Artificial Sweeteners in US-Marketed Oral Nicotine Pouch Products: Correlation with Nicotine Contents and Effects on Product Preference.

Introduction: Artificial sweeteners, sucralose and acesulfame-k, are listed as ingredients of oral nicotine pouches (ONPs), a product category with rapidly growing market share. The exact quantities of these sweeteners in ONPs remain unknown. Artificial sweeteners in ONPs may reduce aversion, facilitate initiation and encourage consumption behavior.

Methods: Sucralose and acesulfame-k contents in major US-marketed ONP brands (Zyn, on!, Velo) were determined by Liquid-Chromatography-Mass-Spectrometry. Sweetener effects on aversion and consumption of ONP's were modeled in single- and two-bottle drinking tests, offering mice ONP extracts calibrated to contain nicotine levels similar to saliva of people who use smokeless tobacco. To examine the contribution of sweet taste perception, consumption behavior was compared between wild-type and sweet-taste receptor deficient mice (Tas1r2-/-).

Results: Acesulfame-K was detected in on!, Zyn and Velo ONPs (~0.3 to 0.9mg/pouch), including products marketed as "Unflavored" or "Flavor ban approved". In Velo ONPs, sweetened with sucralose (~0.6 to1.2mg/pouch), higher nicotine strength products contained higher sucralose levels. Tas1r2-/- mice consumed less ONP extracts than wild-type mice in both sexes. ONP extracts with both higher nicotine and sweetener strengths were tolerated by wild-type mice, but produced stronger aversion in Tas1r2-/- mice.

Conclusions: ONPs contain significant amounts of artificial sweeteners acesulfame-k and sucralose, with some brands adding more sweetener to higher nicotine strength ONPs. In mice, artificial sweeteners, at levels present in ONPs, increase nicotine consumption. Increasing sweetener contents facilitate consumption of higher nicotine strength ONPs. Sweetness imparted by sweetener addition to ONPs likely reduces aversive sensory effects of nicotine and other ONP constituents.

Implications: Artificial sweeteners such as acesulfame-K or sucralose reduce aversion and likely facilitate consumption of ONPs. The marketing of some artificially sweetened ONPs as "Unflavored" or "Flavor ban-approved" suggests that the tobacco industry rejects sweet taste as a determinant for the presence of a characterizing flavor. Sweetness as imparted by artificial sweeteners in tobacco products needs to be addressed by regulators as a component of a characterizing flavor, with the aim to reduce product appeal and initiation by never users, and especially youth attracted to sweet flavors.