{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T03:35:09Z","timestamp":1789443309195,"version":"build-2803163510"},"reference-count":24,"publisher":"BMJ","funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2026,2,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Nicotine pouch sales have substantially increased in the US. We examined the patterns of dually using nicotine pouches with other tobacco products, and whether nicotine pouch use was associated with tobacco product use cessation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A nationally representative sample of US adults (\u226521 years) participated in an online survey in 2024 and provided information about their tobacco use behaviours in 2023 and 2024, along with demographics. This analysis was restricted to those who reported using any tobacco products in 2023 (n=1460). Data were weighted to be nationally representative. Predictive marginal probability differences (PMPDs) were used to examine the association between nicotine pouch use in 2023 and tobacco product use cessation in 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2023, 12.0% of US adults who used tobacco products reported currently using nicotine pouches with another tobacco product. Among those who used nicotine pouches dually with at least one other tobacco product in 2023, none switched to exclusive nicotine pouch use in 2024 and 47.1% continued dual-use, 10.1% stopped using all tobacco products and 42.8% stopped using nicotine pouches in 2024. US adults who dual-used nicotine pouches with other tobacco products in 2023 had lower probabilities than those who did not dual-use to quit tobacco product use in 2024 (10.1% vs 23.7%; PMPD=\u221215.2%, 95% CI \u221220.8% to \u22129.6%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among US adults who dually used nicotine pouches with other tobacco products, none completely switched to exclusive nicotine pouch use. Nicotine pouch use was also not associated with increased probabilities of quitting tobacco product use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2025-059832","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T18:20:34Z","timestamp":1772562034000},"page":"tc-2025-059832","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Patterns of tobacco product use among US adults who use nicotine pouches and the association between nicotine pouch use and tobacco product use cessation"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6753-2883","authenticated-orcid":false,"given":"Kelvin","family":"Choi","sequence":"first","affiliation":[{"name":"Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2209-6532","authenticated-orcid":false,"given":"Bambi","family":"Jewett","sequence":"additional","affiliation":[{"name":"Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5184-2601","authenticated-orcid":false,"given":"Kristen R","family":"Hamilton-Moseley","sequence":"additional","affiliation":[{"name":"Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-0111","authenticated-orcid":false,"given":"Kasra","family":"Zarei","sequence":"additional","affiliation":[{"name":"Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiana","family":"Hacker","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4583-2911","authenticated-orcid":false,"given":"Lilianna","family":"Phan","sequence":"additional","affiliation":[{"name":"Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA"},{"name":"Division of Graduate Nursing, Drexel University College of Nursing and Health Professions, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"2026030310202474000_tc-2025-059832v1.1","doi-asserted-by":"publisher","DOI":"10.1136\/tc-2022-057734"},{"key":"2026030310202474000_tc-2025-059832v1.2","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.42235","article-title":"Nicotine Pouch Sales Trends in the US by Volume and Nicotine Concentration Levels From 2019 to 2022","volume":"5","author":"Majmundar","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2026030310202474000_tc-2025-059832v1.3","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.amepre.2024.11.001","article-title":"Patterns of Emerging Tobacco Product Use Among U.S. Adults, 2019\u20132022","volume":"68","author":"Reyes-Guzman","year":"2025","journal-title":"Am J Prev 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Total and unprotonated (freebase) nicotine content in new types of oral \u201ctobacco-free\u201d nicotine products. Tob Control 2024. doi:10.1136\/tc-2024-058914","DOI":"10.1136\/tc-2024-058914"},{"key":"2026030310202474000_tc-2025-059832v1.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12903-024-04598-8","article-title":"What is the impact of nicotine pouches on oral health: a systematic review","volume":"24","author":"Rungraungrayabkul","year":"2024","journal-title":"BMC Oral Health"},{"key":"2026030310202474000_tc-2025-059832v1.11","doi-asserted-by":"crossref","DOI":"10.1186\/s13000-024-01549-3","article-title":"Oral mucosal changes caused by nicotine pouches: case series","volume":"19","author":"Miluna-Meldere","year":"2024","journal-title":"Diagn Pathol"},{"key":"2026030310202474000_tc-2025-059832v1.12","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms12081514","article-title":"The Effects of Nicotine Pouches and E-Cigarettes on Oral Microbes: A Pilot Study","volume":"12","author":"Miluna-Meldere","year":"2024","journal-title":"Microorganisms"},{"key":"2026030310202474000_tc-2025-059832v1.13","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.2020.305999"},{"key":"2026030310202474000_tc-2025-059832v1.14","doi-asserted-by":"crossref","DOI":"10.1016\/j.pmedr.2019.101009","article-title":"Patterns and trends of dual use of e-cigarettes and cigarettes among U.S. adults, 2015-2018","volume":"16","author":"Owusu","year":"2019","journal-title":"Prev Med Rep"},{"key":"2026030310202474000_tc-2025-059832v1.15","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1111\/add.16734","article-title":"Trends and patterns of dual use of combustible tobacco and e-cigarettes among adults in England: A population study, 2016-2024","volume":"120","author":"Jackson","year":"2025","journal-title":"Addiction"},{"key":"2026030310202474000_tc-2025-059832v1.16","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.10686"},{"key":"2026030310202474000_tc-2025-059832v1.17","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2025.31155","article-title":"Patterns of Nicotine Pouch Use Among Adults in the US, 2022-2023","volume":"8","author":"Delnevo","year":"2025","journal-title":"JAMA Netw Open"},{"key":"2026030310202474000_tc-2025-059832v1.18","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.54608","article-title":"Knowledge and Use of Menthol-Mimicking Cigarettes Among Adults in the US","volume":"8","author":"Choi","year":"2025","journal-title":"JAMA Netw Open"},{"key":"2026030310202474000_tc-2025-059832v1.19","unstructured":"Rivers D . Sampling for web surveys. Joint Statistical Meetings; 2007."},{"key":"2026030310202474000_tc-2025-059832v1.20","unstructured":"Rivers D , Bailey D . Inference from matched samples in the 2008 u.s. National Elections. American Association of Public Opinion Research Joint Statistical Meeting 2009; 2009"},{"key":"2026030310202474000_tc-2025-059832v1.21","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1093\/ntr\/ntaf024","article-title":"The Promotion of Oral Nicotine Pouches for Non-Smoking Cessation Purposes on TikTok","volume":"28","author":"Zenone","year":"2026","journal-title":"Nicotine Tob Res"},{"key":"2026030310202474000_tc-2025-059832v1.22","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1093\/ntr\/ntaf016","article-title":"Describing ZYN-Related Content on TikTok: Content Analysis","volume":"28","author":"Donaldson","year":"2026","journal-title":"Nicotine Tob Res"},{"key":"2026030310202474000_tc-2025-059832v1.23","doi-asserted-by":"publisher","DOI":"10.1136\/tc-2022-057360"},{"key":"2026030310202474000_tc-2025-059832v1.24","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntaa156"}],"container-title":["Tobacco Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tc-2025-059832","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T18:20:37Z","timestamp":1772562037000},"score":1,"resource":{"primary":{"URL":"https:\/\/tobaccocontrol.bmj.com\/lookup\/doi\/10.1136\/tc-2025-059832"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,3]]},"references-count":24,"alternative-id":["10.1136\/tc-2025-059832"],"URL":"https:\/\/doi.org\/10.1136\/tc-2025-059832","relation":{},"ISSN":["0964-4563","1468-3318"],"issn-type":[{"value":"0964-4563","type":"print"},{"value":"1468-3318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,3]]}}}