Sir, I agree with the author of the letter on nicotine pouches that we as dentists should update our knowledge regarding new products under the garb of being 'safe' when the only word we have is that of the manufacturer.1 While they may be utilised for recreational purposes, nicotine pouches are sold as a means of nicotine replacement therapy in Norwegian pharmacies, approved by the Norwegian Medicines Agency for the purpose of smoking cessation under the brand name 'Zonnic'.2,3

The manufacturer recommends using not more than 8-12 pouches per day, never to exceed 24. A stated feature of these pouches is that the user can control the release rate by moving the pouch around the mouth for a faster release and leaving it in place for a slower effect.4

Another major difference between this product and other nicotine replacement therapies is the fact that this particular product is manufactured by a commercial tobacco company rather than a pharmaceutical. These products should be viewed with extreme caution as they threaten to blur the line between nicotine replacement therapy and smokeless tobacco.