Nicotine pouch products, oral smokeless products that contain nicotine but no tobacco leaf material, have recently entered the US marketplace. Available data indicate sales of these products in the United States have increased since 2018; however, the extent of use among US youth and adults is uncertain. To assay the chemistry of these emerging tobacco products, we analyzed 37 nicotine pouch brands from six total manufacturers. Almost all of the products had flavor descriptors (36 of 37), such as mint, licorice, coffee, cinnamon, and fruit. The amount of free nicotine, the form most easily absorbed, was calculated for each product using total nicotine, product pH, the appropriate pK_a, and the Henderson–Hasselbalch equation. Nicotine pouch products varied in pouch content mass, moisture content (1.12%‒47.2%), alkalinity (pH 6.86‒10.1), and % free nicotine (7.7%‒99.2%). Total nicotine content ranged from 1.29 to 6.11 mg/pouch, whereas free nicotine ranged from 0.166 to 6.07 mg/pouch. These findings indicate that nicotine and pH levels found in some of these nicotine pouches are similar to conventional tobacco products, such as moist snuff and snus, and that most of these pouch products are flavored. Although these products likely lack many tobacco-related chemicals, each product analyzed contained nicotine, which is both addictive and can harm human health. Given that nicotine pouches may appeal to a spectrum of users, from novice to experienced users, it is important to include these emerging tobacco products in tobacco control research, policy, and practice. These “tobacco-free” nicotine pouches have similar pH and nicotine content to conventional tobacco products, such as moist snuff and snus. Although they lack many tobacco-related chemicals, most are highly flavored which could increase experimentation from new users. Given that nicotine pouches may appeal to a spectrum of users, from novice to experienced users, in terms of their flavors and nicotine content, it is important to examine and include these emerging tobacco products as they relate to tobacco control research, policy, and practice.

Objective:Survey of nicotine, tar, and carbon monoxide (CO) smoke deliveries from 77 cigarette brands purchased in 35 countries was conducted using a standardised machine smoking method. The goal of this study was to determine regional variations and differences in the tar, nicotine, and CO smoke yields of a cigarette brand manufactured by a leading transnational corporation and of non-US locally popular cigarette brands.Design:The majority of the cigarettes were purchased in each of the participating countries by delegate members of the World Health Organization and forwarded to the Centers for Disease Control and Prevention for analysis. Smoke deliveries were determined using a standardised smoking machine method and subsequent gravimetric and gas chromatography analysis.Results:The smoke deliveries varied widely. Mainstream smoke deliveries varied from 6.8 to 21.6 mg tar/cigarette, 0.5 to 1.6 mg nicotine/cigarette, and 5.9 to 17.4 mg CO/cigarette. In addition to the smoke deliveries, the cigarettes were examined to determine physical parameters such as filter composition, length, and ventilation levels.Conclusion:Analysis of the smoke deliveries suggested that cigarettes from the Eastern Mediterranean, Southeast Asia, and Western Pacific WHO regions tended to have higher tar, nicotine, and CO smoke deliveries than did brands from the European, American, or African WHO regions surveyed.

As the technology of electronic nicotine delivery systems (ENDS), including e-cigarettes, evolves, assessing metal concentrations in liquids among brands over time becomes challenging. A method for quantification of chromium, nickel, copper, zinc, cadmium, tin, and lead in ENDS liquids using triple quadrupole inductively coupled plasma mass spectrometry was developed. The method’s limits of detection (LODs) were 0.031, 0.032, 3.15, 1.27, 0.108, 0.099, 0.066 µg/g for Cr, Ni, Cu, Zn, Cd, Sn, and Pb respectively. Liquids analyzed were from different brands and flavors of refill bottles or single-use, rechargeable, and pod devices from different years. Scanning electron microscopy with energy dispersive spectroscopy further evaluated the device components’ compositions. Refill liquids before contacting a device were below lowest reportable levels (LRL) for all metals. Copper and zinc were elevated in liquids from devices containing brass. Cadmium was <LRL in all liquids and was not observed in device components. Cr, Ni, Cu, Zn, Sn, and Pb, reported in µg/g, ranged from <LRL to 0.396, 4.04, 903, 454, 0.898, and 13.5 respectively. Elevated metal concentrations in the liquid were also elevated in aerosol from the corresponding device. The data demonstrates the impact of device design and materials on toxic metals in ENDS liquid.

Tobacco-specific nitrosamines (TSNAs) comprise one of the major classes of carcinogenic compounds in mainstream cigarette smoke. As part of collaborative efforts between the World Health Organization and the U.S. Centers for Disease Control and Prevention (CDC) to reduce tobacco use and resulting disease, the CDC examined carcinogenic TSNA levels from cigarettes obtained from selected countries around the world. Using a modern, high-throughput liquid chromatography/mass spectrometry/mass spectrometry method under stringent quality control protocols, we determined the carcinogenic TSNA levels in mainstream smoke from a globally marketed brand, Marlboro, and from local top-selling cigarette brands from 14 countries. The levels of carcinogenic TSNAs in mainstream smoke collected using a 35-ml puff volume, 60-s puff interval, and 2-s puff duration correlated well (RTobacco-specific nitrosamines (TSNAs) comprise one of the major classes of carcinogenic compounds in mainstream cigarette smoke. As part of collaborative efforts between the World Health Organization and the U.S. Centers for Disease Control and Prevention (CDC) to reduce tobacco use and resulting disease, the CDC examined carcinogenic TSNA levels from cigarettes obtained from selected countries around the world. Using a modern, high-throughput liquid chromatography/mass spectrometry/mass spectrometry method under stringent quality control protocols, we determined the carcinogenic TSNA levels in mainstream smoke from a globally marketed brand, Marlboro, and from local top-selling cigarette brands from 14 countries. The levels of carcinogenic TSNAs in mainstream smoke collected using a 35-ml puff volume, 60-s puff interval, and 2-s puff duration correlated well (R = 0.79, p<.0001) with previously reported levels in the corresponding tobacco filler. Marlboro cigarettes purchased in 10 countries had significantly higher carcinogenic TSNA levels in mainstream smoke than did local-brand cigarettes from the same country. In only one country, Brazil, were the carcinogenic TSNA levels in mainstream smoke from Marlboro cigarettes significantly lower than in the locally popular brand. However, carcinogenic TSNA levels in mainstream smoke from Brazilian Marlboro cigarettes were usually lower than those in mainstream smoke from the Marlboros purchased in the other 13 countries, suggesting a reason for the difference. The wide range of mainstream smoke carcinogenic TSNA levels measured in the present study (8.7–312 ng/cigarette) suggest that manufacturers can lower the carcinogenic TSNA levels and that, for similar filter ventilation, carcinogenic TSNA levels in the tobacco filler of a cigarette are a useful indicator of the corresponding levels in mainstream smoke. 0.79, p<.0001) with previously reported levels in the corresponding tobacco filler. Marlboro cigarettes purchased in 10 countries had significantly higher carcinogenic TSNA levels in mainstream smoke than did local-brand cigarettes from the same country. In only one country, Brazil, were the carcinogenic TSNA levels in mainstream smoke from Marlboro cigarettes significantly lower than in the locally popular brand. However, carcinogenic TSNA levels in mainstream smoke from Brazilian Marlboro cigarettes were usually lower than those in mainstream smoke from the Marlboros purchased in the other 13 countries, suggesting a reason for the difference. The wide range of mainstream smoke carcinogenic TSNA levels measured in the present study (8.7–312 ng/cigarette) suggest that manufacturers can lower the carcinogenic TSNA levels and that, for similar filter ventilation, carcinogenic TSNA levels in the tobacco filler of a cigarette are a useful indicator of the corresponding levels in mainstream smoke.