Nicotine pouches, newly legal in the United Arab Emirates, are drawing interest from smokers looking for a “smoke-free” alternative, but experts warn that while the products bypass the lungs and may reduce cancer risks, they remain addictive and carry their own set of health concerns.
The Ministry of Industry and Advanced Technology (MoIAT) authorised the sale of tobacco-free nicotine pouches from late July, provided they meet Emirates Conformity Assessment Scheme (ECAS) certification. The move aligns with the UAE’s wider tobacco harm-reduction strategy, which has previously included strict regulation of e-cigarettes and shisha.
Doctors say the legalisation has triggered a noticeable rise in patient enquiries.
“Since the UAE approved tobacco-free nicotine pouches in late July 2025, I’ve had noticeably more patients asking about them as a ‘smoke-free’ option, especially smokers who’ve struggled with vaping or standard nicotine replacement therapy,” said Dr Ash Shishodia, a psychiatrist at Thrive Wellbeing Centre in Dubai.
“The questions are mainly about safety, dental effects, and whether pouches ‘count’ as quitting. I treat them as another nicotine delivery system, not a quick fix.”
Specialists acknowledge that nicotine pouches, which are placed under the lip and absorbed through the gums, eliminate exposure to smoke or vapour. This reduces the risk of respiratory illnesses linked to cigarettes and shisha. But health experts stress that “smoke-free” does not mean harmless.
Cardiovascular, addiction risks remain
Cardiologists warn that nicotine – regardless of delivery method – still affects the heart and circulatory system.
“Nicotine pouches mitigate the problem as far as cardiovascular health is concerned, but do not eliminate it,” Dr Georgie Thomas, consultant interventional cardiologist and head of department at Burjeel Hospital in Abu Dhabi, told Arabian Business. “They still cause an increased pulse rate and blood pressure, which can be detrimental to patients with cardiac conditions.”
He noted that pouches have been linked to arterial stiffness, palpitations and chest pain. “Smokers with existing heart conditions should use medically approved nicotine replacement therapy under medical guidance,” he said. “The dose delivered per pouch is uncertain, which could pose added risks.”
For respiratory health, nicotine pouches are considered less harmful than cigarettes or vapes because they bypass the lungs.
“Unlike cigarettes and vapes, nicotine pouches are not inhaled. In theory, this could significantly reduce the risk of smoking-related illnesses such as chronic obstructive pulmonary disease, emphysema and lung cancer,” said Dr Mohammed Noufal, a pulmonologist at Lifecare Hospital in Mussafah.
However, he warned that complications are emerging in other areas. “We are seeing gum irritation, ulcers and cardiovascular strain. Long-term studies on their safety are still lacking. They should not be mistaken for a safe product,” he said.
Beyond physical health, addiction specialists are warning about the potential appeal of nicotine pouches to young people.
“International data show fast growth in youth experimentation with pouches, often alongside vaping,” said Dr Shishodia. “Nicotine is highly addictive and risky for the developing brain. These products are for adult smokers trying to quit – not for youth or non-smokers, full stop.”
Globally, regulators have flagged similar concerns. In January this year, the US Food and Drug Administration authorised marketing for certain pouch products following a review of their reduced-risk profile. The agency stressed the decision was not an endorsement of safety for youth or non-smokers.
Step down, not solution
Nicotine pouches could play a role in helping smokers transition away from cigarettes, but only as part of a structured quitting plan, UAE doctors said.
“My goal is freedom from smoke first, then freedom from nicotine,” said Dr Shishodia.
“For a heavily dependent smoker who won’t or can’t use other first-line options, a tightly supervised switch to pouches can be a step down the risk ladder. But I frame it as a temporary tool with a taper plan, pairing it with behavioural support and a clear exit strategy.”
Dr Noufal agreed that pouches should not be seen as a guaranteed solution.
“They may help some smokers transition away from cigarettes or vapes, particularly if used as a bridge to complete cessation. But the evidence is stronger for licensed nicotine replacement therapies such as patches and gums,” he said.
Under the new framework, only MoIAT-certified products can be sold legally in the UAE. Imports outside the approved system remain prohibited.
Experts say this regulation is essential to ensure quality control and consumer safety.
“Patients should avoid unregulated imports and stick to MoIAT-compliant products,” said Dr Shishodia. “Whatever the product, the destination is the same: a structured quit attempt with follow-up, not indefinite nicotine use.”
A cautious welcome
The legalisation of nicotine pouches has been welcomed by some tobacco harm-reduction advocates as an additional option for smokers unable to quit immediately. But doctors interviewed by Arabian Business remain consistent in their message: lower-risk is not the same as low-risk.
“They’re not harmless,” said Dr Noufal. “They’re simply another tool in the box – one that must be used carefully, with medical oversight.”
Public health experts argue that the real measure of success will be whether nicotine pouches help reduce smoking prevalence in the UAE, where cigarettes, shisha and midwakh remain widely used despite years of anti-tobacco campaigns.
According to the World Health Organisation, tobacco use is a leading cause of preventable death globally, responsible for more than eight million deaths each year. While alternative products may reduce exposure to some toxins, WHO maintains that complete cessation is the only way to eliminate the health risks of nicotine and tobacco.
In the UAE, smoking rates among adults have declined in recent years, but doctors say vaping has become increasingly popular among young people. The arrival of nicotine pouches could shift consumption patterns further, though their long-term impact remains uncertain.
“The UAE’s decision to regulate rather than ban reflects a pragmatic approach,” said Dr Shishodia.
“It gives smokers another option, but with standards and oversight. The challenge will be ensuring these products are used responsibly – as a stepping stone to quitting, not as a permanent crutch or a new trend among youth.”
