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Nicotine pouch product awareness, interest and ever use among US adults who smoke, 2021
  1. Mary Hrywna1,2,
  2. Nishi J Gonsalves1,
  3. Cristine D Delnevo1,2,
  4. Olivia A Wackowski1,2
  1. 1 Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
  2. 2 Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
  1. Correspondence to Dr Mary Hrywna, Rutgers Center for Tobacco Studies, New Brunswick, NJ 08901, USA; mary.hrywna{at}


Background Tobacco-free nicotine pouches are one of the fastest growing tobacco product categories in the US market. However, data on awareness, appeal or ever use of these products in the USA are limited.

Methods We surveyed a population-based sample of US adults who smoked (n=1018) between January and February 2021 about awareness, ever use of or interest in nicotine pouches. Multivariable logistic regression models explored the relationship between nicotine pouch variables and demographic and tobacco use characteristics.

Results In early 2021, 29.2% of adults who smoked had ever seen or heard of nicotine pouches, 5.6% had ever tried pouches and 16.8% reported interest in using pouches in the next 6 months. Adults who smoked aged 18–44 years and those who had ever used smokeless tobacco (SLT) were more likely to be aware of nicotine pouches. Interest in using nicotine pouches was more prevalent among adult smokers who planned to quit within 6 months, attempted to quit before using counselling or another tobacco product and had ever used pouches. Among adults who smoked, those with more education had lower odds of ever using nicotine pouches while those who had attempted to quit before using traditional methods or ever used SLT had higher odds of ever use.

Conclusion Levels of awareness, appeal and trial of nicotine pouches among US adults who smoke were modest, with variation by age, education, quit plans and quit attempt methods. Continued surveillance is warranted, including among naïve users and users of other tobacco and nicotine products.

  • nicotine
  • harm reduction
  • non-cigarette tobacco products
  • surveillance and monitoring

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  • Twitter @maryhrywna, @crisdelnevo, @owackowski

  • Contributors OAW conceptualised the study design and obtained funding. MH wrote the first draft of the manuscript. NJG conducted the data analysis and contributed to writing results. All authors contributed to the interpretation of data and critical revisions of the manuscript.

  • Funding This work was supported by the National Cancer Institute (NCI) of the National Institutes of Health under Award Number R37CA222002. OAW, CDD and MH were also supported in part by NCI and the US Food and Drug Administration Centre for Tobacco Products under Award Number U54CA229973.

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or US Food and Drug Administration.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.