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The only brand of toothpick in this study was Pixotine, a manufacturer of nicotine-infused toothpicks, whose website states that it aimed to offer a solution for smokeless nicotine/tobacco users dealing with hand-to-mouth actions and oral fixations.35 The website indicates that the product consists of nicotine derived from tobacco leaves and is sold in two nicotine strengths: zero nicotine or 3 mg.35 Although advertised as 3 mg per toothpick, the measured total nicotine content was about two times less than labelled, with a mean of 1.33 mg/toothpick (SE=0.85)

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The habit itself by nature holding a product in the hand and inhaling the product to then release its content is the same as smoking

Nicotine can also stay in your body up for eight hours or more after you smoke

They do not contain tobacco leaf and do not require combustion or spitting (4446)