Nicotine pouches could offer smokers a harm-reduction option with a risk profile similar to pharmaceutical nicotine replacement therapies (NRT), according to a newly published scientific review.

The paper, by harm-reduction researcher Dr Konstantinos Farsalinos and published in Internal and Emergency Medicine, concludes that the tobacco-free oral products deliver nicotine effectively while exposing users to far fewer toxicants than cigarettes.

Lowest end of toxicant risk spectrum

The review found that nicotine pouches sit at “the lowest end of the toxicant risk continuum”, with harmful compounds such as tobacco-specific nitrosamines largely undetectable or present only at negligible levels compared with traditional tobacco products.

As a result, smokers who switch completely to nicotine pouches can achieve reductions in toxicant exposure comparable to quitting smoking altogether, the author reported.

The products are tobacco-free and evolved from Swedish snus, but without using tobacco leaf, significantly reducing their toxicological burden.

Potential role in smoking cessation

Pharmacokinetic evidence shows modern nicotine pouches deliver nicotine efficiently enough to reduce cravings, although more slowly than cigarettes. This slower delivery profile may still be sufficient to help smokers move away from combustible tobacco.

The review concludes nicotine pouches “could represent a promising harm reduction tool” and may be considered by clinicians as an alternative for smokers who are unable or unwilling to quit using approved cessation methods.

Healthcare professionals were also encouraged to record nicotine pouch use in patients’ medical histories as part of routine assessment.

While long-term epidemiological data on nicotine pouches specifically are not yet available, the review points to extensive research on Swedish snus, which has not been linked to lung cancer or significant cardiovascular disease, as a strong indication of likely lower risk.

This “bridging evidence” supports the view that tobacco-free nicotine pouches are unlikely to carry the same health risks as combustible cigarettes.

Regulatory and monitoring needs remain

Despite the positive harm-reduction potential, the review highlights several regulatory issues that require attention, including consistent product labelling, limits on nicotine strength and oversight of flavouring additives

The author also noted that current population-level evidence suggests nicotine pouches are unlikely to act as a gateway into smoking, although continued surveillance is recommended.

The findings come as nicotine pouches continue to expand rapidly across global nicotine markets, including the UK convenience and specialist vape sectors.

The review concludes that, with appropriate regulation and further research, nicotine pouches could play an important role in reducing smoking-related harm and supporting smokers who struggle to quit nicotine entirely.