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

Introduction:
This text provides a summary of a research study evaluating the effects of nicotine concentration on the appeal and nicotine delivery of oral nicotine pouches (ONPs) among rural and appalachian adults who smoke cigarettes. The study used a randomized cross-over design to compare the use of ONPs with different nicotine concentrations to cigarettes. The key points of the study include the plasma nicotine concentrations and craving relief experienced by participants after using the different products.

Key points:

* The study used a randomized cross-over design with 30 participants.
* Participants used a 3 mg nicotine concentration ONP, a 6 mg nicotine concentration ONP, and their usual brand cigarette in separate visits.
* Plasma nicotine concentrations were measured at several time points after product use.
* Craving relief was measured using the Minnesota Withdrawal Scale.
* Mean plasma nicotine concentration at 30 minutes differed significantly between the 3 and 6 mg nicotine concentration ONPs and between the 6 mg nicotine concentration ONP and cigarette.
* Using the usual brand cigarette resulted in greater self-reported reductions in craving at 5 minutes of product use than either ONP.
* Neither ONP matched the maximum plasma nicotine concentration of participants' usual brand cigarettes.

Main message:
The study found that using ONPs resulted in lower plasma nicotine concentrations and less craving relief compared to cigarettes. The 6 mg nicotine concentration ONP delivered more nicotine than the 3 mg ONP, but it still did not match the nicotine delivery of cigarettes. These findings suggest that ONPs may not be a suitable substitute for cigarettes, particularly for rural and appalachian adults who smoke. Further research is needed to determine whether specific varieties of ONPs could reasonably be used to help adults reduce their cancer risks from cigarette smoking.

Keller‐hamilton, Brittney, Mahmood a. alalwan, hayley Curran, alice hinton, Lauren Long, Kirsten Chrzan, Theodore L. Wagener, Leanne atkinson, Sriya Suraapaneni, and Darren Mays. “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.” addiction, November 14, 2023, add.16355. https://doi.org/10.1111/add.16355.