New study on nicotine pouches stresses importance of understanding products

As the market for nicotine pouches swells, there is – just as with heated tobacco a few years ago – a risk that regulatory interest outpaces scientific research.

And where there is uncertainty about the safety or public-health implications of a new product category, it’s all the more likely that regulators will err on the safe side and impose restrictions that might not, in reality, have been necessary.

So it’s worth considering the priorities set out in a new paper (albeit one that has been floating around in preprint form for a year or so) written by the British doctor Sudhanshu Patwardhan and the eminent smoking scholar Karl Fagerström and published in the journal Nicotine & Tobacco Research.

In this article, “The New Nicotine Pouch Category: A Tobacco Harm Reduction Tool?”, Patwardhan and Fagerström identify some key priorities for research into pouches. They include:

• Product chemistry, especially regarding flavourings.
• Pharmacokinetics, for different nicotine and additive levels.
• Absolute and relative safety – as always, how pouches compare to other forms of tobacco in risk profile is important; even if they are not entirely risk-free, a reduced risk can be a benefit.
• Maximum nicotine levels compatible with a cessation goal. The authors observe that in some countries, pouches have been sold in “much higher strengths (>20 mg/pouch) than needed for craving relief and withdrawal management in tobacco cessation”.
• Likelihood of unintended use in the population – in other words, the chances that non-tobacco users (especially young ones) will take them up, and if so whether they lead to use of other tobacco products.
• Transition time for switching – that is, when people start out with nicotine pouches, do they go through a dual-use phase also involving other tobacco products, and if so for how long?
• Effect on cessation intentions – do pouches influence users’ plans to completely give up tobacco, and if so what role does marketing play?
• Consumer understanding – do users grasp the intended purpose of pouches and how to use them?

Patwardhan and Fagerström are not anti-pouch in this paper, but they do stress that understanding more about the products will help to “maximize this category’s public health potential and minimize its unintended consequences”.

It may be hopeful to imagine that an agenda like this will be universally followed (just look at the amount of repetitive and/or poorly designed research into e-cigarettes), but if nothing else it will provide a useful checklist for assessing the state of pouch science in a year or two. Companies in the sector can help by aiding research in these areas, too.

Want to know more about the evolution of the nicotine pouches industry? You can now download for free our business briefing “Swedish Match sees 2021 finish with strong growth in smoke-free products” using the form at the top of this page.

– Barnaby Page TobaccoIntelligence staff

Photo: Bengt Wiberg

Barnaby Page

Editorial director

Before joining ECigIntelligence in early 2014 as one of its first employees, Barnaby had a 30-year career as a reporter and editor for newspapers, magazines and online services, working in Canada, the US and the Middle East as well as his current British location. He has edited publications covering fields including technology and the advertising industry, and was launch editor of the first large daily online news service in the British regional media. Barnaby also writes on classical music and film for a number of publications. Barnaby manages the editorial and reporting teams and works closely with the analyst teams, to ensure that all content meets high standards of quality and relevance. He also writes for the site occasionally, mostly on science-related issues, and is a member of the Association of British Science Writers.