Raidió Teilifís Éireann (RTE) is Ireland’s state broadcaster. It’s kind of a low-rent BBC with something of a mixed reputation among the public, with plummeting trust levels to boot. That said, I’ll always have a soft spot for the media organisation due to its excellent football coverage and its Thursday night comedy program from the late-90s that featured The Larry Sanders Show and Seinfeld back-to-back.
Recently, they posted an article on nicotine pouches that included all the usual pearl-clutching and innuendo that we’ve all come to expect about articles on the subject. Accompanying the piece was a short piece on RTE Radio 1 that looked at the Snus “epidemic” in Ireland.
The program reached out to Professor Ray Walley, who is a GP and a board member of the Standing Committee of European Doctors, a Brussels‑based umbrella body representing national medical associations from across Europe.
I want to take a look at what Walley had to say on nicotine pouches.
“There are 3,000+ poisons in tobacco; however, nicotine, which is in snus and other products, creates problems as well.”
Right out of the gate, Walley uses a false equivalence. Smoking is uniquely lethal, and it’s choc full of poisons like benzene, tar, and carbon monoxide. However, while there are thousands of poisons in nicotine, the majority of these chemicals are created or released when tobacco is burned.
Trying to smuggle nicotine and snus into that framing obscures the truth. The listener could easily walk away from hearing that statement and think nicotine pouches are in the same ballpark. They’re tobacco-free, and the nicotine is not burned. As such, these products are not equivalent. If anything, the absence of these 3,000 chemicals is a good thing.
“If you are putting snus products in your lip, where it equals twenty cigarettes, understandably, you have high addiction rates.”
Another popular misconception.
Typically, cigarettes contain around 10-12 mg of nicotine, and about 1-2 mg is absorbed by the user.
Pharmacokinetic studies on snus suggest that something in the regions of ⅓ or ¼ is absorbed. Most pouches in Ireland come in 4-20mg. Even taking 20mg as the benchmark, the user might take in 5mg to 7mg. That’s some way short of Walley’s suggestion of 20mg to 40mg.
The other thing we have to remember is that taking nicotine via the lungs and via the oral mucosa is different. With pouches, absorption is slower, and the time to peak concentration is significantly longer than for a cigarette. Speed of delivery is a big part of nicotine “addiction”, so there is a solid argument to suggest pouches are less habit-forming.
“This is also a product which has been proven to cause an increase in blood pressure, it has been proven to negatively impact the developing adolescent brain, leading to problems with attention, learning, mood disorders, and anxiety.”
Once again, Walley is playing a little fast and loose with the facts here. Yes, nicotine does increase blood pressure, but not in a lasting or clinically meaningful way. While the stimulant is active, it does produce a small bump in heart rate and blood pressure… because it’s a stimulant. A coffee will do the same.
As for the “proven” negative impacts on the adolescent brain? Well, studies in mice aren’t going to swing it. Later in the sentence, Walley chucks the entire DSM index at the wall and blames nicotine. I think we’d all love to see this mythical proof.
“Also, it has been proven to cause problems with damage in the gums and the lining of the mouth.”
There is a lot of work done on this topic in Sweden because snus has been used for many decades by a large portion of the population. Sure, some people do experience irritation, and I’ve even seen photos of lesions in the literature. However, whether it’s a widespread problem that hits all pouch users is very much up for debate. What’s more, there are good products like Sting Free that are recommended by dentists.
Final thoughts
RTE has waded into the nicotine pouch debate, but they have abandoned even the pretence of journalistic balance. Make no mistake, this is just another hit piece with no voices to counter the WHO narrative carried by Walley and the other doctors.
The big question here is whether the reader or listener will come away with a better understanding of nicotine pouches. You’d have to say they would come out misinformed about pouches and their impact on health, but well-versed in WHO propaganda and talking points. That, of course, is probably the point.
