Awareness and Use of Vaping Products With a Nicotine Analogue Among Adolescents and Young Adults.

Abstract

E-cigarettes and other products containing synthetic nicotine analogues, such as 6-methyl-nicotine, are exempted from US premarket tobacco product application (PMTA) requirements, allowing rapid market expansion. Understanding the prevalence and correlates of adolescents' and young adults' (AYA) awareness and use of nicotine analogue products is critical for informing pediatric care, youth-focused interventions, and regulatory actions. A cross-sectional survey was conducted during May to June 2024 among US participants aged 14 to 25 years (N = 1760) oversampled with ever-tobacco-product-using AYA recruited by a convenience online sampling panel. Demographic factors, tobacco product use, and awareness and ever-use of Spree Bar and other vaping products containing "Metatine"-6-methyl-nicotine's proprietary name-were assessed. Nicotine analogue vaping product awareness and ever-use were reported by 20.1% and 8.4%, respectively, and varied by ever vs never tobacco product use (awareness: 24.4% vs 14.8%; ever-use: 14.7% vs 0.6%). Most demographic categories showed no differences, except for lower odds of awareness among all other races compared with non-Hispanic white. AYA who reported current use of any tobacco product had higher odds of nicotine analogue awareness (adjusted odds ratio [AOR], 1.74; 95% CI, 1.34-2.24) and ever-use (AOR, 24.91; 95% CI, 10.11-61.49) compared with never-use. These associations generalized across individual tobacco product types. In this nonprobability convenience US AYA sample, awareness and ever-use of 6-methyl-nicotine products were appreciable and overrepresented among tobacco product-using AYA. A nonnegligible proportion of AYA who never used tobacco were aware of nicotine analogue vaping products. Given the PMTA requirement exemption and possible addictiveness and toxicity of 6-methyl-nicotine, local regulatory actions may be needed to protect AYA from nicotine analogue products.