{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:06:17Z","timestamp":1787893577004,"version":"build-2784847793"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Use of oral nicotine pouches, and specifically the brand Zyn, has increased among all age groups in the United States (U.S.), and these products have a wide advertising and social media presence. The purpose of our study was to identify prevalence and correlates of oral nicotine pouch use, Zyn use, and Zyn susceptibility in the U.S. and identify sources of advertising exposure for Zyn.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We conducted an online national survey in the U. S, through Qualtrics, from March\u2013June 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants\/Cases<\/jats:title>\n                    <jats:p>Participants were 13\u201340\u2010year\u2010olds (N\u2009=\u20095733), with a 1:1:1 ratio of people ages 13\u201317, 18\u201320, and 21\u201340; 66.1% were female.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>We asked participants about lifetime and past 30\u2010day oral nicotine pouch use, Zyn use in particular, susceptibility to use Zyn, use of Zyn flavors, detailed patterns of Zyn use, and exposure to Zyn advertising, overall and stratified by age group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Among our sample, lifetime use of any nicotine pouch and Zyn specifically were 11.5% and 9.3%, respectively; past 30\u2010day use of any nicotine pouch and Zyn specifically were 5.0% and 3.9%, respectively. Lifetime use and past 30\u2010day use increased across age groups. Among those who had never used any nicotine pouch, 27.6% were susceptible to Zyn use. Using logistic regressions, we identified correlates to oral nicotine pouch use and Zyn susceptibility, including covariates for age group, sex, race\/ethnicity, financial comfort, e\u2010cigarette use, and cigarette use. Increasing age group and e\u2010cigarette and cigarette use were associated with any oral nicotine pouch use and Zyn susceptibility. The most popular Zyn flavors ever used were mint (n\u2009=\u2009388) and drinks (n\u2009=\u2009190). On average, participants with past 30\u2010day Zyn use reported a median of using 4.0 (interquartile range [IQR]: 4.0) pouches per day; a median of placing 2.0 (IQR: 3.0) pouches in their mouth at once; and a median of using 2.0 (IQR: 2.0) cans of Zyn per week. TikTok (18.2%, n\u2009=\u20091044), YouTube (17.8%, n\u2009=\u20091021), and Instagram (16.3%, n\u2009=\u2009935) were the top platforms participants reported ever seeing a Zyn advertisement or promotion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A United States national survey found substantial rates of use, susceptibility to use, and exposure to marketing for Zyn and other oral nicotine pouches. Mint and drinks were the most commonly used Zyn flavors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70530","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T09:21:24Z","timestamp":1783416084000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Zyn and other oral nicotine pouch use, correlates, and advertising exposure among a national sample of United States adolescents, young adults and adults"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8455-0127","authenticated-orcid":false,"given":"Jessica","family":"Liu","sequence":"first","affiliation":[{"name":"REACH Lab, Division of Adolescent Medicine, Department of Pediatrics Stanford University  Palo Alto CA USA"},{"name":"Department of Health Science California State University  Long Beach CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9276-1322","authenticated-orcid":false,"given":"Bonnie","family":"Halpern\u2010Felsher","sequence":"additional","affiliation":[{"name":"REACH Lab, Division of Adolescent Medicine, Department of Pediatrics Stanford University  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP270492"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2012.04026.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a012120"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dcn.2011.05.010"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2023.107632"},{"key":"e_1_2_9_7_1","unstructured":"Truth Initiative.What is Zyn and what are oral nicotine pouches?2024. 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Available from:https:\/\/www.census.gov\/quickfacts\/fact\/table\/US\/PST045224Accessed 14 January 2026."},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abrep.2018.08.005"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/1179173X211065643"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntu254"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2019.03.017"},{"key":"e_1_2_9_45_1","unstructured":"U.S. Food & Drug Administration.FDA authorizes marketing of 20 ZYN nicotine pouch products after extensive scientific review.2025. Available from:https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-authorizes-marketing-20-zyn-nicotine-pouch-products-after-extensive-scientific-review?utm_campaign=ctp-pmta&utm_content=pressrelease&utm_medium=email&utm_source=govdelivery&utm_term=stratcomms"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.70530","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.70530","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.70530","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T09:21:35Z","timestamp":1783416095000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.70530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":44,"alternative-id":["10.1111\/add.70530"],"URL":"https:\/\/doi.org\/10.1111\/add.70530","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"assertion":[{"value":"2025-10-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"add.70530"}}