Nicotine pouches, small tobacco-free sachets delivering nicotine orally, are emerging globally as a potential harm reduction tool. In Saudi Arabia, where smoking remains a major health burden and cultural factors shape patterns of tobacco use, new research provides the first comprehensive look at how nicotine pouches are being adopted, their perceived benefits, and the risks that need close monitoring.
Study Findings: Who Uses Nicotine Pouches?
A cross-sectional survey of 657 adults across Saudi Arabia revealed that 21.2% of respondents had tried nicotine pouches, with use most common among young men aged 18–30. Students reported higher rates of use than other occupational groups, while moderate-income participants were more likely to experiment than either lower- or higher-income groups.
This demographic profile suggests that nicotine pouches are gaining traction among younger adults seeking alternatives to smoking, a pattern mirrored in international studies. Importantly, most pouch users were already tobacco or e-cigarette consumers, highlighting their role as substitutes rather than entry points for nicotine initiation.
Smoking Cessation: Promise With Limits
Among participants who had used nicotine pouches:
- 41% reported successfully quitting smoking,
- 38% reported partial success, and
- 21% reported no success.
These findings suggest that while nicotine pouches may help some smokers transition away from cigarettes, outcomes vary considerably. As with other cessation tools, success depends on motivation, support, and patterns of use.
Side Effects: Mostly Mild, But Worth Monitoring
The most commonly reported side effects were:
- Nausea (13.4%),
- Fatigue (6.7%), and
- Headache (6.5%).
Though generally mild, these symptoms can affect adherence and should be closely tracked. More severe oral issues, such as lesions or stomatitis, observed in international studies, were not widely reported in this Saudi sample but remain a concern for long-term use.
Predictors and Patterns
Regression analysis showed that heavier smokers were significantly more likely to try nicotine pouches, with the odds highest among those smoking 7–9 cigarettes per day. This suggests pouches are being adopted primarily by those with established nicotine dependence, consistent with their role as a harm reduction tool.
Interestingly, women and older adults were far less likely to use pouches, underscoring cultural and demographic factors that may shape adoption differently from Western markets.
Implications for Policy and Public Health
Saudi Arabia has invested in nationwide cessation centers, but traditional tools may not reach everyone. This study highlights that nicotine pouches are already in use—often outside formal medical support, and may appeal in contexts where smoking is culturally discouraged.
However, without regulation, the risks are clear: counterfeit products, improper dosing, and a lack of quality standards could undermine harm reduction potential. Internationally, the FDA’s authorization of certain nicotine pouches as modified risk tobacco products highlights their reduced toxicant profile compared to smoking, but balanced oversight remains critical.
The Road Ahead
For Saudi Arabia, the findings offer both opportunity and caution:
- Opportunity: Pouches could complement national cessation programs, offering smokers a culturally discreet, less harmful option.
- Caution: Without regulation, public education, and quality control, risks of misuse, dependence, and adverse effects may grow.
As the study concludes, nicotine pouches show promise for smoking cessation, but long-term safety data and larger, more representative studies are essential. Saudi Arabia now faces a pivotal choice: to ignore these emerging products or to develop evidence-based frameworks that harness their potential for harm reduction while safeguarding public health.
