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Nicotine pouches side effects: what's known

People look up nicotine pouches side effects for different reasons: a sore gum, a racing heart after a strong pouch, or a child who got hold of a can. This page sets out what health authorities and published studies actually report, and where the evidence runs out. We sell nicotine pouches, so every statement below is tied to a primary source listed at the end. Where we couldn't find a source, we've left the claim out.

Updated

Are nicotine pouches bad for you?

The US Centers for Disease Control and Prevention (CDC) puts it plainly: there are no safe tobacco products, including nicotine pouches. The CDC says youth, young adults and women who are pregnant should not use them, and that people who don't currently use tobacco or nicotine products should not start.

The World Health Organization (WHO) describes nicotine pouches as a rapidly expanding product category with high addiction potential and strong youth appeal. It also notes that pouches promoted as "tobacco-free" may contain nicotine extracted from tobacco.

Dependence is the main known effect

Nicotine pouches contain a powder made of nicotine, flavourings and other ingredients. According to the CDC, the powder dissolves in the mouth and the nicotine is absorbed through the gums and the lining of the mouth. Nicotine is highly addictive, and the CDC notes that pouches can contain high levels of it.

The CDC adds that young people can start showing signs of nicotine addiction quickly, even when they aren't using nicotine regularly or daily. The WHO says early nicotine use can increase the likelihood of long-term dependence.

Short-term effects reported in studies

Most of what's known about short-term effects comes from small, short clinical studies. Two are worth knowing about:

  • Mouth irritation. In a crossover study of 15 regular smokers, every pouch tested caused mouth irritation, including a nicotine-free pouch. Pouches with 30 mg of nicotine per pouch caused strong irritation; the others caused moderate irritation. Increased redness was seen in some participants, and one ulcer was found after a 6 mg pouch (Mallock-Ohnesorg et al., Frontiers in Pharmacology, 2024).
  • Heart rate. In the same study, heart rate rose by about 12 beats per minute with 20 mg pouches and about 25 with 30 mg pouches. The researchers also asked about headache, dizziness, nausea and urge to vomit; none was rated above 3 out of 10 at any point. The 30 mg pouches had the strongest side effects overall.
  • Mostly mild effects, more at higher doses. A 2025 systematic review of seven randomised trials with 269 adults found adverse events were mostly mild, such as cough, throat irritation and headache, and more frequent at higher nicotine doses. No serious adverse events were reported (Heshmati et al., Addiction, 2025).

Effects in the mouth

A Swedish cross-sectional study recruited 18 to 30 year olds through nine dental clinics. Oral lesions were found in 79% of the 126 nicotine pouch users examined. Pouch users more often had redness (erythema) of the lining of the mouth and reported more oral symptoms, while thickened mucosa (hyperkeratosis) was more common among tobacco snus users. The authors concluded that pouches appear to cause broader mucosal responses than tobacco snus (Daneshian et al., Oral Diseases, 2026).

Sore spots, white patches or bleeding gums that don't settle are a reason to see a dentist. Our guide to gum irritation explains when.

Heart and blood vessels

The WHO states that nicotine use increases cardiovascular risk. The heart-rate rise measured in the study above is one short-term sign of nicotine's effect on the body. Long-term data on heart disease in people who use nicotine pouches doesn't exist yet, because the products are new. If you have a heart condition or high blood pressure, talk to your doctor before using any nicotine product.

Pregnancy and young people

The CDC says nicotine is toxic to developing fetuses and is a health danger for pregnant women. Women who are pregnant should not use nicotine pouches. If you're pregnant and use nicotine, your midwife or doctor can help.

The CDC also says nicotine can harm brain development, which continues until about age 25. In Sweden it's illegal to sell nicotine pouches to anyone under 18, and we verify age at checkout.

Children and accidental swallowing

This is the most serious short-term risk. A study of calls to US poison centers found that the rate of nicotine pouch ingestions among children under 6 rose by 763% between 2020 and 2023. Pouch ingestions were more likely to lead to a serious medical outcome or a hospital admission than other nicotine product types combined (Olivas et al., Pediatrics, 2025).

In September 2025 the FDA reported that about 72% of nicotine pouch exposure cases reported to US poison centers between April 2022 and March 2025 involved children under 5. The FDA says toxic effects in young children have been reported with nicotine doses as low as 1 to 4 mg, and that symptoms can include confusion, vomiting and loss of consciousness.

  • Store cans in a secure place away from children, in their original packaging, as the FDA advises.
  • United States: if anyone swallows a pouch, call Poison Control at 1-800-222-1222 straight away.
  • Sweden: in an emergency call 112 and ask for Giftinformation; in less urgent cases call 010-456 6700. Both lines are open around the clock.
  • A child with breathing problems, increasing drowsiness, loss of consciousness or seizures needs emergency care immediately.

What isn't known yet

Nicotine pouches entered the US market in 2016, and the CDC says scientists are still learning about their short- and long-term health effects. The longest study in the 2025 Cochrane review of pouches ran for eight weeks. We found no long-term studies of cancer, heart disease or other chronic illness in people who use only nicotine pouches, so nobody can honestly tell you those risks are low or high. A missing study is not evidence of safety.

If you want to cut down or stop

Nicotine is highly addictive, which is why stopping can be hard. Free help exists: in the US, 1-800-QUIT-NOW (1-800-784-8669); in Sweden, Sluta-röka-linjen on 020-84 00 00, a free support line for anyone thinking about stopping smoking or snus. Our guide on stopping covers what to expect.

Related guides

Sources

  1. CDC: Nicotine pouches
  2. CDC: Tips From Former Smokers: How to quit smoking
  3. World Health Organization: Tobacco and nicotine (fact sheet)
  4. U.S. Food and Drug Administration: FDA urges nicotine pouch manufacturers to use child-resistant packaging following increasing reports of accidental exposure (2 September 2025)
  5. Frontiers in Pharmacology: Mallock-Ohnesorg N, et al. Small pouches, but high nicotine doses: nicotine delivery and acute effects after use of tobacco-free nicotine pouches (2024)
  6. Addiction: Heshmati J, et al. Nicotine pouches and clinical outcomes related to smoking cessation: a systematic review of randomized trials (2025)
  7. Oral Diseases: Daneshian M, et al. Oral lesions and dental status in individuals using oral tobacco-free nicotine pouches (2026)
  8. Pediatrics: Olivas M, et al. Nicotine ingestions among young children: 2010-2023 (2025)
  9. Cochrane: What are the benefits and risks of oral nicotine pouches when used to help people stop smoking or vaping nicotine? (2025)
  10. Giftinformationscentralen: Förgiftningar hos barn
  11. Sveriges riksdag: Lag (2022:1257) om tobaksfria nikotinprodukter
  12. Sluta-röka-linjen: Om oss

Checked against the sources listed above on 5 October 2026. This page is general information, not medical advice. If you're pregnant, have a health condition or take medication, talk to a doctor or pharmacist.

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