REVIEW PAPER
The safety of using oral nicotine pouche – consideration of their effects on general health, oral mucosa and periodontal diseases, comparing them to snus and other nicotinecontaining products
1
Department of Oral Mucosal and Periodontal Diseases, Medical University, Łódź, Poland
These authors had equal contribution to this work
Corresponding author
Amelia Weronika Rusiecka
Department of Oral Mucosal and Periodontal Diseases Medical University of Łódź, Pomorska 251, 92-217, Łódź, Poland
Department of Oral Mucosal and Periodontal Diseases Medical University of Łódź, Pomorska 251, 92-217, Łódź, Poland
KEYWORDS
addictioninflammationriskbacteriateethtoxicityperiodontiumsnusoral nicotine pouchesnicotine pouches and mucosa
TOPICS
ABSTRACT
Introduction and objective:
Oral nicotine pouches (ONPs) are tobacco-free and non-combustible products that are pouch-shaped and fit between the alveolar process and the upper lip. Through their use, nicotine is absorbed into the body through the oral mucosa. Their harmfulness is significantly less than that of traditional cigarettes because they do not require combustion.
Review methods:
A review was carried out of the literature in English from 2010–2023 using the PubMed database.
Brief description of the state of knowledge:
Research indicates ONPs have lower cytotoxicity compared to snus and cigarettes, with some studies suggesting reduced harm-related biomarkers. However, they still pose health risks. The unregulated status and accessibility of nicotine pouches, especially to youth, underscore the need for awareness of their potential dangers. It is important to emphasize their potential negative effects on the oral mucosa and periodontium, as well as on the body, due to their content of nicotine and other potentially dangerous substances. ONPs are suspected of contributing to mucosal lesions, gingival recession, alveolar bone loss, and increased mediators of periodontitis like MMP- 1, MMP-3, and IL-1. Application of ONP to human gingival epithelial cells (HGEPp) resulted in elevated levels of lactate dehydrogenase (LDH), ROS, and inflammatory cytokines (TNF-α, IL-6, and IL-8). ONPs contain low levels of tobacco-derived carcinogens, and may include substances classified by the IARC as potentially carcinogenic.
Summary:
Due to the short time the product has been on the market and narrow period of widespread use, the effects of ONP on human health cannot be predicted with certainty. It is very important to conduct further research in several areas regarding the health effects of ONP and potential consequences that may occur in the future.
Oral nicotine pouches (ONPs) are tobacco-free and non-combustible products that are pouch-shaped and fit between the alveolar process and the upper lip. Through their use, nicotine is absorbed into the body through the oral mucosa. Their harmfulness is significantly less than that of traditional cigarettes because they do not require combustion.
Review methods:
A review was carried out of the literature in English from 2010–2023 using the PubMed database.
Brief description of the state of knowledge:
Research indicates ONPs have lower cytotoxicity compared to snus and cigarettes, with some studies suggesting reduced harm-related biomarkers. However, they still pose health risks. The unregulated status and accessibility of nicotine pouches, especially to youth, underscore the need for awareness of their potential dangers. It is important to emphasize their potential negative effects on the oral mucosa and periodontium, as well as on the body, due to their content of nicotine and other potentially dangerous substances. ONPs are suspected of contributing to mucosal lesions, gingival recession, alveolar bone loss, and increased mediators of periodontitis like MMP- 1, MMP-3, and IL-1. Application of ONP to human gingival epithelial cells (HGEPp) resulted in elevated levels of lactate dehydrogenase (LDH), ROS, and inflammatory cytokines (TNF-α, IL-6, and IL-8). ONPs contain low levels of tobacco-derived carcinogens, and may include substances classified by the IARC as potentially carcinogenic.
Summary:
Due to the short time the product has been on the market and narrow period of widespread use, the effects of ONP on human health cannot be predicted with certainty. It is very important to conduct further research in several areas regarding the health effects of ONP and potential consequences that may occur in the future.
Rusiecka AW, Szymacha K, Lewkowicz N. The safety of using oral nicotine pouches – consideration of their effects on the general health, oral mucosa and periodontal diseases, comparing them to snus and other nicotine-containing products. J Pre-Clin Clin Res.
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