A new paper in Nicotine & Tobacco Research, published by Oxford University Press, indicates that different nicotine pouches, which have become very popular in recent years, particularly among young people, may influence user preferences very differently. An investigation using rats finds some flavors lead to much more nicotine consumption than others.
According to the World Health Organization, tobacco use remains a major global health threat, with 1.3 billion tobacco users, and 8 million tobacco-related deaths annually. While cigarette smoking is the most prevalent form of tobacco use worldwide, people also use other tobacco products including e-cigarettes, smokeless tobacco, and oral nicotine products.
The rise of oral nicotine products, including gums, pouches, and other novel formats, represents a significant shift in nicotine consumption pattern. For example, there is noted interest in and use of nicotine pouches among adult smokers planning to quit. Young people may perceive nicotine pouches as less addictive, due to their noncombustible form and due to the influence of youth-oriented advertising. US sales of nicotine pouches increased more than 600% between 2019 and 2022.
As the market for oral nicotine products expands, with an increasing diversity in flavors, nicotine concentration, and sources, many observers believe it's important to investigate the implications of these products on consumer behavior and public health. A recent American national online survey revealed that flavored nicotine use is preferred among youth. Although flavors do not significantly impact nicotine absorption, they significantly influence user satisfaction and increase the likelihood that people will continue using nicotine products.
Researchers from the Yale School of Medicine here investigated the effects of the sweeteners sucrose and saccharin, as well as the commonly used flavor additive cinnamaldehyde (cinnamaldehyde is the principal chemical of cinnamon) on nicotine preference and oral choice behavior in female and male adult Sprague Dawley rats supplied with various nicotine and flavor-enhanced water solutions.
The investigation found that both male and female rats significantly preferred sucrose and saccharin, but not the cinnamon flavor. Moreover, when rats were given a choice of different solutions, rats differentiated between sweet and bitter solutions, with the highest preference for saccharin.
Between different solutions, females showed the highest nicotine preference when combined with sucrose, while males preferred nicotine combined with cinnamon. When rats were given multiple options with saccharin and cinnamaldehyde, saccharin increased nicotine preference in females, but not in males. These findings suggest that sweeteners may play a greater role in nicotine preference for females, while flavors are more influential for males. Consistent with this potential differential extent of flavor effects in females and males, menthol flavoring increases oral nicotine intake and preference in male rats but not in female rats.
"The study examined the choice behaviors between sweetened and flavored solutions, said the paper's lead author," Deniz Bagdas. "Females rats showed the highest preference for nicotine when combined with sweeteners, while males showed highest nicotine preference when combined with cinnamon. Understanding the role of sweeteners and flavorants in oral nicotine product appeal can inform regulatory policies and harm reduction strategies."
The paper, "Effects of Sweeteners and Cinnamon Flavor on Oral Nicotine Choice Behaviors," is available (at midnight on March 18th) at https://doi.org/10.1093/ntr/ntaf037 .
Direct correspondence to:
Deniz Bagdas
Department of Psychiatry
Yale School of Medicine
300 George Street, Suite 901
New Haven, CT, 06511
