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DOI: 10.1080/15592294.2020.1724401 Deregulation of Biologically Significant Genes and Associated Molecular Pathways in the Oral Epithelium of Electronic Cigarette Users by Stella Tommasi, Andrew W

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Cardiovascular Effects Acute blood pressure spikes with each pouch, multiple times daily Elevated heart rate with each use Chronic vascular effects nicotine contributes to arterial stiffness over time A 2025 study found regular pouch users showed cardiovascular risk markers that didn't immediately improve even after 12 weeks of quitting Addiction and Dependency Average user: 812 pouches/day Heavy users (men 2534): 14 pouches/day ZYN 6mg = nicotine equivalent of 12 cigarettes At 10 pouches/day at 6mg = 60mg nicotine daily (equivalent to 1020 cigarettes) Withdrawal symptoms include intense cravings, irritability, anxiety, insomnia, difficulty concentrating, increased appetite, and headaches

Nicotine inhibits apoptosis induced by cisplatin in human oral cancer cells