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Factors associated with considering switching to nicotine pouches among US adults who smoke

2026/03/07 by Juhan Lee, Rachel N. Cassidy · 1 voice
Medicine · Biochemistry, Genetics and Molecular Biology · #Smoking Behavior and Cessation #Nicotinic Acetylcholine Receptors Study #Substance Abuse Treatment and Outcomes

paper · doi:10.1016/j.dadr.2026.100420

openalex publication_date 2026/03/07 · openalex created_date 2026/03/08 · openalex updated_date 2026/08/01

Abstract

Oral nicotine pouches (ONPs) have gained popularity in recent years and are more popular among people who smoke. As ONPs are less harmful than cigarettes, understanding what factors are associated with considering switching to ONPs is critical. This study aims to examine the factors associated with consideration of switching from smoking to ONPs among US adults who smoke. Using data from the Wave 7 (2022-2023) of the Population Assessment of Tobacco and Health (PATH) Study (N=6315), we analyzed a sample of adults who currently smoke. The outcome was whether participants had considered switching from smoking to nicotine pouches, and a priori predictors were age, sex, race, ethnicity, income, sexual identity, region, internalizing/externalizing tendencies, current use of e-cigarettes, smokeless/snus, nicotine pouches, days of cigarette smoking, and having tried to quit cigarette smoking. Among adults who currently smoke in Wave 7 (N = 6315), 122 (weighted %=1.7) reported having considered switching from smoking to ONPs (outcome). In the adjusted model, considering switching was more likely to be associated with being male (vs. female) (aOR=2.75, 95%CI=1.44–5.24), non-Hispanic (vs. Hispanic) (aOR=3.33, 95%CI=1.27–8.70), sexual minorities (vs. heterosexual) (aOR=2.54, 95%CI=1.08–5.99), currently using nicotine pouches (vs. no) (aOR=30.50, 95%CI=13.08–71.10), and having attempted to quit cigarette smoking (vs. no) (aOR = 2.10, 95% CI = 1.14–3.89). This study identified factors associated with having considered switching to ONPs among U.S. adults who smoke. Policymakers and clinicians should also consider these subgroups when developing and implementing ONP-related policies and guidelines. • Switching from cigarettes to oral nicotine pouches was more considered by males and non-Hispanic. • Switching from cigarettes to oral nicotine pouches was more considered by sexual minorities and current nicotine pouch users. • Switching from cigarettes to oral nicotine pouches was more considered by those who have attempted to quit cigarette smoking.

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