Table 1.
Characteristics of the included studies and outcome of nicotine pouch usage
| Authors (year) |
Type of Study |
Country | Number of participants | Sex | Age (years) Mean ± SD Range |
Frequency Mean ± SD Range & duration of usage |
Outcome | Note | |||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Oral mucosal changes | Dental & gingival status | Adverse effects | Salivary biomarkers | ||||||||
|
Dowd et al. (2024) |
Cross-sectional | USA | 118 |
M = 40 F = 78 |
30 ± 10 18–67 |
2 ± 1 NP/session (1–5 NP, Mostly with tobacco-cigarette and/or e-cigarette) Average session time 11 ± 7 mins Mean 13 ± 6 days |
Oral lesions | - |
- Sore mouth - Sore throat - Upset stomach - Nausea - Strange jaw sensation |
- |
Retrospective self-reported data Past 30-day NP use |
| Alizadehgharib et al. (2022) | Prospective | Sweden | 60 (57 completed) |
M = 39 F = 21 |
31 ± 10 |
Ratio NP/total nicotine product = 0.84 For 6 weeks |
Clinical four-grade severity scale (1–4) Changes from previous lesions (0–4) - Increased score = 6 - No score change = 12 - Reduced score = 39 |
- DMFT = 3.7 ± 4.6 (at the beginning) - Gingival retraction 54–57% (no change) - Gingival blisters |
- Nausea - Dry mouth - Dizziness |
- |
Substituted regular Swedish snus users (≥ 2 snus cans for > 1 year) with NP |
|
Miluna et al. (2022) |
Cross-sectional | Latvia | 12 |
M = 10 F = 2 |
25.08 |
Snus and/or NP user = 12 For 2–10 years |
9/12 with oral lesions at upper anterior and premolar areas - White, localized and leathery - White grainy lesion - White linear or round lesions |
- | - |
-Increased levels of IL-1, IL-6, IL-8, TNF-alpha and LRG1 -IL-6 correlated with mucosal change |
Swedish snus and NP group |
SD standard deviation, NP Nicotine pouch, M Male, F Female, DMFT Decayed, Missing, filled Teeth, IL Interleukin, TNF tumor necrosis factor, LRG1 leucine-rich alpha-2-glycoprotein 1