Current nicotine pouch use among US tobacco users more than tripled

What happened

Nicotine pouch use climbed fast among US adults who already use tobacco. In an analysis of national survey data, the share who had ever tried pouches nearly doubled from 2021 to 2024. The share currently using them more than tripled, as first reported by Medical Xpress.

One caveat first. We could not open the paper, which appeared in Addiction. The figures below come from Medical Xpress's write-up of a University of Cincinnati release, so treat them as unverified until someone checks them against the study.

The headline question, who uses nicotine pouches, also has a narrower answer than it sounds. This study is about people who already use tobacco.

What the study found

The lead investigator is Ashley Merianos of the University of Cincinnati School of Human Services. Her co-authors are Joshua Lambert (UC College of Nursing) and Dan Petrovitch (Texas Tech). It is a repeated cross-sectional analysis of 2021 and 2024 YouGov survey data, described as nationally representative of US adult tobacco users.

The authors call for continued monitoring. They want to track use, understand how pouches fit into people's overall nicotine use, and identify the groups with the highest use.

A 2021 paper in the International Journal of Environmental Research and Public Health surveyed current US tobacco users on pouch awareness, beliefs, use and susceptibility. It may be an earlier wave from the same group, but we have not confirmed that.

What it does not show

• It doesn't describe all US adults. The 10.2% applies to people who already use tobacco, so it should not be read as a general-population rate.
• It doesn't describe young adults. The item we saw mentions no age breakdown, so any claim that young adults drive the trend needs the paper's age-specific estimates.
• It doesn't show people switching or starting. A repeated cross-sectional design compares two snapshots of different respondents. It shows prevalence changing, not individual paths.
• It says nothing about health effects, and nothing about marketing.
• It leaves out basic details. The coverage gives no sample sizes, confidence intervals or stated limitations. Online panel surveys generally carry self-report and panel-selection limits, but that is our general inference, not the authors' words.

What it means for you

If you don't use nicotine, nothing here is a reason to start. If you do use tobacco, the numbers suggest pouches are now a growing part of the mix among these respondents, and about one in three tobacco users in this sample had tried them.

This study can't tell you whether pouches are a safe swap or a new route into nicotine dependence. It wasn't designed to. Its health unknowns are the main reason to stay cautious, especially if you are young and see pouches framed as a clean, low-key option.

If you are trying to cut back on nicotine overall, a clinician or a quit line can talk through options. Don't rely on a single survey headline for that decision.

Context: other data and the FDA

Other work points the same direction. A study of 2023–2024 data concluded that US adult pouch use increased in that period. An ITC survey analysis of adults who currently or formerly smoked or vaped called pouches one of the fastest-growing US tobacco product categories.

General-population numbers are a different story. Medical Xpress's related coverage includes a 2024 item headlined "Few US adults use nicotine pouches." We haven't read that study, but it may suggest that the 10.2% figure reflects the tobacco-user sample rather than the general population.

Youth use is rising too, though that is not young-adult data. A nationally representative study of 10,146 US youths found lifetime pouch use went from 3.0% to 5.4% between 2023 and 2024. Past-12-month use went from 2.4% to 4.6%.

On marketing, a content analysis of US pouch ads from 2021–2023 examined the features of those ads. We haven't read it in full, and it doesn't establish that advertising caused the rise.

Regulation is moving as well. The FDA authorized Zyn for sale in January 2025. On June 30, 2026, it issued modified-risk orders for 20 Zyn products. The permitted claim says using Zyn instead of cigarettes puts you at a lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and chronic bronchitis. That is a comparison with cigarettes, not a statement that pouches are harmless.

According to JAMA's news summary, the order covers the 3-mg and 6-mg pouches but not the Zyn Plus line. The manufacturer must run postmarket surveillance, and the FDA may withdraw authorization if, for example, youth uptake rises significantly.

The American Heart Association said it was deeply concerned by the decision. It argued the FDA must weigh marketing, real-world use and initiation, not just the comparison with cigarettes.