Nicotine Pouches Growing in Popularity - But Are They Safe?

Nicotine pouches have been rapidly gaining popularity, particularly among teens and young adults.

These products are marketed as tobacco- and smoke-free and often are perceived as a “safer” alternative to cigarettes, vaping and smokeless tobacco or “dip.”

“Tobacco-free” doesn’t mean “risk-free,” however. The nicotine that these small pouches contain can have long-term impacts on the brain, cardiovascular system and your overall health.

What Are Nicotine Pouches?

Nicotine pouches are small fiber pouches that are placed in the mouth between the gum and lip, containing nicotine, flavorings, sweeteners and other ingredients.

These products do not contain tobacco leaf or produce smoke, but nicotine is a highly addictive substance that can affect nearly every organ system in the body, reports the Food and Drug Administration (FDA), which regulates nicotine pouches as tobacco products in the U.S.

Once a pouch is placed between the gum and the lip, the nicotine is absorbed through the mouth lining and enters the bloodstream without requiring users to smoke, vape or spit.

Nicotine and Heart Health

While long-term research on these products is still ongoing, the effects of nicotine on the cardiovascular system are well established.

Nicotine stimulates the release of adrenaline, releasing epinephrine from the adrenal glands, explains Dr. Stuart Smalheiser, a board-certified interventional cardiologist at Beaufort Memorial Heart Specialists. This causes the heart to beat faster and blood vessels to constrict.

This can increase heart rate, elevate blood pressure and add stress to the cardiovascular system.

“Nicotine is particularly risky for individuals who have existing heart disease or risk factors for heart disease such as diabetes,” Dr. Smalheiser adds.

Over time, repeated exposure to nicotine products may contribute to:

• Increased heart rate
• Elevated blood pressure
• Greater strain on the heart and blood vessels
• Potential worsening of existing heart conditions
• Increased risk factors associated with heart disease

“For patients managing high blood pressure, heart disease or other cardiac conditions, we encourage avoiding starting or continuing the use of nicotine products,” says Dr. Smalheiser.

Read More: Coronary Artery Disease Symptoms and What They Mean for Your Heart

Do Nicotine Pouches Have Any Benefits?

Many consumers assume that nicotine pouches are “safe” because they do not contain tobacco or produce smoke.

“Pouches and other smokeless tobacco products still expose users to nicotine, develop and sustain nicotine addiction, and impact heart health,” Dr. Smalheiser says. “They are also still fairly new on the market, so scientists are still learning about their short and long-term health effects.”

Despite also being marketed as heathier alternatives to smoking, nicotine pouches are not FDA-approved smoking cessation products.

Instead, evidence-based smoking cessation methods include:

• Nicotine replacement therapy (patches, gum and lozenges, which are all FDA-approved and regulated NRT products often used with a tapering-off plan to break off nicotine addiction)
• Prescription medications
• Behavioral counseling
• Structured tobacco cessation programs

Read More: Small-Cell Lung Cancer: Risk Factors and When to Get Screened

Nicotine and the Brain

Nicotine pouch sales are estimated to have grown by 660% worldwide since 2020, with much of the marketing surrounding the products aimed at youth and first-time tobacco or nicotine users.

In the 2024 National Youth Tobacco Survey, nicotine pouches were the second most commonly used tobacco product behind e-cigarettes/vapes.

Read More: Can Vaping Cause Lung Cancer? What We Know So Far

One of the biggest risks surrounding nicotine pouches is their potential to develop and sustain addiction in their users. Dependence on the substance can develop quickly, especially among teens and young adults, reports the Centers for Disease Control and Prevention (CDC).

The CDC warns that brain development continues until approximately age 25. Exposure to nicotine during this critical period can alter the parts of the brain responsible for attention, learning, memory, mood regulation and impulse control.

Research has linked youth nicotine use to:

• Reduced attention and concentration
• Difficulties with learning and memory
• Increased impulsivity
• Changes in mood and emotional regulation
• Greater vulnerability to future substance addiction

In 2024, approximately 1.8% of U.S. middle and high school students reported current nicotine pouch use.

So, are these products safe?

Nicotine pouches may be discreet, smoke-free and increasingly popular, but they are not risk-free.

While researchers continue studying their long-term health impacts, current evidence is clear: nicotine pouches should not be viewed as harmless alternatives to traditional tobacco products.

The safest choice for overall health is to avoid nicotine products altogether and seek professional guidance when trying to quit.

Looking to break free from a nicotine addiction? Talk to your primary care provider about smoking cessation programs that may be right for you. Need help finding a primary care provider? Search our online provider directory.