What Do We Know About the Use of Oral Nicotine Pouches? A Scoping Review of Quantitative Studies

Oral nicotine pouches (ONPs) represent a rapidly emerging nicotine product. Little is known about the current state of quantitative research regarding patterns of ONP use; perceptions and motives related to ONP use; adverse consequences of ONP use; and use of ONPs relative to other tobacco products. To address this gap, this review aimed to summarize the findings of published, population-based research on ONPs. A comprehensive search of electronic databases (PubMed, Scopus, Web of Science, and Google Scholar) was conducted in March 2024 to identify relevant studies on ONP use. A narrative synthesis of the findings was performed. A total of 11 studies were identified including experimental (n=3), cross-sectional (n=7), or intervention-based (n=1). Nine to 10% of adolescents and young adults report ever using ONPs. ONP use is most common among young people who also currently smoke cigarettes or use electronic-cigarettes (e-cigarettes). Marketing messages centered around flavors and social facilitation appear to resonate with young people and experiencing pleasant flavors appears to a key motive for ONP use. Immediate adverse consequences of ONP use appear to be mild. Some evidence suggests that ONPs may be appealing as a reduced-harm alternative for habitual smokers. Evidence regarding ONP use patterns among adolescents and adults appears to be lacking. More longitudinal studies are needed to better understand the antecedents and consequences of ONP use. In addition, more studies are needed to compare the health effects of ONP vs. e-cigarettes and to better understand the dynamics of exclusive and dual use of e-cigarettes and ONP.