Toxicant contents of oral nicotine pouches: comparative quantitative analysis with Swedish snus and cigarette smoke

Abstract Background and aims Swedish snus is a smokeless tobacco product (STP) associated with potentially reduced health risks compared to conventional cigarettes, due in large part to the absence of high toxicant levels generated by combustion. In 2019 and renewed in 2024, the US Food and Drug Administration has granted modified risk tobacco product (MRTP) status to eight Premarket Tobacco Application (PMTA) authorised General snus products, pointing to the viability of Swedish snus as reduced risk alternatives for adults who would otherwise continue to smoke. Oral nicotine pouches (ONPs) are similar to snus but differ by being tobacco-free (containing nicotine but not tobacco leaf thereby suggesting that exclusive ONP use may present less health risks than smoking cigarettes and comparable or even less risk than using snus. The aim of this study was to conduct a comprehensive analysis of toxicant levels in ONPs compared with Swedish snus. Measurements Using standard and verified methods, 132 analytes were measured in 11 commercial ONPs (including nine Velo products), a non-commercial, unflavoured zero-nicotine content ONP, and two snus products (1S4 reference snus and a commercial snus) to better understand each product’s toxicant profile. Findings In total, the contents of 70 analytes were not quantifiable in any of the analysed ONPs or snus. A higher number of analytes were present at quantifiable levels in snus ( n = 58) than in ONPs ( n = 47) on a per-pouch basis. Of the 43 analytes that were above the detection limit in both product types, 15 analytes were quantifiable only in snus, and four were quantifiable only in some ONPs. In most tests, the ONPs contained lower levels of analytes (> 90% lower) than the snus study products. Comparing the chemical contents of ONPs with historical cigarette smoke data showed almost all comparators were substantially lower in ONPs. Regarding the subset of analytes listed in the GOTHIATEK ® standard, none of the ONPs tested exceeded the maximum allowable limits established for snus. Conclusion The results support the hypothesis that exclusive use of ONPs might offer a potentially reduced risk alternative relative to continued smoking and comparable or even less risk than using snus.