Oral Nicotine Product Use in Emerging Adults: Intersection with Sociodemographics, Other Nicotine Use, Withdrawal, and Dependence

BACKGROUND: Sales, marketing, and use of nicotine pouches have grown substantially in the US, yet understanding of emerging adults' use of these products is limited. OBJECTIVES: The present study examined sociodemographic characteristics associated with pouch use, pouch use frequency and e-cigarette attempts, and nicotine withdrawal and dependence, cannabis, and alcohol use among students using different combinations of nicotine products. METHODS: = 19.34, Range 18-30; 76% female; 62% White) from six US colleges/universities completed an online survey. RESULTS: = 183) reported past 30-day use. A binary logistic regression showed that male sex (vs. female); conservative (vs. liberal); Northeast or Mountain West (vs. Mid-Atlantic) US region; and a history of e-cigarette or combustible use were associated with a greater likelihood of lifetime pouch use. Identifying as a sexual minority (vs. heterosexual); middle class (vs. wealthy); or as a racial/ethnic minority (vs. white) was associated with a lower likelihood of use. A chi-square showed past 30-day pouch use was associated with using oral nicotine products for e-cigarette or combustible cessation. One-way ANOVAs showed more e-cigarette quit attempts among students with past 30-day pouch use (vs. no history). ANOVAs indicated that students reporting past 30-day nicotine polyproduct use (pouch/e-cigarette/combustible) had more binge drinking days and withdrawal compared to students who only used e-cigarettes, but no differences in dependence. CONCLUSIONS: Students may benefit from programming addressing risks of polyproduct use, support in managing withdrawal symptoms, and information about pouches in campus-based intervention programs.