Nicotine Replacement Therapy and Smoking Cessation for Patients

There is limited current literature and research available to classify ONPs, as nicotine replacement therapy (NRT), or to suggest them as an option for smoking cessation during patient care. The FDA has not approved ONPs as a method for smoking cessation at this time due to lack of clinical evidence.¹² Compared to lozenges, the concentration of nicotine delivery was similar, while concentration was greater than that in nicotine gum.⁵ Oral nicotine pouches can be considered to have addictive attributes, leading young adults to continue to advance to more severe habitual levels of smoking addictions, due longer periods of usage. Oral nicotine pouches can also present as a gateway for other more addictive behaviors and habits as well. The potential of addiction is boldly labeled on all packaging for ONPs purchase.³ Currently, more research is needed regarding NRT and long-term addictive patterns regarding ONPs.¹⁹

Oral health care providers must still prepare and supply tobacco/nicotine cessation treatment for their patients, as an ethical obligation of duty and responsibility of standard care. Several countries and organizations such as the World Health Organization have adopted the 5A’s approach, Ask, Advise, Assess, Act and Assist as a guide to cessation for clinicians.²⁰ The 5A’s approach is suggested to be implemented in patient treatment, for oral professionals caring for patients, that are actively using tobacco and nicotine products.²¹