The UK Government has taken steps to combat smoking, and now nicotine pouches, through legislation, public health campaigns, youth prevention and support services.
In the UK the age limit for smoking is 18 years old, meaning that individuals must be at least 18 to buy or possess tobacco products. And starting from January 2027 it will be illegal to sell tobacco products to anyone born on or after January 1 2009, a policy which aims to protect younger generations from the harmful effects of smoking and nicotine addiction. From 29th October 2026 it will be an offence across the UK to sell nicotine products, including pouches, to anyone under 18. Proxy purchasing, free distribution and promotional discounting also become offences from that date. A ban on advertising and sponsorship of nicotine products is due to follow on 1 June 2027. The Tobacco and Vapes Act also gives the government powers to restrict packaging, display and content, subject to consultation. According to the Government website the products in scope of the restrictions include: vaping and nicotine products.
For nicotine products, this includes but is not limited to: nicotine pouches (tobacco-free pouches containing nicotine powder that are placed between the gum and lip), nicotine strips (dissolvable films containing nicotine that are placed on the tongue or between the gum and lip), nicotine pearls (small dissolvable balls containing nicotine that dissolve under the tongue). All types of nicotine are included in the scope, including synthetic nicotine produced in a lab, rather than extracted from plants.
So whilst the regulatory gap is set to close on 29th October, the oral health implications will be more pressing than ever.
The availability of nicotine pouches has huge implications from a clinical perspective and the oral health consequences of this are significant and should not be underestimated.
A study led by researchers at UCL and published in The Lancet Public Health shows that oral nicotine pouch and snus-style product use in Great Britain rose from 0.1% to 1% of adults (about 522,000 people) between 2020 and 2025. This surge is driven mostly by young men under 25, alongside targeted marketing and increased use as a smoking cessation aid. Research also carried out in 2024 surveyed 628 male Premier League and EFL players, of whom 18% reported current use of taking nicotine orally, either in tobacco-free nicotine pouches or Swedish-style snus (which is illegal to sell in this country), according to a study published by Loughborough University, commissioned by the Professional Footballers’ Association.
Use of nicotine pouches has risen substantially in Great Britain over the last five years, particularly among young men, with one in 13 (7.5%) men aged 16 to 24 now using them, according to the same study. And on 30th August 2026 The FT published an article stating that sales of nicotine pouches are expected to rise by more than a third this year as big tobacco companies push advertising ahead of restrictions coming into force next year.
In order to understand the impact of nicotine pouches on oral health it’s important to recognise how they are used and work. Nicotine pouches are used by placing the small pouch between the gum and upper lip, allowing nicotine to be absorbed through the lining of the mouth. They’re designed to be discreet and a convenient alternative to smoking or vaping, and once the nicotine is absorbed, within the first 20 to 30 minutes, then they can be removed and discarded.
And while nicotine pouches do not contain tobacco leaf, meaning they may carry fewer risks for serious health conditions compared to smoking, they do contain nicotine which is addictive and can lead to a number of health issues and oral health concerns. Regular use is associated with a whole host of oral health issues including: tooth discolouration, gum recession, mucosal lesions, localised oral tissue change and periodontal disease. Another side effect of nicotine pouches can include dry mouth, soreness, gingival blisters and some people also experience a strange jaw sensation. What is particularly worrying is that the extent of their oral health implications has not been fully investigated. Research has also shown that manufacturers position the product as a tool that may reduce nicotine cravings and support smoking reduction or cessation, however, evidence regarding their actual clinical impact remains limited.
As the former President of the British Academy of Cosmetic Dentistry and an award-winning dentist and founder, I’ve seen first-hand the impact this habit has on oral health and have witnessed patients with tooth discolouration, gum recession and mucosal lesions, as well as localised oral tissue change. Whilst tooth discolouration is predominantly cosmetic and can typically be addressed in-clinic, symptoms such as gum recession, mucosal lesions and oral tissue change are more serious implications which can result in tooth mobility and loss if left untreated.
It’s time that the country, and indeed the world, become aware of the oral health implications of nicotine pouches and that further research is done in order to fully explore this. Oral health is vital for overall health because it’s a gateway to the rest of the body and has an influence on heart, brain, lungs and even mental health.
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