OTTAWA, September 26, 2025 — Researchers at the Ottawa Heart Institute have completed the first major review of studies looking at how tobacco-free nicotine pouches affect smoking habits. Their work, published in the peer-review journal Addiction, finds that while nicotine pouches may reduce the number of cigarettes smoked per day, the reduction is similar to that of other nicotine products. Further, they do not appear to increase quit rates.
Nicotine pouches are a fast-growing tobacco-free nicotine product, placed between the lip and gum to deliver nicotine in various strengths and flavours. Some manufacturers and researchers have promoted them as tools to curb nicotine cravings and support smoking cessation. However, the evidence supporting these claims has remained unclear.
"Nicotine pouches may help some individuals reduce how much they smoke, but there is no evidence they work better than existing nicotine replacement therapies that are proven in large clinical trials and used effectively in clinical care for decades to help people quit smoking,” said Hassan Mir, MD, senior author, cardiologist and chair of the Ottawa Model for Smoking Cessation at the Ottawa Heart Institute.
"None of the included studies demonstrated that nicotine pouches actually help people quit smoking when compared to control or other nicotine products," said Javad Heshmati, PhD, lead author and postdoctoral fellow at the Ottawa Heart Institute.
The review included seven clinical trials from high-income countries in Europe, North America, and New Zealand. These studies involved 269 adult participants who were currently smoking. Researchers evaluated outcomes such as product satisfaction, the urge to smoke, and changes in cigarette consumption.
“We encourage people who smoke to rely on proven treatments such as nicotine replacement therapy, varenicline, bupropion, and cytisine,” said Dr. Mir. “Until more large-scale, independent trials are completed, nicotine pouches should not be considered an evidence-based smoking cessation aid and caution is warranted.”
The Ottawa Heart Institute remains committed to advancing research on smoking cessation tools and improving cardiovascular health for all Canadians.
For more information
- Read the study: Nicotine pouches and clinical outcomes related to smoking cessation: A systematic review of randomized trials
- Learn more: Read the Canadian Cardiovascular Society clinical practice update on smoking cessation led by Dr. Mir.
Media contact
Leigh B. Morris
Communications Officer
University of Ottawa Heart Institute
613-316-6409 (cell)
lmorris@ottawaheart.ca