Nicotine pouch use triples among U.S. smokers in three years
A University of Cincinnati survey indicates that nearly one in ten adult tobacco users now use the tobacco-free products, a jump from three percent in 2021.
By Takeshi Davidson ·
Nicotine pouch use has tripled among adult tobacco users in the United States over the last three years, according to a survey published this week in the journal Addiction. The data shows a rapid shift in how people consume nicotine, moving away from traditional cigarettes and smokeless tobacco toward small, tobacco-free pouches.
Between 2021 and 2024, the percentage of adult tobacco users who had ever tried a nicotine pouch rose from 16.4 percent to 31.1 percent. Current use, defined as using the product regularly, increased from 3 percent to 10.2 percent. Ashley Merianos, a professor at the University of Cincinnati’s School of Human Services and the lead investigator, noted that what was once a niche product is becoming mainstream.
The study analyzed repeated cross-sectional data from the YouGov survey. It included a nationally representative sample of U.S. adults who use tobacco. Merianos, along with researchers from the UC College of Nursing, Texas Tech University, and the National Institutes of Health, found that men, adults aged 21 to 45, and current tobacco users were the most likely to adopt the new product.
Smokeless tobacco users showed the highest rates of pouch use. Merianos explained that this overlap suggests many people are using pouches alongside other tobacco products rather than replacing them entirely. This dual or poly-tobacco use raises concerns about the cumulative impact of nicotine on the body.
The fastest growth occurred among adults aged 21 to 24. Since the human brain is not fully developed until age 25, researchers are watching this group closely. Merianos said it is unclear if young adults who start with pouches will become addicted to nicotine or switch to other products later. "We don't yet know the long-term health consequences, and we also don't know the long-term addiction potential," she said.
Healthcare providers are increasingly meeting patients who use these products. Merianos asked if medical professionals are prepared to discuss the knowns and unknowns of emerging nicotine products. The tobacco industry continues to introduce new marketing tactics, following the rise of electronic cigarettes with these new pouches.
The research team recommends continued surveillance to track how pouches fit into overall nicotine use. They aim to identify which populations have the highest rates of use and understand the long-term effects of the products.
