Nicotine pouches offer path to reduced tobacco harm — study

Researchers at the Rutgers Institute for Nicotine and Tobacco Studies recently published a study in JAMA Network Open that provides the first national estimates of daily nicotine pouch use among U.S. adults. While the products are not marketed as cessation aids, the study found that many users had recently quit smoking or vaping, suggesting the products may support harm reduction efforts.

“For people who smoke or use other nicotine products and don’t want to stop using nicotine, switching completely from the more harmful product and moving down the risk continuum with nicotine pouches is likely good for public health,” said lead researcher Cristine Delnevo, director of the Rutgers Institute for Nicotine and Tobacco Studies.

Nicotine is a chemical compound naturally found in the tobacco plant. It is addictive, but does not itself cause cancer, according to studies.

The results of the study come as countries around the world prepare for the eleventh session of the Conference of the Parties (COP11) of the WHO FCTC in Geneva in November this year. Public health experts and advocates have called on the WHO FCTC to finally accept and adopt harm reduction strategies to end the global smoking problem.

The Rutgers Institute study analyzed data from the U.S. Census Bureau’s 2022-2023 Tobacco Use Supplement, which surveyed more than 110,000 adults across the country on their use of nicotine pouches and traditional tobacco products. Researchers also examined the quitting behavior of other tobacco products before and after 2019, when the product became widely available nationally.

Overall, the study found that the percentage of adults using the product remains low, at just 2.5 percent. Non-Hispanic white men were the most likely to have used the product, while use among adults who had never used tobacco was “virtually nonexistent,” according to the study.

Researchers said the highest prevalence of current and daily nicotine pouch use was among adults with a history of tobacco use who had recently quit, suggesting that nicotine pouches may have played a role in their cessation.

“Our results suggest that adults may be using nicotine pouches for harm reduction, given that use is highest among those that have recently quit another tobacco product or e-cigarettes,” said Delnevo.

Delnevo said that when used by established tobacco users, pouches may offer a health benefit. “People who have never used tobacco products should not suddenly be using nicotine pouches,” she said.

“But for people who smoke or use other nicotine products and don’t want to stop using nicotine, switching completely from the more harmful product and moving down the risk continuum with nicotine pouches is likely good for public health,” said Delnevo.

Mary Hrywna, an associate professor in the Department of Health Behavior, Society and Policy at the Rutgers School of Public Health, and a study co-author, said that as nicotine pouches gain increased attention in the U.S., “many agree that we need to better understand who is using these products and how.”

“This study offers a snapshot of use patterns that is informative and, at least for now, somewhat reassuring,” said Hrywna.

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