Correlates of oral nicotine pouch use, use frequency and flavour use among US adults.

backgroundAs oral nicotine pouches (ONPs) have gained popularity in the US, little is known from nationally representative data about who uses them and how they are being used.

objectivesTo examine tobacco use and sociodemographic correlates of ONP use, use frequency and flavour use among US adults.

methodsData were drawn from the 2022-2023 Tobacco Use Supplement to the Current Population Survey (n=1 57 485). Weighted logistic regression models were used to identify predictors of (1) current ONP use, (2) daily versus non-daily ONP use and (3) flavoured versus unflavoured ONP use.

resultsThe odds of current ONP use were higher among younger adults, males, non-Hispanic Whites, individuals with higher income and those who had ever used cigarettes, e-cigarettes or smokeless tobacco (SLT). People who currently use cigarettes, e-cigarettes or SLT had lower odds of daily (vs non-daily) ONP use, whereas people with a history of cigarette use who do not currently smoke had higher odds. Males, younger adults and people with a history of SLT use who do not currently use SLT were more likely to use flavoured ONPs.

conclusionsONP use was common among individuals with current and prior tobacco use which may be consistent with alternative nicotine use. However, a small proportion of ONP users reported no prior use of other tobacco products, highlighting the need for continued research on nicotine uptake through ONPs among tobacco-naïve populations, particularly among young adults. In addition, the prevalence of co-use with other tobacco products may limit potential public health benefits.