As nicotine pouches gain traction in the United States, public health experts and legislators are closely scrutinizing their safety and role within a shifting nicotine marketplace. Recent research from Rutgers Health sheds light on the demographics and usage patterns of these tobacco-free nicotine products, which have emerged as an alternative to conventional tobacco consumption. Unlike traditional cigarettes or smokeless tobacco products, nicotine pouches deliver nicotine through an oral route without combustion or tobacco leaf, representing a novel form of nicotine ingestion that could have significant public health implications. This Rutgers-led investigation provides the first comprehensive national data on daily nicotine pouch use among U.S. adults and contextualizes the findings against prevailing trends in tobacco consumption and cessation efforts.
Nicotine pouches have surged as tobacco cigarette sales decline precipitously, prompting tobacco manufacturers to pivot their product portfolios. Leading brands, such as Velo and Zyn, capitalized on this downturn, positioning nicotine pouches as potentially lower-risk alternatives to combustible tobacco products. These pouches contain nicotine salts encapsulated in a white, powdery substance placed between the gum and lip, releasing nicotine while minimizing odor and smoke. Despite these products’ growing popularity, regulatory frameworks have yet to authorize them as smoking cessation tools. In January 2025, the U.S. Food and Drug Administration (FDA) granted marketing authorization for ZYN, marking the first instance of a nicotine pouch receiving such clearance. Nonetheless, the FDA explicitly prohibits marketing these pouches as cessation aids, reflecting both regulatory caution and the need for further research into their efficacy and safety.
The Rutgers study, led by Cristine D. Delnevo, director of the Rutgers Institute for Nicotine and Tobacco Studies, undertook a rigorous analysis of data obtained from the U.S. Census Bureau’s 2022-2023 Tobacco Use Supplement—a nationally representative survey involving over 110,000 adults. The survey captured detailed patterns of nicotine pouch usage alongside traditional tobacco behaviors, enabling researchers to discern both baseline prevalence rates and associations with tobacco cessation. Methodologically, the study employed sophisticated statistical analyses to assess nicotine pouch use in relation to demographic variables, prior tobacco use history, and quitting behaviors before and after 2019—the point at which nicotine pouches became widely available nationwide.
Findings revealed that despite increasing market presence, nicotine pouch use remains relatively low across the U.S. adult population. The highest usage rates appear among non-Hispanic white men, with only 2.5% reporting current use. Importantly, the study identified that nicotine pouch adoption among tobacco-naïve individuals—those who have never previously used tobacco products—is virtually nonexistent. This suggests that these products are not attracting new nicotine users but rather appealing to current or former tobacco consumers, potentially as a harm-reduction strategy.
Most strikingly, nicotine pouch use was most prevalent among adults with a history of tobacco use who recently quit smoking or e-cigarette use. This pattern intimates a possible role for nicotine pouches as a transitional aid for individuals attempting to relinquish more harmful tobacco products. Given nicotine’s high addictive potential, wholly abstaining from nicotine may be untenable for many; thus, nicotine pouches could serve as a lower-risk alternative by delivering nicotine without the toxicants generated by combustion or vaporization. However, it remains critical to underscore that these pouches are not currently endorsed as cessation devices and lack rigorous longitudinal efficacy data to substantiate such claims.
The health implications of oral nicotine pouch consumption warrant thorough exploration. Unlike carcinogens found in smoked tobacco, nicotine itself is not a direct carcinogen. Nonetheless, nicotine exerts cardiovascular effects, such as elevating blood pressure and contributing to endothelial dysfunction. The chronic health impact of sustained nicotine delivery through these pouches, particularly given the diverse formulations and nicotine concentrations available commercially, is still uncertain. Ongoing studies aim to delineate these risks, factoring in dosage, frequency, and user-specific metabolic responses.
Concerns over youth uptake amplify the complexities surrounding nicotine pouches. Data from the Centers for Disease Control and Prevention’s (CDC) 2024 National Youth Tobacco Survey indicate a modest increase in nicotine pouch use among middle and high school students, rising from 1.1% in 2022 to 1.8% in 2024. Although still low, this upward trajectory signals potential for broader youth exposure, which could subvert decades of progress in youth tobacco prevention. This trend underscores the urgent necessity for regulatory vigilance to prevent nicotine initiation among adolescents, who are more susceptible to nicotine addiction and its deleterious neurodevelopmental consequences.
In line with these concerns, Rutgers researchers have advocated for proactive regulatory measures before nicotine pouch products follow the trajectory of e-cigarettes, which rapidly proliferated with insufficient oversight, resulting in widespread youth addiction and subsequent public health crises. The researchers emphasize the importance of comprehensive surveillance of youth tobacco-use behaviors, including poly-tobacco use and substitution with flavored products, which may mask or facilitate continued nicotine dependence.
At the same time, scientists acknowledge the nuanced role nicotine pouches may play as a harm reduction tool for established adult tobacco users. Such dualistic potential—posing risks to naïve populations while offering lower-risk alternatives for current smokers—complicates public health messaging and regulatory decisions. Experts insist on distinguishing between these user groups and tailoring policies that minimize youth access yet retain potential benefits for harm reduction within adult populations.
Rutgers associate professor Mary Hrywna, a co-author of the study, highlights the emerging complexity of understanding nicotine pouch use patterns. She points out that although the data offer an initial snapshot that is somewhat reassuring, continued surveillance and granular analyses will be essential to comprehensively gauge the evolving landscape of nicotine product use. Such insights are crucial to informing regulatory standards, public health campaigns, and clinical guidelines.
The study’s timing is especially significant given the FDA’s recent authorization of multiple ZYN nicotine pouch products. These are subject to rigorous scientific review, yet critical questions linger regarding long-term safety, behavioral impacts, and potential unintended consequences in nicotine addiction dynamics. Balancing innovation in nicotine delivery systems with prudent regulatory frameworks will be vital to harnessing potential public health benefits while mitigating risks.
In summary, the burgeoning realm of nicotine pouches presents a complex challenge for tobacco control, harm reduction, and regulatory policy. Rutgers researchers’ seminal work lays a foundational understanding of who is using nicotine pouches and under what circumstances—information essential for future policy design. The key takeaways emphasize low population prevalence, predominant use among former tobacco users, inconsequential uptake among nicotine-naïve adults, potential for harm reduction, and a pressing need for vigilance to deter youth initiation. As the nicotine marketplace rapidly evolves, informed, evidence-based approaches grounded in rigorous scientific assessment will play an indispensable role in shaping a healthier future.
Subject of Research: People
Article Title: Patterns of Nicotine Pouch Use Among Adults in the US, 2022-23
News Publication Date: 8-Sep-2025
Web References:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2025.31155
References:
- Delnevo CD, et al. Patterns of Nicotine Pouch Use Among Adults in the US, 2022-23. JAMA Network Open. 2025. DOI: 10.1001/jamanetworkopen.2025.31155
- FDA Press Announcement. FDA Authorizes Marketing of ZYN Nicotine Pouches. January 2025.
- CDC National Youth Tobacco Survey 2024.
Keywords: Human health, Nicotine pouches, Tobacco harm reduction, Nicotine addiction, Tobacco use patterns, Youth tobacco use, FDA regulation
