Swallowing A Nicotine Pouch: Side Effects, Risks, and Facts

Swallowing a nicotine pouch can cause you to feel unwell and can result in temporary side effects such as hiccups, heartburn, dizziness, nausea, upset stomach, and stomach aches. These adverse reactions are generally minor and typically dissipate within 2 hours as your body pushes the contents of your stomach into the small intestine. If you feel unwell a couple of hours after you accidentally swallow nicotine pouches, seek direction from a healthcare professional.

While you may feel unwell if you swallow a nicotine pouch, you are unlikely to experience fatal nicotine poisoning as the nicotine dose is likely to be far below 500mg, which is the accepted dose required to cause a fatality, according to Bernd Mayer, Austrian pharmacologist, medical professional, and professor at the University of Graz.

Alternatives to tobacco products, including tobacco-free nicotine pouches and other smokeless tobacco products such as snus, chewing tobacco, and nicotine chewing gum, should not be swallowed intentionally. While oral nicotine product options are likely to contain less nicotine than the 500mg fatal dose, they can cause temporary harmful effects if ingested. If you are experiencing adverse symptoms, such as hiccups, heartburn, dizziness, nausea, upset stomach, and stomach aches for more than 2 hours after accidentally ingesting a nicotine pouch, consult a doctor immediately.

Why Can Swallowing Nicotine Pouches Make You Feel Unwell?

The oral ingestion of nicotine is the the main reason that nicotine pouches can make you feel unwell if accidentally swallowed. Nicotine has a lethal dose of around 500mg for adults and while each pouch contains far less than this, it’s still possible to experience some toxicity from consuming multiple high-strength pouches.

The other ingredients in nicotine pouches are generally inert and safe. This includes the filler material, flavours, sweeteners, and preservatives. The potential side effects of these additional food grade ingredients is detailed below.

• Filler Material: The bulk of the pouch’s volume, 50-70%, consists of inert filler ingredients like plant-based fibers that give pouches structure to comfortably fit inside the mouth. These fillers are non-toxic, biodegradable, and safe for human consumption, so swallowing small quantities should not pose health risks. They may cause some gastrointestinal side effects when ingested.
• Sweeteners: Many pouches contain non-nutritive sweeteners like sucralose and ace-K under 5mg per pouch to improve palatability. At trace ingestible levels, these sweeteners have no meaningful health impacts and pass through the body unmetabolized, though they could cause diarrhea if consumed in excess.
• Flavours: Additional natural and artificial flavour ingredients are often added, including mint, fruit, coffee, cacao, liquorice, or tobacco flavours. Being GRAS additives approved in food, ingesting flavor traces has no real effect beyond adding to taste.
• Preservatives: Small quantities of preservatives like sodium chloride, potassium chloride, and potassium sorbate (E202) help pouches retain freshness and moisture and extend shelf life. These have no impact when a tiny residual amount is swallowed.

Nicotine is the primary ingredient of concern when pouches are ingested. The other components - fibers, sweeteners, flavors, preservatives - are unlikely to cause adverse side effects in the modest levels contained in nicotine pouches.

Are Nicotine Pouches Absorbed In The Stomach?

According to a study published in The American Journal of Digestive Diseases, nicotine can be absorbed in the stomach, but the extent of absorption and bioavailability depends on the pH of the gastric environment. The study found that nicotine was well absorbed (18.6±3.4%) at a pH of 9.8, less absorbed (8.2±2.9%) at a pH of 7.4, and negligibly absorbed (3.3±1.4%) at a pH of 1.0.

The normal pH of the stomach is typically around 1.5 to 3.5, which suggests that nicotine absorption from accidentally swallowed nicotine pouches would be minimal under normal gastric conditions. However, factors such as the presence of food, certain medications, or medical conditions can increase the stomach's pH, potentially leading to higher nicotine absorption.

The study also noted that gastric absorption of nicotine was accompanied by side effects such as nausea, vomiting, and delayed gastric emptying. This suggests that accidentally swallowing a nicotine pouch may result in discomfort and slower absorption compared to using it as intended.

Nicotine pouches are designed for oral absorption through the buccal mucosa, which is more efficient and consistent compared to the variable absorption in the stomach when accidentally swallowed. While some nicotine may be absorbed in the stomach if a pouch is ingested, the amount is likely to be lower and more unpredictable than when used as directed, placed between the gum and upper lip.

What this means is that while less total nicotine will be absorbed when nicotine pouches are swallowed, absorption into the bloodstream still occurs through the stomach and intestines. Just at a much lower rate.

Can I Swallow My Saliva When Using Nicotine Pouches?

Yes, you can swallow your saliva when using nicotine pouches, this is a natural and necessary process. When using nicotine pouches, the nicotine and other ingredients mix with your saliva, which then gets absorbed through the buccal mucosa in your mouth.

Swallowing small amounts of saliva while using nicotine pouches is not harmful and will not lead to significant nicotine absorption in the stomach. A study published in The American Journal of Digestive Diseases found that nicotine absorption in the stomach is minimal under normal acidic conditions (pH 1.0-3.5).

However, it is essential to avoid swallowing the nicotine pouch itself. Nicotine pouches are designed to be placed between the gum and the lip or cheek, allowing for the gradual release and absorption of nicotine through the oral mucosa. Intentionally swallowing a nicotine pouch can lead to discomfort, nausea, and other side effects, as well as inconsistent and unpredictable nicotine absorption.

Swallowing your saliva while using nicotine pouches is a normal and necessary process that will not result in significant nicotine absorption in the stomach. Just be sure to avoid swallowing the pouch itself to prevent potential side effects and ensure optimal nicotine delivery.