• Non-cigarette tobacco products
• Surveillance and monitoring
• Tobacco industry
• Packaging and Labelling

In recent years, several major tobacco companies have rapidly expanded their offerings in what they frequently term ‘modern oral’ products or oral tobacco products marketed for recreational use beyond traditional forms like chewing tobacco or snus.1 2 While the rising popularity of nicotine pouches (tobacco-free oral nicotine products similar to snus) has already been noted in the literature,3 4 the availability and trends in consumption of other newer oral products are yet to be documented.5 These emerging product types, including recreational nicotine lozenges, tablets, gummies and gum, are now available from several major tobacco manufacturers in the USA. While these products were preceded by other oral or dissolvable tobacco products like Camel Orbs and Marlboro Sticks, these brands were generally unsuccessful and were pulled off the market in the early 2010s.6

Nicotine lozenges are flavoured, candy-sized oral products which, as described by one manufacturer, ‘dissolve slowly in the mouth’ over 8–10 min7 and are sold in small, colourful plastic containers (see figure 1). In contrast, nicotine tablets have a similar appearance but are ‘quick dissolving’.7 Finally, recreational nicotine gum is similar in appearance to nicotine replacement therapy (NRT) gum but is explicitly marketed as a recreational product, with one manufacturer describing it as ‘a convenient and satisfying way to enjoy nicotine’.8 Another nicotine product alternative available for purchase in convenience stores in the USA is nicotine gummies, for example, the ‘NICables’ brand manufactured by Reel World Brands (see figure 2), which are marketed as ‘a sweet alternative for adults’ and described as ‘supplements’ on product packaging. Since the Food and Drug Administration (FDA) lacks the authority to regulate supplements,9 this may be an attempt …