New publication looks at impact of popular smokeless oral nicotine products on cardiovascular disease

Mary Rezk-Hanna, PhD, FAAN, FAHA, an assistant professor in the UCLA School of Nursing, has co-authored a new policy statement from the American Heart Association on the impacts of smokeless oral nicotine products. The publication is an update to the 2010 AHA policy statement and offers key insights into the impact these products have on cardiovascular health. 

Smokeless oral nicotine products, including pouches, gums, lozenges, tablets, and gummies, are not only addictive; they may also have adverse effects on some markers of cardiovascular risk, according to the publication. They are associated with increased mortality in people with ischemic heart or cerebrovascular disease, and some products may increase the risk of oral cancer. 

Rezk-Hanna says the updated statement identifies key research gaps necessary to better understand the impact of these rapidly evolving products and emphasizes the critical role of clinicians in preventing use and supporting cessation efforts. 

“While there is a continuum of risk across tobacco and oral nicotine products, with the greatest risk associated with combustible products, it is important to emphasize that no tobacco product is safe,” says Rezk-Hanna. “Smokeless tobacco is not without risk, including nicotine addiction, particularly among youth, as these products can deliver significant amounts of nicotine.”

This new update reviews the chemical composition of smokeless oral nicotine products, including those containing synthetic nicotine; describes patterns of use in youth and adults across geography, sex, gender, race, and ethnicity; and evaluates the products’ potential cardiovascular and oral effects. The statement also examines how health care professionals along with robust public policies can help end addiction to all tobacco products.

Read the full publication in Circulation