Evidence map›Paper›PMID 41494224›Full record

ArticleDrug and alcohol dependence2026

Association of tobacco and other substance use with nicotine pouch awareness and use in US adolescents.

Dae-Hee Han, Tahsin Rahman, Richard A Miech, Alyssa F Harlow, Hongying D Dai, Junhan Cho, Steve Y Sussman, Louisiana M Sanchez, Leah R Meza, Adam M Leventhal

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug and alcohol dependence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Dae-Hee HanDepartment of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, GA, USA; Department of Health Policy and Management, Emory University, Atlanta, GA, USA; Winship Cancer Institute of Emory University, Atlanta, GA, USA. Electronic address: dae.hee.han@emory.edu.
Tahsin RahmanDepartment of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.
Richard A MiechInstitute for Social Research, University of Michigan, Ann Arbor, MI, USA.
Alyssa F HarlowDepartment of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.
Hongying D DaiDepartment of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA.
Junhan ChoDepartment of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.
Steve Y SussmanDepartment of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.
Louisiana M SanchezDepartment of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.
Leah R MezaDepartment of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.
Adam M LeventhalDepartment of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA.

Funding

Monitoring the Future: Drug Use & Lifestyles of American Youth (Supp1: Nicotine Pouch and E-cigarette Use Among US Adolescents: National Estimates of Brand Use and Flavor Preferences)R01DA001411 · NIDA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Richard A Miech · 1985 to 2026
$144.9M
USC Tobacco Center of Regulatory ScienceU54CA180905 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Jennifer Beth Unger · 2018 to 2026
$39.0M
Tobacco Use Treatment Research for Vulnerable PopulationsK24DA048160 · NIDA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Adam Matthew Leventhal · 2019 to 2026
$1.4M
The Tobacco and Cannabis Retail Environment, Neighborhood Disadvantage, and Adolescent VapingK01DA058084 · NIDA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Alyssa Fitzpatrick Harlow · 2023 to 2026
$752k
Effect of Product Characteristics on the Abuse Liability of Nicotine PouchesR00DA058241 · NIDA · EMORY UNIVERSITY · PI Dae Hee Han · 2025 to 2026
$498k
Effect of Product Characteristics on the Abuse Liability of Nicotine PouchesK99DA058241 · NIDA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI HAN, DAE HEE · 2024 to 2025
$312k
NCI NIH HHS U54 CA180905NIDA NIH HHS K01 DA058084NIDA NIH HHS K24 DA048160NIDA NIH HHS K99 DA058241NIDA NIH HHS R00 DA058241NIDA NIH HHS R01 DA001411
6 · The paper itself

Abstract

introductionEvidence on the association between tobacco/nicotine and other substance use (TOSU) and adolescent nicotine pouch (NP) awareness and use is lacking but vital for policy and prevention planning.

methodsThe sample was drawn from the 2023 Monitoring the Future study, a nationally representative survey of U.S. adolescents (8th, 10th, 12th graders). One-third of participants were randomly selected to complete questions on NP awareness and use (lifetime, past 12-month, past 12-month frequency) and past 30-day TOSU measures (yes/no). We estimated risk ratios (RRs) and incident rate ratios (IRRs) to examine the associations between TOSU and NP awareness and use.

resultsOverall (n = 6958; 53.4 % female), 35.4 % reported NP awareness, 2.5 % reported lifetime use, and 1.8 % reported past 12-month use. Past 30-day use of tobacco/nicotine products was each positively associated with NP awareness (RRs:1.42-1.70), lifetime (RRs:7.14-20.40), and past 12-month (RRs:5.84-22.44) use, with the strong associations for youth with vs. without smokeless tobacco use. Cannabis, alcohol, and other drug past 30-day use were each associated with NP awareness (RRs:1.49-1.68), lifetime (RRs:3.47-10.49), and past 12-month (RRs:4.70-15.70) use.

conclusionsNP awareness and use prevalence were disproportionately high among adolescents with various forms of TOSU in 2023, especially smokeless tobacco. These findings suggest the importance of monitoring NP use among youth with TOSU while recognizing that awareness may also reflect broader marketing, product availability, or incidental exposure. Policy and prevention efforts should address NP use alongside TOSU with established health risks.

Indexed as

Adolescent BehaviorAwarenessHealth Knowledge, Attitudes, PracticeSubstance-Related DisordersTobacco UseAdolescentFemaleHumansMaleSurveys and QuestionnairesUnited StatesAdolescentsAwarenessNicotine pouchTobacco/substance use correlatesUse prevalence

Identifiers

PMID41494224
PMCPMC13075962

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.