Work

Scientific assessment of oral nicotine pouches and associated risk reduction in comparison to combustible cigarettes

Year: 2026

Type: article

Abstract: Oral nicotine pouches (ONPs) are a relatively new category of products that are structurally and functionally similar to Swedish snus, an oral tobacco product popular in Sweden which has shown through decades of epidemiological studies to present substantially lower health risks than smoking cigarettes. ONPs may offer users reduced health risks relative to conventional cigarettes, provided that smokers completely switch. Confirming this potential requires a weight of evidence approach analysing data from chemical, toxicological, behavioural and clinical studies and comparing data with products for which long-term epidemiological evidence exists. Using an established scientific framework, we evaluated Velo 1 ONPs, marketed outside the United States. Comparisons were made with snus, and where relevant, pharmaceutical nicotine replacement therapy (NRT) products. Chemical studies find fewer toxicants, lower levels than both cigarette smoke and snus, and generally similar to levels to NRT products. In vitro toxicological studies find little evidence of mutagenicity or genotoxicity in ONP extracts, and generally lower biological activity than snus extracts. Daily ONP consumption patterns are generally similar to that of Swedish snus. Clinical studies showed nicotine uptake profiles for ONPs are different from cigarette smoke and more like snus and NRT lozenges. Biomarkers of exposure (BoE) to major toxicants in ONP users were more like that of former and never smokers than current smokers with favourable biomarkers of potential harm (BoPH). Overall, the evidence supports that ONPs have similar or lower health risks, than Swedish snus products, and substantially lower health risks than cigarette smoking.

Source: Toxicology Reports

DOI: 10.1016/j.toxrep.2026.102356