Use of Nicotine Pouches among Adults who Currently or Formerly Smoked Cigarettes and/or Vaped Nicoti

Gravely S, Hrywna M, Meng G, Hyland A, Cummings KM, Fong GT, Delnevo CD.
Use of Nicotine Pouches among Adults who Currently or Formerly Smoked Cigarettes and/or Vaped Nicotine: Findings from the 2022 and 2024 US ITC Smoking and Vaping Surveys
Tob Control. 2025 Nov 7:tc-2025-059556. doi: 10.1136/tc-2025-059556. Epub ahead of print. PMID: 41203432.

Background: Nicotine pouches (NPs) are one of the fastest growing tobacco product categories in the United States (US). We estimated the prevalence of NP use in 2022 and 2024 among US adults with established nicotine product use.

Methods: Data are from the 2022 (n=2087) and 2024 (n=2083) US ITC Smoking and Vaping Surveys. A nationally representative sample of adults (≥18 years) who smoked cigarettes and/or vaped nicotine or quit smoking and/or vaping completed at least one survey. Using weighted data, generalised estimating equation models were applied to estimate ever-use and current use (≥monthly). Data from both surveys were pooled to examine characteristics related to NP ever-use and current use.

Results: Between 2022 and 2024, the prevalence of NP ever-use increased by 42% (16.1%-22.8%, p<0.001), and current use increased by 66% (4.7%-7.8%, p=0.007). NP ever-use increased significantly among all age groups, except adults aged 25-39. Current use increased among all age groups, but only significantly for adults aged 18-24 and 55+. Compared with all other age groups, adults aged 18-24 had an 11.8% greater increase in current use (p=0.045). In the pooled analyses, current NP use was significantly higher among those who were male, were using other smokeless tobacco products (p<0.001), were smoking and vaping (dual use), exclusively vaping or had quit smoking and/or vaping compared with adults who were exclusively smoking (p<0.001). There were non-significant increases in frequency of daily, non-daily and occasional use.

Conclusions: We found a significant increase in NP ever-use and current use between 2022 and 2024 among adults with established nicotine product use, consistent with national sales trends. Further research is needed to determine whether adults are using NPs as a tool to quit smoking or sustain abstinence after quitting.