For decades, Sweden’s traditional tobacco pouch, snus, has stood apart from cigarettes as a safer nicotine alternative. In recent years, nicotine pouches, a modern, tobacco-free evolution of snus, have entered global markets and attracted millions of adult consumers seeking a cleaner, smoke-free option. Both products deliver nicotine orally and avoid the toxic by-products of combustion, yet their composition, risk profiles and regulatory treatment differ significantly. Understanding these differences is essential to evaluating their role in tobacco harm reduction.
Old world snus, new world pouches
A considerable body of evidence supports the relative safety of snus when compared to smoking. Data from Sweden, where snus use is widespread among men, show that the country has the lowest smoking prevalence and smoking-related mortality in the European Union. Research published in The Lancet and Tobacco Control links Sweden’s success directly to its long-standing snus culture. According to the Swedish Public Health Agency, fewer than 5% of Swedish men now smoke cigarettes daily, while the EU average remains above 20%. Consequently, Sweden reports roughly 40% lower tobacco-related deaths than the European average. While snus is not risk-free, studies from institutions such as the U.S. National Cancer Institute and the UK’s Royal College of Physicians consistently show that it does not significantly increase risks of oral, lung or cardiovascular cancers. Some research suggests that long-term use may slightly raise the risk of pancreatic disease or cause gum irritation, but these risks remain dramatically lower than those associated with smoking.
Nicotine without smoke or tobacco
Nicotine pouches are more recent and therefore less extensively studied, but early evidence suggests a similarly favourable risk profile. A 2025 Cochrane review conducted by researchers at the University of Massachusetts Amherst provided the first systematic assessment of nicotine pouch studies and concluded that smokers who switch to pouches experience substantially reduced exposure to toxic and carcinogenic compounds. While the review emphasised the need for more long-term data, it supported the central principle of harm reduction: replacing high-risk products like cigarettes with lower-risk alternatives can significantly reduce harm.
Both snus and nicotine pouches provide clear benefits by eliminating combustion, the primary cause of smoking-related disease. By avoiding smoke, they remove tar, carbon monoxide and thousands of chemical by-products that contribute to cancers, heart disease and respiratory illness. They have also proven effective as smoking cessation tools. In Norway, where snus use surged over the past decade, adult smoking rates have dropped dramatically, and young adults have turned to snus instead of cigarettes at historically high rates. Early evidence suggests that nicotine pouches may serve a similar role for younger generations seeking cleaner, more discreet alternatives to smoking. Their lack of odour and ease of use make them socially acceptable in environments where smoking and vaping are prohibited, and the fact that they contain no tobacco, means that they do not stain teeth like snus. Unlike disposable vapes, both snus and nicotine pouches create far less environmental waste, avoiding the plastics, batteries and electronic components that have raised concerns in several countries.
Risks and regulations
Despite these advantages, both products have drawbacks. The one which causes most concern among policymakers is the fear that they can prolong nicotine dependence and make complete cessation challenging for some users. Although the health risks of snus and pouches are relatively low, they may cause oral irritation, gum recession or minor mucosal changes, though these typically reverse when use stops. Swedish brand Stingfree AB has compensated for these issues by creating snus and nicotine pouches with integrated protection for the gums. For nicotine pouches specifically, regulators stress that long-term research is still limited due to their recent introduction. Youth uptake remains a concern in some markets, prompting calls for stricter age-verification measures and responsible marketing practices.
The regulatory treatment of snus and nicotine pouches varies widely across regions. In the European Union, snus is banned under the Tobacco Products Directive, with the exception of Sweden, which negotiated an exemption when it joined the EU in 1995. Despite decades of Swedish data showing strong public health benefits, the EU has resisted re-evaluating the ban. Nicotine pouches, by contrast, occupy a regulatory grey zone. Some EU member states classify them under pharmaceutical rules or impose nicotine strength limits, while others allow open sale with minimal restrictions.
In the United States, both products are legal. Certain brands of snus, such as General Snus, have been granted modified-risk tobacco product status by the U.S. Food and Drug Administration (FDA). In 2025, the FDA authorised the marketing of 20 Zyn nicotine pouch products, concluding that their availability would likely benefit overall public health by helping smokers transition to lower-risk alternatives. In the United Kingdom, snus is banned for sale but allowed for personal import, while nicotine pouches are sold widely under general product safety rules and are recognised by public health agencies as substantially safer than smoking.
The growing case for the oral smokefree products
Snus and nicotine pouches ultimately represent two points on the same harm-reduction spectrum: one a traditional tobacco product with decades of epidemiological evidence, the other a modern, tobacco-free innovation designed to offer similar benefits with potentially even fewer risks. Both demonstrate that when adult smokers have access to appealing, low-risk alternatives, smoking rates fall. The challenge for policymakers remains ensuring that regulations protect young people without undermining access for the adults whose lives stand to be saved.
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