{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:29:50Z","timestamp":1792171790065,"version":"4.4.0"},"reference-count":41,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/100010628","name":"FDA Center for Tobacco Products","doi-asserted-by":"crossref","award":["R21CA234968"],"award-info":[{"award-number":["R21CA234968"]}],"id":[{"id":"10.13039\/100010628","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2024,1,2]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Little is known about how nicotine pouch products are perceived by people who smoke, including if they are perceived as a cessation aid or a substitute for when they cannot smoke. We qualitatively investigated the reactions and perceptions about On!, a leading brand of nicotine pouches.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted online semistructured interviews with 30 adults who smoke cigarettes. Participants viewed an On! brochure and an image of an opened nicotine pouch and were asked about their initial impression, who the intended user is, and how they thought of the product\u2019s safety compared with other tobacco and cessation products. Transcripts were independently coded and the data were analysed using thematic content analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Among the participants, half identified as female and slightly more than half were white (n=16). The mean age was 43 years old. The following are the central themes that emerged: (1) participants perceived the concealability, flavours and packaging of On! as appealing to youth and young adults; (2) participants perceived nicotine pouches as a product that would supplement rather than replace tobacco use; and (3) the product raised health concerns, which decreased interest in trying nicotine pouches.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Participants believed that the On! nicotine pouch promotional material may promote youth and young adult nicotine product initiation and dual product use for people who smoke. Most viewed On! as a product to use with cigarettes, rather than a way to quit cigarettes. Increased surveillance of nicotine pouches is warranted to monitor the trajectory of this emerging tobacco product and prevent youth initiation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/tc-2023-058334","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T13:21:24Z","timestamp":1706880084000},"page":"378-381","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Qualitative perspective on nicotine pouches from adults who smoke cigarettes in North Carolina"],"prefix":"10.1136","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0748-3338","authenticated-orcid":false,"given":"Sonia A","family":"Clark","sequence":"first","affiliation":[{"name":"Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"},{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Baler","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6707-3058","authenticated-orcid":false,"given":"Kristen L","family":"Jarman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1162-9907","authenticated-orcid":false,"given":"M Justin","family":"Byron","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"},{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"},{"name":"Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam O","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"},{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9766-4767","authenticated-orcid":false,"given":"Leah M","family":"Ranney","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"},{"name":"Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"2025101704051670000_34.3.378.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.10366"},{"key":"2025101704051670000_34.3.378.2","unstructured":"Truth Initiative. 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