Correlates of Oral Nicotine Pouch Use, Use Frequency and Flavour Use among US Adults

He Y, Roberts ME, Li D, Zhang S, Keller-Hamilton BL, Mays D, Shang C.
Correlates of Oral Nicotine Pouch Use, Use Frequency and Flavour Use among US Adults
Tob Control. 2026 Jul 17:tc-2025-059971. doi: 10.1136/tc-2025-059971. Epub ahead of print. PMID: 42469028.

Background: As oral nicotine pouches (ONPs) have gained popularity in the US, little is known from nationally representative data about who uses them and how they are being used.

Objectives: To examine tobacco use and sociodemographic correlates of ONP use, use frequency and flavour use among US adults.

Methods: Data were drawn from the 2022-2023 Tobacco Use Supplement to the Current Population Survey (n=1 57 485). Weighted logistic regression models were used to identify predictors of (1) current ONP use, (2) daily versus non-daily ONP use and (3) flavoured versus unflavoured ONP use.

Results: The odds of current ONP use were higher among younger adults, males, non-Hispanic Whites, individuals with higher income and those who had ever used cigarettes, e-cigarettes or smokeless tobacco (SLT). People who currently use cigarettes, e-cigarettes or SLT had lower odds of daily (vs non-daily) ONP use, whereas people with a history of cigarette use who do not currently smoke had higher odds. Males, younger adults and people with a history of SLT use who do not currently use SLT were more likely to use flavoured ONPs.

Conclusions: ONP use was common among individuals with current and prior tobacco use which may be consistent with alternative nicotine use. However, a small proportion of ONP users reported no prior use of other tobacco products, highlighting the need for continued research on nicotine uptake through ONPs among tobacco-naïve populations, particularly among young adults. In addition, the prevalence of co-use with other tobacco products may limit potential public health benefits.