Prevalence and Characteristics of Oral Nicotine and Tobacco Product Use among US Adults.

Authors

Alyssa F Harlow, Dae-Hee Han, Steve Sussman, Adam Leventhal

Published in

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. Oct 06, 2026. Epub Oct 06, 2026.

Abstract

Whether demographic and tobacco use characteristics differ between adults using new non-tobacco oral nicotine products (ONPs; e.g., nicotine pouches and other ONPs [e.g., gums, lozenges]) versus those using oral tobacco products (e.g., snus and other smokeless tobacco) is unknown but important to tobacco control.
Using cross-sectional nationally representative data from n=29,705 United States (US) adults (≥18y) in wave 7 (2022-2023) of the Population Assessment of Tobacco and Health Study, we compared weighted distributions of sociodemographic and tobacco use characteristics among those reporting past 30-day use of non-tobacco ONPs and oral tobacco products.
Prevalence of past 30-day use was 1.4% for nicotine pouches, 0.66% for other ONPs, 0.95% for snus, and 2.4% for other smokeless tobacco products excluding snus. Adults who used nicotine pouches were more likely than those who used smokeless tobacco to be 18-24-year-olds (36.6%[95%CI:29.5-44.3] vs. 16.8%[95%CI:13.1-21.3]), be female (21.8%[95%CI:15.5-29.7] vs. 8.6%[95%CI:6.4-11.4]), have a college degree (35.2%[95%CI:27.8-43.3] vs. 15.9%[95%CI:12.1-20.7]), live in the Western US (29.5%[95%CI:22.6-37.5] vs. 16.0% [95%CI:12.1-21.0]), and currently vape nicotine (37.4%[95%CI:29.1-46.5] vs. 21.7%[95%CI:17.4-26.7]), and more likely to have a college degree than those who used snus (15.7%[95%CI:10.3-23.3]). Adults who used other ONPs were more likely to be female (48.7%[95%CI:37.8-59.7]) than all other use groups, and more likely to smoke cigarettes (53.5%[95%CI:43.1-63.5]) than those who used nicotine pouches (29.8%[95%CI:22.9-37.9]) or smokeless tobacco (33.1%[95%CI:27.5-39.2]).
ONP use may be expanding to populations who may otherwise not have used oral tobacco, including younger, female, and higher socioeconomic status populations.

PMID:
42837304
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.

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