The Public Health Reports systematic review, “Oral Nicotine Pouches: Rising Popularity and State of the Science”, examines the growing use of oral nicotine pouches, such as ZYN, and what is currently known about their potential public health implications. While these products have become increasingly visible, the authors find that significant gaps remain in understanding their long-term health effects, patterns of use, and potential role in harm reduction.

The review finds that nicotine pouches can deliver nicotine at levels comparable to other tobacco products, with nicotine absorbed more slowly than cigarettes but similarly to other oral products. Although use among adolescents and young adults remains relatively low, it is increasing and is more common among people who already use e-cigarettes or smokeless tobacco.

The authors also note that much of the available research on toxicant levels, pharmacokinetics, and harm-reduction potential has been industry funded, highlighting the need for more independent evidence. While nicotine pouches could potentially serve as a harm-reduction option for people who smoke, important questions remain about youth appeal, long-term health effects, and regulatory oversight.

The review calls for continued independent research to better understand use patterns, health outcomes, and the evolving public health implications of these products.