Correlates of the Use of Nicotine Pouches to Quit Other Nicotine and Tobacco Products among United States Adults: Results from the Population Assessment of Tobacco and Health Study Wave 7 (2022-2023)

Abstract

Background: As nicotine pouches are increasingly adopted as a harm reduction method for tobacco cessation, it is important to understand who incorporates nicotine pouches into cessation attempts. This preliminary study examined correlates of nicotine pouch use for tobacco cessation in a United States (US) nationally representative sample. Methods: Data were from Wave 7 (2022–2023) of the US Population Assessment of Tobacco and Health Study. Outcomes were past-12-month use of nicotine pouches to quit cigarettes or other non-electronic nicotine delivery system (ENDS) and other nicotine/tobacco products (N = 3622) and to quit ENDS (N = 1934). Predictor variables included sociodemographic, psychological, and behavioral factors. Results: Ninety individuals reported using nicotine pouches during their most recent quit attempt for non-ENDS products, while 65 individuals reported use during the quit attempt for ENDS. Multivariable regression analyses showed that males were significantly more likely to use nicotine pouches to quit non-ENDS and ENDS (Adjusted Prevalence Ratio [APR] = 2.00, 95% Confidence Interval [CI] = 1.19, 3.37; APR = 6.28, 95% CI = 2.77, 14.25). Having used other methods to quit other nicotine/tobacco products was associated with higher likelihoods of having used nicotine pouches to quit non-ENDS (APR = 2.43, 95% CI = 1.48, 4.01) and ENDS (APR = 1.95, 95% CI = 1.05, 3.61). Having used nicotine pouches to quit non-ENDS was less likely to be reported by Black individuals (APR = 0.31, 95% CI = 0.11, 0.88). Conclusions: This preliminary study observed positive associations of male gender and use of other cessation methods and a negative association of Black race with having used nicotine pouches to quit other nicotine/tobacco product use. Implications: In a national United States sample, having used nicotine pouches to quit other nicotine/tobacco product use was more likely to be associated with being male and using other nicotine/tobacco product use cessation methods, but less likely to be associated with Black race. Ongoing surveillance and research examining the health effects of nicotine pouch use is warranted, particularly regarding sex and racial/ethnic differences in nicotine pouch use as a harm reduction approach for other nicotine/tobacco product use cessation.