Surprisingly Low Adult Pouch Use: Study

Despite a 641 percent increase in sales of nicotine pouches between 2019 and 2022, few U.S. adults use modern oral products, according to a nationally representative study conducted by the Keck School of Medicine of the University of Southern California (USC) and the University of Nebraska Medical Center.

“The low prevalence of nicotine pouch use in adults surprised us, given the rapid increase in sales,” said study co-author Adam Matthew Leventhal, a professor in the Department of Population and Public Health Sciences at the Keck School of Medicine and executive director of the USC Institute for addiction science, in a statement. “But it’s also possible that the sales are being diverted to adolescents, who were not represented in this survey.”

The researchers surveyed nicotine pouch use in a nationally representative sample of 39,557 U.S. adults. They found that 2.9 percent of adults had ever used nicotine pouches, with 0.4 percent reporting current use. The majority of adults currently using pouches also currently smoke cigarettes. Additionally, 5.2 percent of those who attempted to quit smoking in the past year and had relapsed back to smoking reported using pouches to help with their cessation efforts.

One question raised by the findings is whether adults who use nicotine pouches may be using them to “top off” nicotine in situations where they cannot smoke or use other tobacco products, Leventhal said, rather than as a way to quit smoking.

Based on the study results, Leventhal estimates that of all U.S. adults who currently used nicotine pouches in 2022, about 35 percent had previously smoked cigarettes and 25 percent were currently smoking cigarettes. The remaining 40 percent of adult pouch consumers had never regularly smoked cigarettes and could be at risk for developing nicotine dependence.

“In summary, we didn’t see a large population of adults using nicotine pouches, and fewer appear to be using them in a fashion that would potentially reduce their harm from smoking cigarettes,” Leventhal said.