Doctor compares nicotine pouches, vaping and smoking to see which is worse for you and the results are clear
A doctor has carried out a comparison of the health impact of nicotine pouches, vaping, and smoking tobacco.
Dr Rayyan Zafar said that while all three are bad for you, one was significantly worse.
It's no secret that smoking tobacco is extremely bad for your health, with decades' worth of medical studies linking it to a myriad of conditions, including major killers cancer and heart disease, among many others.
Burning tobacco and all the various chemicals they put in cigarettes produces lots of carcinogens, and that's going to absolutely mess you up on the inside.
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The NHS says smoking increases the risk of hearing and vision problems, dementia, joint pain, Crohn's disease, pancreatitis, gallstones, liver problems and high blood pressure.
Speaking to Metro, Dr Zafar said that while smoking, vaping and puches all carry a risk of someone becoming addicted to nicotine, cigarettes were the worst of the bunch 'by a very large margin'.
As Dr Zafar put it, there was 'no safe level of cigarette smoking' and even lighting up just a few times could lead to 'disproportionate cardiovascular harm'.
Smoking vs vaping
Vaping remains more complicated, as the NHS currently advises that switching to vaping can be useful as a way to reduce harm if you already smoke cigarettes, cigars, or somehow still manage to smoke a pipe in 2026.
However, if you neither smoke nor vape, then the advice is that you shouldn't take up vaping in its own right.
Studies are starting to show the health risks of vaping, but more research is still needed to understand just how serious the danger is, and what vaping could do to you.
One factor in vaping is also the amount of highly addictive nicotine that it contains, as well as criticisms of how vapes are marketed.
Studies on people who vape have found it reduced their red blood functionality, meaning oxygen wasn't getting around their body like it should.
Meanwhile, a 2024 study noted that many teenagers who vaped experienced poor concentration, anxiety, mood disorders and sleep disturbance.
A number of vapers have been hospitalised in a seriously unwell condition after vaping such a significant amount they did themselves major damage.
According to NHS data, between 2020 and 2023, 233 hospital admissions cited vaping-related disorders’ as the primary diagnosis. In total, there were 941 cases where vaping was either a secondary or primary cause.
The risks of nicotine pouches
As for nicotine pouches, Dr Zafar said these 'may be the least harmful' of the three but stressed they were still bad for you.
Information on just how harmful they can be is thin on the ground since they're relatively new and more studies need to be conducted, but researchers have found gum irritations, mouth ulcers and white lesions where the pouches have been placed among the harmful consequences.
Swallowing one of the pouches also risks nicotine poisoning, so definitely don't do that.
The doctor also didn't like how nicotine products were being marketed in ways he fears 'encourages users to start low'.
He also says that 'snus' - pouches that contain tobacco - is probably worse than vaping, and definitely worse than tobacco-free pouches.
Ultimately, his verdict was that if you're switching from cigarettes to another nicotine product that's probably going to be 'a substantial reduction in harm', but the healthiest thing is not to use any of them at all.
Joe Harker