What is the difference between chewing tobacco and pouches

The term total nicotine represents the sum of nicotine in all of its ionic forms—both protonated and unprotonated.

Protonated nicotine predominates at pH lower than pH 6. Unprotonated nicotine free or freebase nicotine is the form that is most readily absorbed across oral membranes, and this form increasingly predominates as pH levels increase above 6.

Nicotine concentrations in products were measured using a gas chromatography—mass spectrometry method with parameters previously described 24 with slight modifications to the extraction process.

A mL aliquot of methyl tert-butyl ether extraction solution containing quinoline internal standard was then added and the sample extracts were shaken for 1 hour. All statistical analysis was performed using JMP version Statistical significances were assessed when sample sizes were adequate. Means and SE of moisture, pH, and nicotine total, free in analyzed products are summarized in figures and Table 1.

Many of the manufactures had multiple product offerings distinguished by flavor or different nicotine content as labeled on their respective packaging. Summary of means standard error of moisture, pH, and nicotine total, free in products analyzed in this study. Median mass values of pouch contents are shown followed by the range shown in brackets Figure 1.

Mass of pouch content filler mg for nicotine pouch products by brand and labeled nicotine content. Powdered contents inside of pouches were removed see insert and the mass measured in milligrams. The Outlier Box Plots display the median, interquartile range, min, max, and potential outliers.

The median mass per pouch for 4-mg Velo pouches was more than double that of 2 mg Velo pouches, indicated by the red arrows. The median mass for the other brands was similar regardless of the nicotine dose indicated on the label. All the pouch products were found to have pH levels ranging from pH 6. The difference in moisture is observed between products of different manufacturers rather than different flavors or brands from the same manufacturer. Among all the pouch products, pH levels ranged from pH 6.

The 2- and 4-mg Velo pouches had pH values ranging from pH 7. The 3- and 6-mg Rogue pouches had mean alkalinity of pH 7. The 3- and 6-mg ZYN pouches had mean alkalinity of pH 8.

The 3- and 6-mg ON! Licorice 6 mg Among all the 37 products analyzed, total nicotine content ranged from 0. The 2-mg Velo pouches had mean total nicotine values of 1. The 4-mg Velo pouches had mean total nicotine values of 2.

The 3-mg ZYN pouches had mean total nicotine values of 2. The 6-mg ZYN pouches had mean total nicotine values of 5. The 3-mg ON! The 6-mg ON! The 3-mg Rogue pouches had mean total nicotine values of 2. The 6-mg Rogue pouches had mean total nicotine values of 5. For seven LYFT products, which do not have nicotine dose levels on its product labels, the mean total nicotine was 4. Only one White Fox product was available, which had the highest alkalinity pH For White Fox, the mean total nicotine was 6.

The levels of total and free nicotine found in nicotine pouches by brand and nicotine content on label if available. Among the individual 6-mg ZYN products, the highest free nicotine per pouch were coffee 4. White Fox had the highest free nicotine per pouch concentrations 6. When comparing free nicotine doses per pouch, the Velo 4-mg pouches contained 0. The weights per pouch for 3- and 6-mg products of the ON!

Due to increasing pH values pH 7. The free nicotine was 0. White Fox had slightly higher total nicotine 6. In terms of mean values, seven LFYT brands, which lack nicotine dose information on the label, had slightly less total nicotine [4. For the LFYT brands, free nicotine amount of 1. Conversely, two Rogue products were dissimilar. The free nicotine in the Rogue Honey Lemon 6 mg 1. The free nicotine in the Rogue Mango 6 mg 2. The free nicotine in the ZYN Cinnamon 6 mg 4.

The free nicotine in the ZYN Peppermint 6 mg 2. For Velo, the nicotine doses on the product labels were either 4 or 2 mg. The free nicotine in the 4-mg products 0.

Overall, the Velo 2-mg products had the least free nicotine Table 1 , Supplementary Table 1. Data from the 37 nicotine pouch products examined reveal that these products have a wide range of pouch contents — mg , moisture content 1.

The higher pH values are due to the addition of alkaline agents, such as carbonates and bicarbonates. The characteristics of the assessed nicotine pouches are generally consistent with previously observed levels in conventional smokeless tobacco products.

For example, the pH levels in conventional moist snuff in one large study ranged from pH 5. Pharmacokinetic studies show that nicotine pouch products can result in blood nicotine levels comparable or higher than those resulting from the use of certain snus or moist snuff products.

Nicotine toxicity among young people following the use of these products is also a potential concern. These findings have important implications for tobacco control research. Retail scanner data indicate that nicotine pouches are a small but rapidly growing segment of the tobacco product landscape, with combined unit sales for the category exceeding It is therefore important for researchers to include nicotine pouches in public health surveillance, research, and evaluation efforts to better capture the extent of use and inform tobacco prevention and control strategies.

Specifically, future research is warranted to further characterize these products, including their inherent health risks. Specifically, the Family Smoking Prevention and Tobacco Control Act, 27 which gave the US Food and Drug Administration the authority to regulate tobacco products, defines a tobacco product as any product made or derived from tobacco that is intended for human consumption.

Although these nicotine pouches contain lower levels of harmful and potentially harmful ingredients than traditional tobacco products, the findings from this study indicate that these products could deliver nicotine comparable to traditional tobacco products.

The high levels of nicotine and prominent use of flavors in nicotine pouches raise concerns about potential initiation and use among vulnerable populations, including youth. The findings in this study are subject to some limitations. First, potential sampling bias may exist due to undercoverage. The 37 assessed products purchased for this study were selected from products commercially available in the metropolitan Atlanta, GA, area in This could limit the generalizability of the findings to the entire nicotine pouch product class as products not available in the metropolitan Atlanta area in were not analyzed.

Second, sample size was small, which could also limit representativeness. Nonetheless, the findings from this study provide valuable new information on a new product class in terms of moisture, pH, and both total nicotine and free nicotine levels. Nicotine pouches are gaining market share, but little is known about their chemistry or potential health risks.

The tested products spanned a wide range of total and free nicotine values that are comparable in deliveries from conventional snus or moist snuff pouches, which they visually resemble. Long-term data is yet to come, so we are unsure how reduced exposure may translate into reducing harm to our health.

No current regulations exist that prevent or restrict flavored nicotine pouches and marketing restrictions are not as rigid as those on smokeless or combustible tobacco products.

Side effects of use can include irritation of the gums, sore mouth, hiccups, nausea and most importantly, nicotine addiction which increases relapse risk with other tobacco products. There is no data to show nicotine pouches as a safe or effective way to quit.

Approved nicotine replacement therapies include nicotine patches, gum, lozenges, nasal spray and nicotine inhaler. If you're trying to quit, there is good news. You don't have to try and quit on your own. You can do it and you will do it! What I want for my patients is for them to be their best self and I can confidently say that tobacco is not a part of that plan.

While the health effects are yet to be clearly known, nicotine pouches are still a source of an addictive substance that is not healthy. Are you struggling with nicotine or tobacco dependence? We're here to help. To get started, call Even men and women who have smoked for many years can reduce their lung cancer risk after five years of quitting smoking. Using smokeless tobacco is as dangerous as smoking cigarettes, and can cause serious damage to the body.

Oral cancer cancer of the mouth is the cancer most often linked to smokeless tobacco use. But users also can get cancer in the stomach, the throat, and the bladder because the chemicals from the tobacco get into their digestive systems through their spit.

In the most severe cases, problems caused by smokeless tobacco can lead to permanent disfigurement, such as the loss of teeth and even bones in the face. Smokeless tobacco also causes bad breath, yellowish-brown stains on the teeth, and mouth sores in most users.

Quitting is hard, and using smokeless tobacco while trying to quit is common. But don't give up. Your chances of quitting get better each time you try! Larger text size Large text size Regular text size.