Nicotine pouches: Correlates and changes in use in the United States between 2021 and 2024

BACKGROUND AND AIMS: Nicotine pouches have become popular in the United States (US), but recent changes in nicotine pouch use patterns and correlates of use remain understudied. This study assessed changes in ever and current nicotine pouch use between 2021 and 2024 among US adult tobacco users and examined correlates of nicotine pouch use among US adults in 2024. DESIGN: Repeated cross-sectional analysis of 2021 and 2024 YouGov survey data. SETTING: Surveys were administered by the YouGov online panel across the US. PARTICIPANTS: Participants included 1583 U.S. adults aged ≥21 years with past 12-month tobacco use in 2021 and 3200 US adults aged ≥21 years in 2024 irrespective of tobacco use status; 1355 adults were tobacco users in 2024. MEASUREMENTS: Participants reported nicotine pouch use (never, used before but not currently, and currently using it every day or some days). Socio-demographic characteristics and current tobacco use were assessed. Weighted multi-variable logistic regression analyses were conducted. RESULTS: Ever nicotine pouch use increased from 16.4% in 2021 to 31.1% in 2024, and current use increased from 3.0% to 10.2% among adult tobacco users. Between 2021 and 2024, increases in nicotine pouch use were observed in almost all socio-demographic and current tobacco use groups. In 2024, among all adults, men and adults aged 21-30 or 31-45 years old had higher predicted marginal probability differences (PMPDs) for ever or current nicotine pouch use than women and adults aged >60 years. Current users of any tobacco product had higher PMPDs for ever and current nicotine pouch use than non-users; current smokeless tobacco users had the largest PMPDs for ever and current use. SUMMARY: Nicotine pouch use appears to have increased among adult tobacco users in the United States between 2021 and 2024.