Loading ...

TOPLINE:

Among adolescents who used e-cigarettes, those who used oral nicotine products, like nicotine pouches, and gums and lozenges showed a reduced risk for persistent vaping after 6 months. The use of nicotine pouches was particularly linked to less frequent vaping.

METHODOLOGY:

• Researchers used data from a prospective cohort study to examine the link between the use of oral nicotine products and vaping behaviors in adolescents from Southern California.
• Students (9th or 10th grade) enrolled from 11 high schools completed surveys on tobacco use twice a year from 2021 to 2024.
• During each survey, teens reported their use of oral nicotine products, like nicotine pouches and other edible nicotine products (gums, mints, or lozenges), and e-cigarettes over the past 6 months, detailing frequency and persistence.
• Vaping persistence was defined as self-reported use of e-cigarettes in the past 6 months, examined over five 6-month intervals, whereas use in the past 30 days represented vaping frequency.
• A total of 1173 person-interval observations from 703 participants (mean age, 16.2 years; 59.2% girls) were included.

TAKEAWAY:

• Among oral nicotine product users, 63.9% used both nicotine pouches and other products. The prevalence of nicotine pouch use in the past 6 months increased among adolescents who used e-cigarettes from 8% in 2021 to 25% in 2023.
• Compared with no use, the use of nicotine pouches in the past 6 months was associated with a reduced vaping frequency (adjusted incidence rate ratio, 0.43; 95% CI, 0.26-0.72) and risk for continued vaping (adjusted risk ratio [aRR], 0.43; 95% CI, 0.32-0.58).
• Adolescents who used other nicotine products like gums, mints, or lozenges in the past 6 months had a lower risk for continued vaping than those who did not (aRR, 0.72; 95% CI, 0.59-0.89).
• Among participants who reported using e-cigarettes in the past 30 days, using nicotine pouches in the past 6 months was inversely associated with subsequent vaping persistence at follow-up (aRR, 0.70; 95% CI, 0.54-0.90).

IN PRACTICE:

“It will be important to continue to monitor nicotine pouch use among youth and its impact on vaping patterns to determine whether nicotine pouches may be inhibiting progress in reducing overall nicotine use among youth,” the authors of the study wrote.

“[T]he authors suggest that using oral nicotine pouches may serve as a substitute for e-cigarettes among youth who vape,” experts wrote in a commentary.

SOURCE:

The study was led by Alyssa Harlow, PhD, MPH, of the Department of Population and Public Health Sciences at the University of Southern California in Los Angeles. It was published online on May 19, 2025, in Pediatrics.

LIMITATIONS:

This study did not include information about why participants used oral nicotine products or quit e-cigarettes. The sample was limited to adolescents from Southern California.

DISCLOSURES:

The study was supported by grants from the National Cancer Institute, the FDA Center for Tobacco Products, and the National Institute on Drug Abuse. No relevant conflicts of interest were disclosed by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.