Oral Nicotine Pouches Studied as a Tool to Quit Smoking

In ongoing efforts to pinpoint the best evidence-based ways to quit smoking, a University of Massachusetts Amherst public health researcher has turned her attention to a tobacco-free product gaining in popularity across the country-oral nicotine pouches.

In the first Cochrane review on the topic, the evidence suggests that switching to oral nicotine pouches from smoking reduces exposure to harmful substances, "which is what we would expect to find," says senior author Jamie Hartmann-Boyce, assistant professor of health policy and management at the School of Public Health and Health Sciences and an editor for Cochrane, the global health research nonprofit based in the United Kingdom.

Because the Cochrane team only found four small studies that were appropriate for their review, the evidence is not yet clear on whether oral nicotine pouches can help people quit smoking or vaping. But the foundation now exists for Hartmann-Boyce and team to continue their investigation. Their ongoing Cochrane reviews have revealed the best evidence-based ways to quit both vaping and smoking.

"Other nicotine products, like patches, gums, and nicotine vapes, are definitely beneficial for helping people quit smoking," says Hartmann-Boyce, a leader in tobacco health policy and management in the U.S. "We knew that we weren't going to have that many studies of pouches in this review when we published the first time, but we also know there are loads in the pipeline, and we hope to regularly update this as those new studies come out. We've given ourselves a platform to collect that data and integrate it quicker than we would have been able to before."

About the size of a tea bag, oral nicotine pouches contain nicotine powder and flavorings, but no tobacco leaf. The pouches are marketed as a smokeless alternative to tobacco products and occasionally as a way to reduce or quit smoking.

Unlike nicotine gum, patches, lozenges, nasal sprays and inhalers, the nicotine pouches are not FDA-approved smoking cessation aids. But earlier this year, the FDA approved the marketing of 20 Zyn nicotine pouches in the U.S., concluding that the evidence showed it offered "greater benefits to population health than risks."

It was the first oral nicotine pouch to be so approved in the U.S., a significant FDA decision, Hartmann-Boyce notes. "An inherent argument behind the decision for these new products to enter the market is that they have the potential to move people away from smoking," she says.