{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T18:42:17Z","timestamp":1783536137677,"version":"3.55.0"},"reference-count":69,"publisher":"BMJ","funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["24\/622"],"award-info":[{"award-number":["24\/622"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2026,6,24]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Marketing frames oral nicotine pouches (ONPs) as convenient, pleasurable and compatible with numerous activities without attracting the stigma sometimes associated with smoking or vaping. Regulation of ONPs varies considerably across countries, though tobacco companies have lobbied for their introduction as a harm-reduced alternative to smoking. Probing how young people perceive ONPs and integrate them into their daily lives should inform ONP regulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We interviewed 25 young people aged 16\u201325\u2009and living in Aotearoa New Zealand in late 2025. We recruited participants via social media, community advertising and snowball sampling and probed their awareness, use and perceptions of ONPs. We interpreted the data using reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified three themes: ONPs\u2019 acceptability and versatility, discretion as an ambiguous attribute and risk calibration. High exposure to social media promotions embedded ONPs within young people\u2019s everyday activities, where they enhanced focus, offered pleasure without impinging on others and enabled nicotine consumption without creating a distinctive and stigmatising smoke, aerosol or smell. Product aesthetics and the absence of inhalation led participants to view ONPs as less harmful than smoking or vaping, though some noted oral health concerns and believed ONPs would increase nicotine product use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sophisticated marketing has framed ONPs as flexible lifestyle accessories. While they may assist some people to stop smoking or vaping, they may also promote poly-use and attract new consumers. Until policy makers have robust independent evidence on safety and cessation efficacy, a precautionary regulatory approach is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2026-060160","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:20:21Z","timestamp":1783531221000},"page":"tc-2026-060160","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Discreet, versatile and ambiguous: young people\u2019s perceptions and use of oral nicotine pouches in Aotearoa New Zealand"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5530-0914","authenticated-orcid":false,"given":"Amelia","family":"Fitton","sequence":"first","affiliation":[{"name":"Early Learning in Medicine, University of Otago Division of Health Sciences, Dunedin, Otago, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jade","family":"Fisher","sequence":"additional","affiliation":[{"name":"Early Learning in Medicine, University of Otago Division of Health Sciences, Dunedin, Otago, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4362-1539","authenticated-orcid":false,"given":"Janet","family":"Hoek","sequence":"additional","affiliation":[{"name":"Public Health, University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2026070810201348000_tc-2026-060160v1.1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2019-055321"},{"key":"2026070810201348000_tc-2026-060160v1.2","unstructured":"Truth Initiative . What is Zyn and what are oral nicotine pouches? 2023. Available: https:\/\/truthinitiative.org\/research-resources\/emerging-tobacco-products\/what-zyn-and-what-are-oral-nicotine-pouches"},{"key":"2026070810201348000_tc-2026-060160v1.3","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntae131"},{"key":"2026070810201348000_tc-2026-060160v1.4","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1177\/00333549251313668","article-title":"Oral Nicotine Pouches: Rising Popularity and State of the Science","volume":"141","author":"Felicione","year":"2026","journal-title":"Public Health Rep"},{"key":"2026070810201348000_tc-2026-060160v1.5","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1146\/annurev-publhealth-040617-013849","article-title":"Harm Minimization and Tobacco Control: Reframing Societal Views of Nicotine Use to Rapidly Save Lives","volume":"39","author":"Abrams","year":"2018","journal-title":"Annu Rev Public Health"},{"key":"2026070810201348000_tc-2026-060160v1.6","first-page":"1023","article-title":"FDA Authorizes Marketing of ZYN Nicotine Pouch Products","volume":"333","author":"Anderer","year":"2025","journal-title":"JAMA"},{"key":"2026070810201348000_tc-2026-060160v1.7","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1037\/pha0000755","article-title":"A comprehensive review on oral nicotine pouches: Available scientific evidence and future research needs","volume":"33","author":"Zamarripa","year":"2025","journal-title":"Exp Clin Psychopharmacol"},{"key":"2026070810201348000_tc-2026-060160v1.8","doi-asserted-by":"crossref","unstructured":"Dobbs P , McCormick C , Murthy D , et al . 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