Nicotine pharmacokinetics and subjective response among adult smokers using different flavors of on! nicotine pouches compared to combustible cigarettes.

Introduction:
This text is a summary of a scientific study investigating the abuse potential of on!® nicotine pouches (NPs) in comparison to combustible cigarettes in adult smokers. The study design is a single-blind, randomized, 7-way crossover trial, where participants used six flavors of NPs and their own brand cigarettes (OBCs) in a controlled and ad libitum setting. The study assessed nicotine pharmacokinetics (PK), subjective effects, and product use behavior.

Key Points:

* The study enrolled 42 healthy adult smokers, who were randomized to one of seven product sequences and used the assigned product for 4 hours in a controlled and ad libitum setting.
* Nicotine PK was assessed by measuring plasma nicotine concentrations at predetermined time points during and following each controlled product use episode.
* Subjective measures, including the Tobacco/Nicotine Withdrawal questionnaire, Direct Effects of Product questionnaire, and Use the Product again questionnaire, were used to assess the magnitude, onset, and offset of product effects during and after each use.
* The study found that all NPs were considered pleasant, but not as much as OBCs. Flavor did not appear to influence the nicotine PK or subjective responses.
* Use of NPs resulted in lower ratings of urge to smoke or craving a cigarette compared to OBCs.
* The NPs demonstrated a slower speed and lower magnitude of nicotine delivery and lower magnitude of positive subjective effects compared to participants’ OBCs.
* The NPs provided subjective satisfaction and reduced cigarette craving, suggesting that completely switching to novel non-combustible products like NPs has the potential for reducing the harm from cigarette smoking.

Main Message:
The study suggests that based on the nicotine PK parameters and subjective responses, NPs, regardless of flavor, likely have lower abuse potential than cigarettes. The NPs may be potentially acceptable switching products for adult smokers, providing a reduced-harm alternative to cigarette smoking. The study supports the potential of NPs as a harm reduction strategy for adult smokers unable or unwilling to quit smoking.

Rensch, J., Liu, J., Wang, J., Vansickel, a., Edmiston, J., & Sarkar, M. (2021). Nicotine pharmacokinetics and subjective response among adult smokers using different flavors of on! Nicotine pouches compared to combustible cigarettes. Psychopharmacology, 238(11), 3325–3334. https://doi.org/10.1007/s00213-021-05948-y