Assessing the gastrointestinal and psychological impacts of nicotine pouch use among adults in Saudi Arabia: A cross-sectional study

Nicotine pouches have recently gained popularity among adults in Saudi Arabia, but limited information is available about the common symptoms' users may experience. This study looks into how frequently users report gastrointestinal and psychological symptoms and explores possible links with different personal and behavioral factors. We conducted an online cross-sectional survey among adult Saudis who used nicotine pouches in the recent half year. The survey collected demographic data, patterns of usage, and gastrointestinal symptoms self-assessed. Psychiatric status was assessed using the Arabic DASS-21 version. Data were analyzed using SPSS version 29 with the help of descriptive and logistic regression analysis. A total of 1214 individuals participated. Most (80.8%) reported at least one gastrointestinal symptom - mainly bloating (66.7%), nausea (47.9%), and heartburn (46.7%). Around 39.3% of participants reported psychological symptoms, with mild symptoms being the most common (19.9%). The analysis showed that people with lower education and income levels were more likely to report psychological symptoms (p=0.004 and p<0.001). A slight trend was also noted among current smokers, though not statistically significant (p=0.076). The study found that many users of nicotine pouches report gastrointestinal and psychological symptoms. The symptoms seem more common among individuals with lower socioeconomic status. Although the findings do not imply direct effects, they indicate that there should be greater awareness and more research, especially long-term research, to establish how nicotine pouch use can be attributed to health problems.