Nicotine pharmacokinetics and subjective response among adult smokers using different flavors of on!® nicotine pouches compared to combustible cigarettes
Abstract
Rationale on!® nicotine pouches (NPs) are oral tobacco-derived nicotine products that are tobacco-leaf free and are available in a variety of flavors and nicotine strengths. Switching completely to NPs from cigarettes may present the potential to reduce harm in adult smokers (AS) unable or unwilling to quit smoking. We characterized the abuse potential of six different flavor variants of NPs compared to cigarettes. Objectives The objective of this study was to evaluate the nicotine pharmacokinetics (PK) and subjective effects of different flavor variants of NPs compared to participants' own brand cigarettes (OBCs) in AS. Methods In this single-blind, randomized, 7-way crossover study, we assessed nicotine PK, subjective measures (using well-established questionnaires), and product use behavior associated with six flavors of 4 mg NPs and OBCs in AS that remained in clinic for the duration of the test period. Results Nicotine C max values ranged from 9.0 to 11.5 ng/mL for the NPs and 16.3 ng/mL for OBCs. The t max ranged from 30.1 to 34.9 min for ONPs and 7.5 min for OBCs. Use of NPs resulted in lower ratings of urge to smoke or craving a cigarette. All the NPs were considered pleasant, but not as much as OBCs. Flavor did not appear to influence the nicotine PK or subjective responses. Conclusions Based on the nicotine PK parameters and subjective responses, we conclude that NPs, regardless of flavor, likely have lower abuse potential than cigarettes. Overall, this study sugges…
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ONP users have lower desire and intention to smoke and anticipation of relief from negative affect.
“Lower desired and intention to smoke and anticipation of relief from negative affect in ONPs users (Rensch et al. 2021)”
From Comparison of the Health Effects Associated with the Use of Snus and Tobacco-Free Oral Nicotine Pouches: A Systematic Review (2026) · cites this paper as Rensch et al. 2021
Rensch et al. (2021) found that flavor does not appear to influence nicotine pharmacokinetics or subjective responses.
“The findings from the study also indicated that flavor does not appear to influence nicotine PK or subjective responses”
From Nicotine pharmacokinetics and subjective responses after using nicotine pouches with different nicotine levels compared to combustible cigarettes and moist smokeless tobacco in adult tobacco users (2022) · cites this paper as Rensch et al. 2021
Rensch et al. (2021) concluded that based on pharmacokinetic profiles and subjective responses, on! nicotine pouches containing 4 mg nicotine were likely to be associated with lower abuse potential than cigarettes.
“The authors concluded that based on the PK profiles and subjective responses, the NPs were likely to be associated with lower abuse potential than cigarettes.”
From Nicotine pharmacokinetics and subjective responses after using nicotine pouches with different nicotine levels compared to combustible cigarettes and moist smokeless tobacco in adult tobacco users (2022) · cites this paper as Rensch et al. 2021
To date, only two published studies inform the abuse potential of nicotine pouches.
“To date, there are only two published studies that inform the abuse potential of NPs (Lunell et al. 2020; Rensch et al. 2021).”
From Nicotine pharmacokinetics and subjective responses after using nicotine pouches with different nicotine levels compared to combustible cigarettes and moist smokeless tobacco in adult tobacco users (2022) · cites this paper as Rensch et al. 2021
Rensch et al. (2021) indicated that nicotine pouches may be potentially acceptable switching products for adult cigarette smokers and adult moist smokeless tobacco users.
“and the NPs may be potentially acceptable switching products for AS and adult MST users (Rensch et al. 2021).”
From Nicotine pharmacokinetics and subjective responses after using nicotine pouches with different nicotine levels compared to combustible cigarettes and moist smokeless tobacco in adult tobacco users (2022) · cites this paper as Rensch et al. 2021
In a previous study, the higher mean Cmax for OBCs was 17.7 ng/mL, than that observed in this study (12.2 ng/mL).
“Also, in a previous study, we observed a higher mean Cmax for OBCs was 17.7 ng/mL (Rensch et al. 2021), than that observed in this study (12.2 ng/mL).”
From Nicotine pharmacokinetics and subjective responses after using nicotine pouches with different nicotine levels compared to combustible cigarettes and moist smokeless tobacco in adult tobacco users (2022) · cites this paper as Rensch et al. 2021
The percent coefficient of variation was relatively higher for OBC (75.4%) in this study compared to that reported for OBC (42.4%) by Rensch et al. (2021).
“For example, the percent coefficient of variation was relatively higher for OBC (75.4%) in this study (Supplementary Table 2) compared to that reported for OBC (42.4%) by Rensch et al. (2021).”
From Nicotine pharmacokinetics and subjective responses after using nicotine pouches with different nicotine levels compared to combustible cigarettes and moist smokeless tobacco in adult tobacco users (2022) · cites this paper as Rensch et al. (2021)
Findings from this study of mint-flavored on!® NPs extend to other on!® flavor varieties.
“A previous study demonstrated that nicotine PK and subjective responses are comparable across different flavor varieties for the 4 mg on!® NP; thus, findings from this study of mint-flavored on!® NPs extend to other on!® flavor varieties (Rensch et al. 2021).”
From Nicotine pharmacokinetics and subjective responses after using nicotine pouches with different nicotine levels compared to combustible cigarettes and moist smokeless tobacco in adult tobacco users (2022) · cites this paper as Rensch et al. 2021
Cited by
Sorted by citations
Liu, J., Rensch, J., Wang, J., Jin, X., Vansickel, A., Edmiston, J., & Sarkar, M. (2022) · Psychopharmacology · doi:10.1007/s00213-022-06172-y · Cited by 37 · see citing works
Self-citationKopa-Stojak, P. N., & Pawliczak, R. (2026) · Exposure and Health · doi:10.1007/s12403-026-00812-w
- Authors
- Rensch, J., Liu, J., Wang, J., Vansickel, A., Edmiston, J., & Sarkar, M.
- Venue
- Psychopharmacology
- Published
- 2021-08-25
- Volume
- 238
- Issue
- 11
- Pages
- 3325-3334
- ISSN
- 0033-3158
- 1432-2072
- Cited by
- 40
- References
- 0
- Language
- en
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