Nicotine Pouch Use Among U.S. Adults in 2023 and 2024.

Abstract

Recent expansion of U.S. nicotine pouch marketing may increase nicotine pouch use. This study estimated U.S. adult pouch use during 2023-2024 overall and across sociodemographic, cigarette smoking, nicotine vaping, and non-nicotine substance use subgroups. Data were drawn from the nationally representative Monitoring the Future longitudinal panel 2023 and 2024 surveys (N=15,340; ages 19-65 years; 59.6% response rate conditional on Wave 1; analyzed in 2025-2026). Past 12-month and past 30-day nicotine pouch use prevalence was estimated each year in the overall sample and stratified by sociodemographic and substance use status. In the overall sample, prevalence increased from 2023 to 2024 for past 12-month (3.4%-5.9%; prevalence ratio=1.75, 95% CI=1.45, 2.13) and past 30-day (2.3%-4.2%; prevalence ratio=1.81, 95% CI=1.44, 2.27) use. Increases in past 12-month prevalence were observed across ages, sexes, and geographies and among non-Hispanic White adults. Past-12-month and past-30-day prevalences increased during 2023-2024 among adults with no past-12-month smoking, never or former vaping, current smoking, with and without current alcohol or cannabis use, and without current other non-nicotine substance use (PRs range:1.53-3.10). No significant cross-year change was observed among those with current vaping, current other non-nicotine substance use, or recent former smoking. Within-year comparisons showed a higher 2024 past 12-month prevalence among young than among older adults, males than females, non-Hispanic White than Black adults, individuals with recent smoking or vaping than those without, and those with current non-nicotine substance use than those without. U.S. adult nicotine pouch use increased from 2023 to 2024 across sociodemographic and nicotine/tobacco use statuses. Further population-level surveillance and longitudinal research on pouch use patterns are warranted.