Uptick in oral nicotine pouch use

Oral nicotine pouch exposure may be rising, particularly among adolescents in the United States.

In a study published in JAMA Otolaryngology-Head & Neck Surgery, investigators examined nicotine pouch use among U.S. youths and adults through national surveillance and survey data, chemical and oral findings, laboratory studies and clinical case reports.

The investigators found that past 30-day use of the pouches doubled among U.S. youths and e-cigarette use declined between 2023 and 2024. Further, about 3% of adult participants and 10% of current smokers reported using oral nicotine pouches. The investigators emphasized that a shift in marketing efforts and social media activity aimed at attracting tobacco-naive users with claims of convenient or discreet placement between the gum and lip as well as discounts and rewards opportunities may have contributed to an increase in use among younger individuals.

Oral nicotine pouches can administer about 3 milligrams of nicotine to the oral mucosa per pouch. However, some products have contained up to 50 milligrams of nicotine. Reports have already detailed the presence of gingival blisters, smokeless-tobacco-type keratosis and elevated inflammatory biomarkers among users.

Although there is currently limited data on the oral health effects of oral nicotine pouches, the investigators stressed that dentists should consider the potential long-term risks, including gingival blisters and precancerous lesions.

Read more: JAMA Otolaryngology-Head & Neck Surgery

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