{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:13:34Z","timestamp":1788200014509,"version":"build-2803163510"},"reference-count":34,"publisher":"BMJ","funder":[{"name":"NIH, Center for Tobacco Products","award":["U54CA287392"],"award-info":[{"award-number":["U54CA287392"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2026,8,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Oral nicotine pouch (ONP) use is increasing among young populations. Many ONP brands are using continuity programmes (also called \u2018rewards\u2019 or \u2018loyalty\u2019 programmes), a marketing strategy that offers points for purchase that can be redeemed for prizes. No research has examined whether awareness of ONP continuity programmes is associated with US young adult intention to use or use of these products.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Undergraduate and graduate students (N=764) from a southern US university completed an online survey. Items asked about intention to use and ever use of ONPs. Participants were also asked about their awareness of and participation with ONP continuity programmes. Relationships between awareness of continuity programmes, controlling for covariates, were examined with ever use and intention to use ONPs in the future.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Zyn Rewards (27.7%) was the most recognised ONP continuity programme. Participants most often first learnt about continuity programmes through word of mouth (31.9%) and social media influencers (27.5%). Only 1.2% ever participated in an ONP continuity programme. Gender, fraternity\/sorority membership and socioeconomic status were all associated with intention to use ONPs. Awareness of an ONP continuity programme was associated with higher odds of intention (adjusted OR (aOR)=4.79 (2.73 to 8.39)) and ever use (aOR=3.99 (2.62 to 6.08)) of ONPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>US college students are aware of ONP continuity programmes, and awareness is associated with intention to use and ever use of ONPs. State and federal agencies are authorised to regulate tobacco marketing, and consumer protections should monitor social media influencers\u2019 promotion of ONP continuity programmes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2026-060300","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T17:20:18Z","timestamp":1788196818000},"page":"tc-2026-060300","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Oral nicotine pouch continuity programmes and US college students\u2019 intention to use"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1913-6488","authenticated-orcid":false,"given":"Page","family":"Dobbs","sequence":"first","affiliation":[{"name":"Health Behavior and Health Education Department, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2213-1015","authenticated-orcid":false,"given":"Tong","family":"Lin","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, Ohio, USA"},{"name":"School of Journalism and Mass Communications, University of South Carolin, Columbia, South Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4743-2145","authenticated-orcid":false,"given":"Megan E","family":"Roberts","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"2026083110201033000_tc-2026-060300v1.1","doi-asserted-by":"crossref","DOI":"10.1136\/tc-2024-059222","article-title":"Trends of oral nicotine pouch prices and sales by product characteristics in the USA, 2021-2024","volume":"12","author":"He","year":"2025","journal-title":"Tob Control"},{"key":"2026083110201033000_tc-2026-060300v1.2","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2025.6739","article-title":"Nicotine Pouch and E-Cigarette Use and Co-Use Among US Youths in 2023 and 2024","volume":"8","author":"Han","year":"2025","journal-title":"JAMA Netw Open"},{"key":"2026083110201033000_tc-2026-060300v1.3","doi-asserted-by":"crossref","DOI":"10.1016\/j.pmedr.2023.102239","article-title":"Patterns of oral nicotine pouch use among U.S. adolescents and young adults","volume":"34","author":"Patel","year":"2023","journal-title":"Prev Med Rep"},{"key":"2026083110201033000_tc-2026-060300v1.4","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1080\/07448481.2025.2552837","article-title":"Oral nicotine pouches have arrived at U.S. college campuses","volume":"74","author":"Roberts","year":"2026","journal-title":"J Am Coll Health"},{"key":"2026083110201033000_tc-2026-060300v1.5","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s10900-026-01577-8","article-title":"Nicotine Pouch Awareness, Susceptibility, and Use Among California College Students","volume":"51","author":"Satybaldiyeva","year":"2026","journal-title":"J Community Health"},{"key":"2026083110201033000_tc-2026-060300v1.6","unstructured":"US Food and Drug Administration . 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