Classification, Perception, and Toxicity of Emerging Flavored Oral Nicotine Pouches

Sadiya Bi Shaikh, Chad Newton, Wai Cheung Tung, Yehao Sun, Dongmei Li, Deborah Ossip and Irfan Rahman ()
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Sadiya Bi Shaikh: Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
Chad Newton: College of Professional Studies, Bethel University, McKenzie, TN 38201, USA
Wai Cheung Tung: Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
Yehao Sun: Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
Dongmei Li: Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY 14642, USA
Deborah Ossip: Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
Irfan Rahman: Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA

IJERPH, 2023, vol. 20, issue 5, 1-14

Abstract: Introduction: Oral Nicotine Pouches (ONPs) are the new form of nicotine pouches that have become a type of emerging smokeless tobacco product sold by various tobacco companies. These smokeless tobacco products are marketed for usage all over as snus containing tobacco-derived nicotine (natural) or as tobacco-free nicotine (synthetic) as substitutes for other tobacco products. Based on perception and socio-behavioral aspects, ONPs have become popular tobacco products among adolescents/young adults, and over 50% of young adult users of ONP use flavored ONPs, such as menthol/mint, tobacco, dessert/candy, and fruity, which are the most popular flavors. Various new ONP flavors are currently popular locally as well as in the online market. Tobacco, menthol, and fruit-flavored ONPs could motivate cigarette smokers to change to ONPs. Methods: We expanded our knowledge on natural/synthetic ONP flavor wheels to available data on ONPs, describing, in detail, their flavors and brands (US and Europe) in both natural and synthetic ONP categories. We classified over 152 snus and 228 synthetic ONPs into the following flavor categories: “Tobacco”, “Menthol/Mint”, “Fruity”, “Candy/Deserts”, “Drink”, “Aroma”, “Spices”, and “Mixed Flavors”. Results: Based on total numbers, we found the most popular ONP flavors, sold as tobacco and menthol, to be among natural ONPs; among synthetic ONPs, fruity and menthol are the most prominent flavors, with varying concentrations of nicotine and other flavoring chemicals, including coolant WS-23. We also showed possible molecular targets and toxicities, due to exposure to ONPs, activating several signaling cascades such as AKT and NF-kappaB, which might possibly lead to apoptosis and epithelial mesenchymal transition (EMT). Conclusions: Considering the marketing of ONP products with various flavor profiles and with most of these products containing tobacco/menthol/fruit flavor, it is likely to have regulation and a marketing disclaimer on some of these products. Further, it would be logical to determine how the market reacts in terms of compliance and non-compliance with flavor restrictions by the regulatory agencies.

Keywords: ONPs; flavors; perception; regulation; menthol; tobacco; nicotine; toxicity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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