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Oral Nicotine Pouches Ineffective at Curbing Smokers’ Cravings
Oral nicotine pouches, an increasingly popular, smoke-free and tobacco-free alternative to cigarettes, do little to curb current smokers’ nicotine cravings, according to a recent study by researchers at the Center for Tobacco Research at The Ohio State University Comprehensive Cancer Center – James Cancer Center and Solove Research Institute.
Findings were published in the journal Addiction.
The pouches—small, portioned bags with nicotine powder, flavorings, artificial sweeteners, and preservative chemicals—entered the consumer market in 2016 and have been touted as a cigarette alternative with fewer known carcinogens and toxins that can also be consumed indoors. Despite being marketed as a cancer-risk-reducing alternative to appeal to current smokers, researchers have expressed concern that the pouches could instead drive up nicotine product use among young people if not formulated and regulated carefully.
“Nicotine addiction is a very real problem for many people, and most current smokers express wanting to quit but often fail because it is so challenging to stop—and to make it stick long term,” study lead author Brittney Keller-Hamilton, PhD, MPH, epidemiologist and assistant professor in the Division of Medical Oncology at The Ohio State University College of Medicine, said in a news release. “For smokers trying to make a healthier choice or stop smoking cigarettes, they should talk with their healthcare providers or call their state’s quit line to find the best smoking cessation options for them.”
For their study, the Ohio State researchers recruited 30 active adult smokers from Appalachian communities in Ohio, where both smoking and lung cancer rates are higher than the national average. Study participants were observed in 3 sessions during which they either smoked their usual brand of cigarette or used oral pouches that contained either 3 mg or 6 mg of nicotine. Blood samples were collected repeatedly to measure changes in plasma nicotine levels, and participants completed questionnaires about their nicotine cravings shortly before product use and again at 5, 15, 30, 60, and 90 minutes after initiating use of the product.
The researchers found that current smokers had both a significantly greater spike of nicotine in their blood levels and a sharper decline in craving symptoms when smoking compared to study participants who used both low- and higher-dose nicotine pouches. Nicotine spikes occurred 5 minutes after smoking, while the nicotine levels in blood had more gradual increases with the pouches, typically taking about 30 minutes to reach peak effectiveness. The decline in nicotine levels for oral pouch users was also more gradual.
As such, it is reasonable to see why the instant gratification of cigarettes would be more appealing than oral nicotine pouches for current smokers, Dr Keller-Hamilton said.
Future studies at Ohio State’s Center for Tobacco Research will examine various dimensions of nicotine affect the appeal, addictiveness, and use of oral nicotine pouches, as well as how these factors influence switches from smokeless tobacco or cigarettes to oral pouches.
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