Trial reportAddiction (Abingdon, England)2024
Evaluating the effects of nicotine concentration on the appeal and nicotine delivery of oral nicotine pouches among rural and Appalachian adults who smoke cigarettes: A randomized cross-over study.
Trial report in Addiction (Abingdon, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05236894 (Examining the Appeal of Nicotine Pouches in Ohio Appalachia), which is not on this map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Examining the Appeal of Nicotine Pouches in Ohio Appalachia
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- What is the impact of nicotine pouches on oral health: a systematic review.BMC oral health · 2024Pooled it
- Switching from Cigarettes to E-Cigarettes and Oral Nicotine Pouches in Adults with Low-Income Who Smoke: Qualitative Findings from a Pilot Randomized Controlled Trial.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Trial
- Cardiovascular and metabolic changes following 12 weeks of tobacco and nicotine pouch cessation: a Swedish cohort study.Harm reduction journal · 2025Trial
- Evaluating the Role of Nicotine Stereoisomer on Nicotine Pouch Abuse Liability: A Randomized Crossover Trial.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Trial
- Oral Nicotine Pouch Use and Associations with Periodontal Status and Salivary Microbiome Dysbiosis.JDR clinical and translational research · 2026Article
- Synergistic effects of nicotine and hyperlipidemia induce cardiac damage via dynamic cardiomyocyte-based biosensing.Microsystems & nanoengineering · 2026Article
- Effects of nicotine concentration and pH on nicotine pouch appeal and sensory experience: A randomized experimental study.Addiction (Abingdon, England) · 2026Article
- The Association Between Product Attributes and Oral Nicotine Pouch Preference-Evidence From Online Stores.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Oral Nicotine Pouch Misuse Popularized Online Raises Concerns.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Investigating the Appeal of Nicotine Pouch Packaging, Flavour, and Nicotine Descriptors Among Adults in the UK: An Online Experiment.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Patterns and characteristics of nicotine pouch use among adults with a history of cigarette smoking.Frontiers in public health · 2026Article
- What Do We Know About the Use of Oral Nicotine Pouches? A Scoping Review of Quantitative Studies.Hawai'i journal of health & social welfare · 2026Article
- Use of nicotine pouches among adults who currently or formerly smoked cigarettes and/or vaped nicotine: findings from the 2022 and 2024 US ITC smoking and vaping surveys.Tobacco control · 2025Article
- Physiological and subjective effects of an oral nicotine pouch in people who use smokeless tobacco.Experimental and clinical psychopharmacology · 2025Article
- Examining the role of freebase nicotine in the harm reduction potential of oral nicotine pouches versus moist snuff: A randomized crossover trial.Addiction (Abingdon, England) · 2025Article
- Effects of oral nicotine pouches on cigarette smoking behaviour and tobacco harm exposure: a randomised pilot trial in adults.Tobacco control · 2025Article
- Advertising the leading US nicotine pouch brand: a content analysis of ZYN advertisements from 2019 to 2023.Tobacco control · 2025Article
- A comprehensive review on oral nicotine pouches: Available scientific evidence and future research needs.Experimental and clinical psychopharmacology · 2025Review
- Nicotine Toxicity From Repeat Use of Nicotine Pouches.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- The Potential Impact of Oral Nicotine Pouches on Public Health: A Scoping Review.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
BACKGROUND AND
aimsOral nicotine pouches (ONPs) probably offer reduced harm compared with cigarettes, but independent data concerning their misuse liability are lacking. We compared nicotine delivery and craving relief from ONPs with different nicotine concentrations to cigarettes.
designThis was a single-blind, three-visit (≥ 48-hour washout), randomized-cross-over study. Participants were encouraged to complete all study visits in less than 1 month.
settingThe study took place in Rural/Appalachian Ohio.
participantsParticipants comprised 30 adults who smoke cigarettes. Participants (mean
interventionParticipants who were ≥ 12-hour tobacco-abstinent used: (1) a 3-mg nicotine concentration ONP, (2) a 6-mg nicotine concentration ONP and (3) usual brand cigarette in separate visits. ONPs (wintergreen Zyn) were used for 30 minutes; cigarettes were puffed every 30 sec for 5 minutes. MEASUREMENTS: Plasma nicotine and self-reported craving were assessed at t = 0, 5, 15, 30, 60 and 90 minutes. The primary outcome was plasma nicotine concentration at t = 30 minutes. A secondary outcome was craving relief at t = 5 minutes.
findingsAt t = 30, mean [95% confidence interval (CI)] plasma nicotine was 9.5 ng/ml (95% CI = 7.1, 11.9 ng/ml) for the 3 mg nicotine ONP, 17.5 ng/ml (95% CI = 13.7, 21.3) for the 6 mg nicotine ONP and 11.4 ng/ml (95% CI = 9.2, 13.6 ng/ml) for the cigarette. Mean plasma nicotine at t = 30 minutes differed between the 3- and 6-mg nicotine ONPs (P = 0.001) and between the 6-mg nicotine ONP and cigarette (P = 0.002). Mean (95% CI) craving at t = 5 minutes was lower for the cigarette (mean = 1.00, 95% CI = 0.61, 1.39) than either the 3 mg (mean = 2.25, 95% CI = 1.68, 2.82; P < 0.0001) or 6 mg nicotine (mean = 2.19, 95% CI = 1.60, 2.79; P < 0.0001) ONP.
conclusionsAmong adult smokers, using 6-mg nicotine concentration oral nicotine pouches (ONPs) was associated with greater plasma nicotine delivery at 30 minutes than 3-mg ONPs or cigarettes, but neither ONP relieved craving symptoms at 5 minutes as strongly as a cigarette. Accelerating the speed of nicotine delivery in ONPs might increase their misuse liability relative to cigarettes.
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