Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;63(4):611-618.
doi: 10.1016/j.amepre.2022.04.019. Epub 2022 Jun 4.

Oral Nicotine Product Awareness and Use Among People Who Smoke and Vape in the U.S

Nicholas J Felicione  1 , Liane M Schneller  2 , Maciej L Goniewicz  2 , Andrew J Hyland  2 , K Michael Cummings  3 , Maansi Bansal-Travers  2 , Geoffrey T Fong  4 , Richard J O'Connor  2
Affiliations

Oral Nicotine Product Awareness and Use Among People Who Smoke and Vape in the U.S

Nicholas J Felicione et al. Am J Prev Med. 2022 Oct.

Abstract

Introduction: Tobacco-free oral nicotine products are an emerging class of noncombustible nicotine products. Oral nicotine product sales have increased since 2016, although little research has investigated consumer awareness, use, or correlates of oral nicotine product use. The purpose of this analysis was to assess the prevalence and correlates of oral nicotine product awareness and use.

Methods: This paper is a cross-sectional analysis of 2,507 U.S. participants from Wave 3 (February-June 2020) of the International Tobacco Control Four Country Smoking and Vaping Survey, a population-based survey of current and former cigarette smokers and nicotine vaping product users in the U.S. Oral nicotine product awareness and use prevalence were compared with those of heated tobacco products. Analyses conducted in late 2021 assessed the correlates of oral nicotine product awareness and use such as demographic characteristics, tobacco use (cigarettes, nicotine vaping products, smokeless tobacco), and tobacco quit attempts.

Results: Almost 1 in 5 respondents claimed to have heard of oral nicotine products, 3.0% reported ever use, and 0.9% were current users, all of which were lower than for heated tobacco products. Ever use of oral nicotine products was more common among younger adults (e.g., aged 18-24 years), males, and current users of smokeless tobacco. Oral nicotine product prevalence was higher among those who reported having made attempts to stop smoking or vaping.

Conclusions: Oral nicotine product use was low among current and former smokers and nicotine vaping product users. Oral nicotine product users were demographically similar to use among individuals who smoke/vape and also use smokeless tobacco. Future studies are needed to understand emerging oral nicotine products, particularly whether they are being used as product supplements (dual use), replacements (switching), or cessation aids (quitting).

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Weighted awareness, lifetime use, and current use prevalence (%) for tobacco free oral nicotine products (ONPs) and heated tobacco products (HTPs) among those who currently and formerly smoke and vape by age group.
Figure 2.
Figure 2.
ONP awareness, lifetime use, and current use prevalence (%) for those who smoke and vape who did and did not make a quit attempt in the past 24 months. ONP, oral nicotine products.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Robichaud MO, Seidenberg AB, Byron MJ. Tobacco companies introduce ‘tobacco-free’ nicotine pouches. Tob Control. 2020;29:e145–e146. 10.1136/tobaccocontrol-2019-055321. - DOI - PMC - PubMed
    1. HHS, Food and Drug Administration. Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act, as Amended by the Family Smoking Prevention and Tobacco Control Act (2016). 81 FR 28973. https://www.fda.gov/tobacco-products/rules-regulations-and-guidance/fdas.... Published September 1, 2021. Accessed May 3, 2022. - PubMed
    1. U.S. Food and Drug Administration. New law clarifies FDA authority to regulate synthetic nicotine. https://content.govdelivery.com/accounts/USFDA/bulletins/30f82ff. Accessed April 11, 2022.
    1. Czaplicki L, Patel M, Rahman B, Yoon S, Schillo B, Rose SW. Oral nicotine marketing claims in direct-mail advertising. Tob Control. In press. Online May 6, 2021. 10.1136/tobaccocontrol-2020-056446. - DOI - PMC - PubMed
    1. Lunell E, Fagerstrom K, Hughes J, Pendrill R. Pharmacokinetic comparison of a novel non-tobacco-based nicotine pouch (ZYN) with conventional, tobacco-based Swedish snus and American moist snuff. Nicotine Tob Res. 2020;22(10):1757–1763. 10.1093/ntr/ntaa068. - DOI - PubMed

Publication types