Patterns and Perception of Nicotine Pouches Use Among Adults in Saudi Arabia

Background Nicotine pouches (NPs) are smokeless, tobacco-free products gaining global popularity, particularly among youth, for perceived harm reduction. However, many concerns remain regarding their side effects, addictive potential and cardiovascular risks as they avoid the inhalation of smoke but still pose toxicity. Research on NP use patterns in regions such as Saudi Arabia is lacking. Methods A cross-sectional survey was conducted online from March to August 2025 targeting NP users aged 18 years or older in Saudi Arabia. The employed questionnaire evaluated demographics, usage habits, health impacts, dependency levels and risk perception. Descriptive statistics and Chi-square tests ( P < .05) were used to analyze the collected data. Results Most participants were male (92.17%), aged 18-24 (46.18%), and Saudi (97.85%), with 88.45% reporting no chronic disease. Nearly half were former smokers (49.51%), 29.35% current, and 21.14% never smokers. The most used NP strength was 10 mg (59.16%), with 61.45% using 1-5 pouches/day; 72.41% reported adequate craving control. Main perceived benefits included being smoke-free (61.45%), odor-free (61.25%), and aiding cessation (58.12%). Common symptoms were nausea (47.55%) and dizziness (32.68%). Craving control was associated with dosage ( P = .018), dependence with perceived advantages ( P < .001), and quitting intentions with smoking status ( P < .001). Conclusion Nicotine pouch consumption in Saudi Arabia is prevalent among young current and former smokers, valued for perceived safety, affordability, and cessation support. Stronger strengths and frequent use correlated with greater dependency and motivation to quit. While effective for craving control, reported side effects highlight the need to raise awareness of potential health risks from long-term use.