NICOTINE pouch use among US adult tobacco users more than tripled between 2021 and 2024, research shows. The findings highlight a substantial shift in nicotine consumption patterns, particularly among younger adults, men, and individuals already using other tobacco products.
A repeated cross-sectional study examined nicotine pouch use among 1,583 US adults aged 21 years and older who had used tobacco within the previous 12 months in 2021, alongside 1,355 comparable participants in 2024.
Ever using nicotine pouches increased from 16.4% in 2021 to 31.1% in 2024. More notably, current nicotine pouch use rose from 3.0% to 10.2%, representing more than a threefold increase.
After adjustment for demographic characteristics and tobacco use, the predicted probability of current nicotine pouch use increased by 6.4 percentage points (95% CI: 4.4–8.3). Increases were observed across nearly all demographic and tobacco use categories.
Among 3,200 US adults surveyed in 2024, regardless of tobacco use history, 10.6% reported ever using nicotine pouches, while 2.7% reported current use.
Current use was highest among adults aged 31–45 years (5.3%), followed by those aged 21–30 years (4.0%), compared with 0.8% among adults older than 60 years.
Men also reported higher current use than women (4.3% versus 1.3%), highlighting demographic differences in nicotine exposure.
Existing tobacco use emerged as a major correlate of nicotine pouch use. Among current smokeless tobacco users, 75.6% reported ever using nicotine pouches, and 43.7% reported current use.
Among tobacco users surveyed across both years, current nicotine pouch use increased most substantially in the smokeless tobacco subgroup, rising from 12.8% to 43.7%.
Higher prevalence was also observed among cigarette smokers and users of electronic vaping products, raising questions about whether nicotine pouches complement or replace existing tobacco products.
These findings underscore the importance of assessing nicotine pouch use alongside conventional tobacco consumption during clinical encounters, particularly when evaluating nicotine dependence and multiple tobacco product use.
However, the observational study relied on self-reported data, and differences in survey methods limit conclusions about individual changes in tobacco use.
Further research is needed to establish whether increasing nicotine pouch use reflects product substitution, continued use alongside other tobacco products, or new patterns of nicotine consumption.
Reference
Merianos AL et al. Nicotine pouches: Correlates and changes in use in the United States between 2021 and 2024. Addiction. 2026; DOI:10.1111/add.70671.
Featured Image: Ljustina on Adobe Stock.
Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.
