dependent on the substance in order to feel normal. This can create intense cravings for users as well as cause them to develop a higher tolerance for the substance. In the end, users can fall victim to nicotine dependence.

Many nicotine pouches contain as much or more nicotine than cigarettes, quickly hooking users.

“Many people do not realize just how much nicotine some of these products actually contain,” says Dr. Posadas. “The higher the level of nicotine in a product, the greater the potential for becoming addicted as well as for experiencing a host of negative nicotine pouch effects.”

Nicotine pouches can have some negative side effects and can even increase the risk of certain health problems.

Nicotine from nicotine pouches can affect the heart and can even increase the risk of heart problems as it makes the heart work harder.

As nicotine travels through the blood, it can constrict blood vessels and cause an increase in your blood pressure and your heart rate, and can even cause a decrease in blood flow and place a lot of strain on the heart.

For people with high blood pressure, heart disease or diabetes, it is especially important to avoid nicotine, as it could cause serious harm.

Using nicotine regularly can also cause a range of problems with the gums and teeth, including gum irritation and sores, and in severe cases can even cause gums to recede from teeth, causing sensitive teeth and an increased risk of periodontal disease.

Any persistent bleeding or painful sores in the mouth should be checked by a dentist or physician.

Nicotine pouches can also have a negative effect on the developing brain. Because the brain continues to develop into the mid-20s, adolescents and young adults may be especially vulnerable to nicotine addiction and its effects.

Nicotine may affect:

• Learning
• Memory
• Attention
• Mood regulation
• Impulse control

“Because the brain is still developing during adolescence, young people become addicted more quickly than many adults. Early nicotine exposure can make quitting much harder as an adult,” Dr. Posadas says.

Another risk associated with nicotine pouches is the risk of nicotine poisoning. Storing nicotine pouches in a safe place, out of reach of children and pets, is very important.

Even small amounts of nicotine can cause nicotine poisoning in children and pets.

Symptoms include:

• Nausea and vomiting
• Excessive drooling
• Dizziness
• Rapid heartbeat
• Difficulty breathing
• Seizures

Nicotine poisoning can cause a variety of symptoms, including nausea and vomiting, excessive drooling, dizziness, rapid heartbeat and difficulty breathing. In severe cases, nicotine poisoning can even cause seizures.

If you suspect a child or pet has come into contact with a nicotine pouch, it’s important to contact Poison Control immediately and seek immediate medical attention if necessary.

Nicotine pouches are not FDA-approved for smoking cessation. While some may choose to use them as a means to stop smoking cigarettes, there are proven treatments to help people stop using nicotine. These include:

• Nicotine patches
• Nicotine gum
• Nicotine lozenges
• Prescription medications to help quit nicotine
• Behavioral counseling to quit nicotine

Possible signs of nicotine dependence include:

• You wake up with your nicotine product right next to you.
• You feel strong or frequent nicotine cravings.
• You feel anxious, irritable or on edge when you are unable to use your nicotine products.
• You find yourself taking more of your nicotine product than you had intended.
• You continue to use your nicotine products even though they are causing you health problems.

Nicotine pouches containing nicotine can lead to nicotine dependence. Some people may experience temporary effects of withdrawal while quitting nicotine pouches.

Withdrawal symptoms can be uncomfortable, but they are temporary and there are very effective ways to quit for good.

“Withdrawal symptoms can include nicotine cravings, irritability, mood swings, anxiety, trouble sleeping, difficulty concentrating, fatigue, increased appetite and restlessness,” says Dr. Posadas.

If you're ready to quit nicotine pouches, these strategies can help:

• Set a quit date and make a plan for how you’ll handle cravings.
• Identify the situations, places or emotions that trigger you to use nicotine pouches and plan healthier alternatives.
• Remove all nicotine products from your home, car and workplace.
• Stay physically active. Exercise can help reduce nicotine cravings and manage stress.
• Drink plenty of water and eat a balanced diet to help manage withdrawal symptoms.
• Tell your family and friends you're quitting so they can offer encouragement and support.
• Talk with your doctor about FDA-approved nicotine replacement therapies or prescription medications that may help you quit successfully.

Schedule an appointment with a clinician if:

• You are having difficulty quitting nicotine.
• You are experiencing chest pain, palpitations or shortness of breath while using nicotine products.
• Your nicotine withdrawal symptoms are affecting your daily life.
• You would like a clinician to develop a personalized quit plan with you.