PMID- 37712111
OWN - NLM
STAT- MEDLINE
DCOM- 20240124
LR  - 20240304
IS  - 1469-994X (Electronic)
IS  - 1462-2203 (Print)
IS  - 1462-2203 (Linking)
VI  - 26
IP  - 2
DP  - 2024 Jan 22
TI  - A Cross-Sectional Survey on Oral Nicotine Pouches: Characterizing Use-Motives, 
      Topography, Dependence Levels, and Adverse Events.
PG  - 245-249
LID - 10.1093/ntr/ntad179 [doi]
AB  - INTRODUCTION: Oral nicotine pouches (ONPs) contain a crystalized nicotine powder 
      instead of tobacco leaves. ONPs come in a variety of flavors and are often 
      marketed as "tobacco-free," but research on ONP use-motivations and related 
      experiences is limited. AIMS AND METHODS: This cross-sectional web-based survey 
      collected self-report data on ONP use-characteristics (eg, frequency), brands and 
      flavors used, use-motivations, dependence (Fagerstrom Test for Nicotine 
      Dependence-Smokeless Tobacco [FTND-ST]), and ONP-related adverse events (AEs) 
      experienced. RESULTS: The sample included 118 adults who reported current (past 
      30-day) ONP use. On average (SD), participants reported ONP use on 13 (6) days 
      during the past month. Most participants (% of the sample) also reported the use 
      of tobacco cigarettes (74%) and/or electronic cigarettes (53%) during the past 
      month. Zyn (27%) and Lucy (19%) were the most currently used ONP brands with mint 
      (23%) and tobacco (16%) as the most currently used flavors. The availability of 
      preferred flavors was the most frequently reported (31%) ONP use-motivation. The 
      sample demonstrated significant dependence levels (FTND-ST = 7, SD = 2). Reported 
      AEs included mouth lesions (48%), upset stomach (39%), sore mouth (37%), sore 
      throat (21%), and nausea (9%). Results should be interpreted in the context of 
      study limitations, including using a relatively small and homogeneous online 
      convenience sample. Acknowledging the limitations, this sample was deemed 
      appropriate to include considering the novelty of the findings, the dearth of 
      related research, and the necessity of examining foundational ONP 
      use-characteristics (eg, topography, AEs); however, future research should 
      consider recruiting larger and more generalizable samples. CONCLUSIONS: The 
      availability of preferred flavors was a key ONP use-motivation in this sample. 
      Mint and tobacco were the most currently used flavors, with Zyn and Lucy being 
      the most currently used ONP brands. Participants reported dependence and a 
      substantial number of ONP-related AEs. Nationally representative surveys should 
      investigate ONP use along with outcomes included in the current study (eg, AEs) 
      to inform ONP surveillance and policy development efforts. IMPLICATIONS: This 
      study is among the first to assess reasons for initiating/maintaining ONP use as 
      well as other relevant use-experiences (eg, AEs, dependence). These results 
      highlight the role of flavors and nicotine dependence in ONP use, which are 
      important considerations for informing ONP regulations.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      Society for Research on Nicotine and Tobacco. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - Dowd, Ashley N
AU  - Dowd AN
AUID- ORCID: 0000-0001-9399-0012
AD  - Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School 
      of Medicine, Baltimore, MD, USA.
FAU - Thrul, Johannes
AU  - Thrul J
AUID- ORCID: 0000-0001-8929-9579
AD  - Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 
      Baltimore, MD, USA.
AD  - Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
AD  - Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC, 
      Australia.
FAU - Czaplicki, Lauren
AU  - Czaplicki L
AUID- ORCID: 0000-0002-7496-0990
AD  - Department of Health, Behavior and Society, Johns Hopkins University School of 
      Public Health, Baltimore, MD, USA.
FAU - Kennedy, Ryan D
AU  - Kennedy RD
AUID- ORCID: 0000-0002-9448-5234
AD  - Department of Health, Behavior and Society, Johns Hopkins University School of 
      Public Health, Baltimore, MD, USA.
FAU - Moran, Meghan B
AU  - Moran MB
AUID- ORCID: 0000-0001-6745-6668
AD  - Department of Health, Behavior and Society, Johns Hopkins University School of 
      Public Health, Baltimore, MD, USA.
FAU - Spindle, Tory R
AU  - Spindle TR
AD  - Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School 
      of Medicine, Baltimore, MD, USA.
LA  - eng
GR  - R01 DA055962/DA/NIDA NIH HHS/United States
GR  - T32DA07209/DA/NIDA NIH HHS/United States
GR  - FD/FDA HHS/United States
PT  - Journal Article
PL  - England
TA  - Nicotine Tob Res
JT  - Nicotine & tobacco research : official journal of the Society for Research on 
      Nicotine and Tobacco
JID - 9815751
RN  - 6M3C89ZY6R (Nicotine)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Nicotine/adverse effects
MH  - *Tobacco Use Disorder/epidemiology
MH  - Cross-Sectional Studies
MH  - Motivation
MH  - *Electronic Nicotine Delivery Systems
MH  - *Tobacco Products
PMC - PMC10803111
COIS- MBM served as a paid expert witness in litigation sponsored by the Public Health 
      Advocacy Institute against RJ Reynolds. The remaining authors have no conflicts 
      of interest to declare related to this work.
EDAT- 2023/09/15 06:42
MHDA- 2024/01/24 06:43
PMCR- 2024/09/15
CRDT- 2023/09/15 04:04
PHST- 2023/06/28 00:00 [received]
PHST- 2023/09/06 00:00 [revised]
PHST- 2023/09/13 00:00 [accepted]
PHST- 2024/09/15 00:00 [pmc-release]
PHST- 2024/01/24 06:43 [medline]
PHST- 2023/09/15 06:42 [pubmed]
PHST- 2023/09/15 04:04 [entrez]
AID - 7274329 [pii]
AID - ntad179 [pii]
AID - 10.1093/ntr/ntad179 [doi]
PST - ppublish
SO  - Nicotine Tob Res. 2024 Jan 22;26(2):245-249. doi: 10.1093/ntr/ntad179.