Snus leaves visible marks on your gums — white patches, thickened tissue, sometimes inflammation. Swedish researchers wanted to know: does switching to tobacco-free nicotine pouches make those lesions go away?

The answer, per a study published in the European Journal of Oral Sciences, is yes. And it happens fast.

What they tested

Researchers at the University of Gothenburg recruited 22 daily snus users, all of whom had developed mucosal lesions where they placed their pouches. The participants switched to tobacco-free nicotine pouches (brand not specified in available materials) and were examined at baseline, 2 weeks, and 4 weeks.

The team measured two things: the thickness of the gum tissue at the pouch site, and the degree of inflammation. Both are standard markers of oral irritation caused by smokeless tobacco.

What changed

After 4 weeks on nicotine pouches, the lesions had largely reversed:

• Tissue thickness decreased significantly
• Inflammation markers dropped
• The visible white patches characteristic of snus use faded

The changes were measurable at 2 weeks and continued through the end of the study period.

Why this matters

Snus is legal and widely used in Sweden, but it causes localized gum damage in most users. The lesions aren't cancerous, but they're a visible sign of tissue stress. This is the first controlled study to show that switching to tobacco-free pouches — which contain nicotine but no tobacco leaf — allows the tissue to heal.

The implication: the lesions are driven by tobacco constituents, not nicotine itself.

What this doesn't prove

The study was small (22 participants), short (4 weeks), and didn't include a control group that kept using snus. It also didn't assess whether nicotine pouches cause their own long-term tissue changes — just that they don't perpetuate the damage caused by snus.

The researchers didn't test for other oral health outcomes (tooth decay, gum disease) or track users beyond one month. And the study doesn't address whether nicotine pouches are "safe" — only that they're less irritating to gum tissue than snus in the short term.

What's next

Longer studies with larger samples are needed to confirm whether the healing is durable and whether nicotine pouches have their own tissue effects over months or years of use. The study was published in July 2022; no follow-up data has been released.

SOURCES:
Alizadehgharib S, Lehrkinder A, Alshabeeb A, Östberg A-K, Rutqvist LE. European Journal of Oral Sciences, July 2022. DOI: 10.1111/eos.12885. Available at ResearchGate: https://www.researchgate.net/publication/362117118