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Some of the most common factors include: Using stronger nicotine pouches that deliver nicotine quickly Taking a pouch on an empty stomach, which intensifies the effects of nicotine Drinking carbonated beverages during nicotine pouch use Increased saliva swallowing, which can irritate the diaphragm Sensitivity around the gums that leads to gum irritation Interestingly, similar reactions sometimes appear with other nicotine replacement therapies, including nicotine gum

Adapted from The Health Consequences of Smoking: 50 Years of Progress

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Reduction of salivary flow : Smoking can cause a decrease in saliva production , a crucial factor in the natural protection against cavities

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