It’s well known that cigarettes are dangerous. Nicotine pouches and vapes don’t have that same reputation, at least not yet, and that gap is concerning. As a doctor, I’m not against giving people options to quit smoking, however, it’s important to note the risks that come with each product.
Here’s what I wish more people understood before they try a pouch or a vape for the first time.
Tobacco-free products are still being researched and definitely aren’t safe.
Most vapes and pouches skip the ingredients that make cigarette smoke a carcinogen. That’s only part of the story.
The cancer risks of vapes are still being studied — that doesn’t mean you’re not going to get COPD from vapes. Plus, the high levels of nicotine can increase blood pressure and worsen anxiety and mental health.
The long-term cancer research on pouches specifically doesn’t exist yet, and I want to be careful not to overstate what isn’t proven. However, I’ve seen this pattern play out elsewhere in medicine. Repeated irritation of soft tissue, whether it’s acid reflux in the esophagus or a pouch tucked against the gumline for hours a day, tends to catch up with the body eventually.
I would not be surprised if research eventually shows an increase in mouth cancers, or esophageal or laryngeal cancers, from products like these. We just don’t know those risks yet. They’re being studied right now.
These products are making the teen mental health problem worse, not better
I see it in my patients all the time: nicotine used as a coping tool for anxiety, sleep trouble and stress. Unfortunately, nicotine in any form makes all three of those things worse.
Users get such a huge dose of nicotine chasing that initial feeling that when they come back down to a normal level, the anxiety is still there, and often higher than it would have been if they’d never gotten up to those doses in the first place.
That cycle is especially rough on a developing brain. Teens are signing up for a dependency they don’t fully understand, using products engineered to deliver far more nicotine than a cigarette ever did. They’re signing up for what they think is cool, because that’s what’s been branded to them as safe, or at least healthier than what their parents did.
These products are marketed like cessation tools. They were never built to be one.
This is the point I keep coming back to. If someone wants to use a vape to quit smoking, it needs to work like an actual medical tool: a measured dose that steps down over time until a person is off nicotine completely. That’s how patches, gum and lozenges are designed to work.
Vape shops and pouch brands aren’t built around that goal. The person selling you that product is incentivized to keep you on it. They’re not telling you how to come off cigarettes. They’re telling you how to get on vapes, upping the dosage to levels higher than before.
Products like patches, gum or lozenges are proven effective and specifically designed to taper addiction over time. They are designed for that purpose only, and the first tool I recommend when patients are quitting.
I also think most people never learned the difference between a habit and an addiction. A habit is something you choose to stop doing. An addiction means your body goes into withdrawal without the substance. Nicotine is one of the most addictive substances we know of. Because of that, it’s very difficult to quit and very easy to start.
My patients confirm it every day. The average person tries to quit smoking dozens of times before it sticks, and I remind every one of them that a failed attempt isn’t failure. It’s the process. There is zero shame in quitting again, because almost everybody has to quit again. That’s the process.
The most important takeaway I want people to have: Vapes and nicotine pouches are not safe. The only guaranteed safe choice you can make is to never pick them up.
If you’re thinking about quitting any type of nicotine product, the Oklahoma Tobacco Helpline offers FREE coaching and free patches, gum or lozenges — the tools actually designed to get you to zero. Visit OKhelpline.com to get started.