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. 2022 Sep 1;150(3):e2022056586.
doi: 10.1542/peds.2022-056586.

Adolescent Use of Flavored Non-Tobacco Oral Nicotine Products

Alyssa F Harlow  1   2 , Erin A Vogel  1   2 , Alayna P Tackett  1   2   3 , Junhan Cho  1   2   3 , Dae-Hee Han  1   2 , Melissa Wong  1   2 , Myles G Cockburn  1   2   3   4 , Steve Y Sussman  1   2   3 , Jennifer B Unger  1   2   3 , Adam M Leventhal  1   2   3 , Jessica L Barrington-Trimis  1   2   3
Affiliations

Adolescent Use of Flavored Non-Tobacco Oral Nicotine Products

Alyssa F Harlow et al. Pediatrics. .

Abstract

Background and objectives: Flavored non-tobacco oral nicotine products (eg, nicotine pouches and nontherapeutic nicotine gum, lozenges, tablets, gummies), are increasingly marketed in the United States. Prevalence of non-tobacco oral nicotine product use among adolescents is unknown.

Methods: We calculated prevalence of ever and past 6-month use of nicotine pouches, other non-tobacco oral nicotine products (ie, gum, lozenges, tablets, and/or gummies), e-cigarettes, cigarettes, hookah or waterpipe, cigars, cigarillos, and snus among high school students in Southern California between September and December 2021. Generalized linear mixed models tested associations of sociodemographic factors and tobacco-product use with use of any non-tobacco oral nicotine product.

Results: Among the sample (n = 3516), prevalence was highest for e-cigarettes (ever: 9.6%, past 6-month: 5.5%), followed by non-tobacco oral nicotine products (ever: 3.4%, past 6-month: 1.7%), and <1% for other products. Ever users of combustible tobacco (adjusted odds ratio [aOR] = 77.6; 95% confidence interval [CI] = 39.7-152) and ever users of noncombustible tobacco (aOR = 40.4; 95% CI= 24.3-67.0) had higher odds of ever using non-tobacco oral nicotine products, compared to never users of combustible and noncombustible tobacco. Use of any non-tobacco oral nicotine product was greater for Hispanic (versus all other races/ethnicities except Asian, aOR = 2.58; 95% CI = 1.36-4.87), sexual minority (versus heterosexual, aOR=1.63; 95% CI = 1.03-2.57), gender minority (versus male, aOR = 2.83; 95% CI = 1.29-6.19), and female (versus male, aOR=1.92, 95% CI = 1.20-3.06) participants.

Conclusions: Non-tobacco oral nicotine products were the second most prevalent nicotine product used by adolescents. They were disproportionately used by certain racial or ethnic, sexual, or gender minority groups, and those with a history of nicotine use. Adolescent non-tobacco oral nicotine product use surveillance should be a public health priority.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: The authors have indicated they have no conflicts of interest relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Examples of flavored non-tobacco oral nicotine products on the market. A, Nicotine pouches. B, Nontherapeutic nicotine gum. C, Nontherapeutic nicotine lozenges. D, Nicotine gummies.
FIGURE 2
FIGURE 2
Prevalence of ever and past 6-month use of 8 different nicotine and tobacco products among 3516 adolescents in Southern California between September and December 2021.a
See this image and copyright information in PMC

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