Data from a new study suggest that nicotine pouches are being adopted primarily by people already familiar with tobacco, not by non-users. Photo credit: L.V. Olavi Rantala, CC.2.0
Nicotine pouches may be playing a role in helping some smokers and vapers move away from more harmful tobacco products, according to a large new study published in JAMA Network Open. The research, conducted by Rutgers Health and described as the first national estimate of daily nicotine pouch use in the United States, analyzed data from more than 110,000 adults surveyed by the US Census Bureau in 2022 and 2023. The findings show that while overall uptake remains low—just 2.5% of adults reported ever using pouches—use was highest among people who had recently quit smoking or vaping. According to the study, former smokers were nearly 4 times more likely to report daily pouch use than current smokers, while former vapers were close to 4 times more likely to be daily users than people still vaping. Use among people who had never consumed tobacco was virtually non-existent.
The study also found that smokeless tobacco users were more than 10 times as likely to have tried pouches, underlining their role as a potential substitute for other oral nicotine products. Demographically, non-Hispanic white men were the most likely to use pouches, and occasional smokers or vapers also showed above-average likelihood of adoption. Lead author Cristine Delnevo, director of the Rutgers Institute for Nicotine and Tobacco Studies, said the data suggest many users are turning to pouches as part of a harm reduction strategy. “Our results suggest that adults may be using nicotine pouches for harm reduction given that use is highest among those that have recently quit another tobacco product or e-cigarettes,” she said.
Nicotine pouches brands such as Velo and Zyn have grown in popularity in recent years as cigarette sales have declined. Unlike nicotine replacement therapies such as gums, patches, or lozenges, pouches are not approved for smoking cessation and cannot be marketed as such. Nonetheless, the Rutgers findings suggest they may be functioning informally as quit aids for some adults.
The researchers cautioned that questions remain about the long-term health effects of pouches. Nicotine itself does not cause cancer, but it is highly addictive and can increase blood pressure and negatively impact cardiovascular health. Another concern is the potential for uptake among youth. The Centers for Disease Control and Prevention’s 2024 National Youth Tobacco Survey reported that 1.8% of US middle and high school students said they had used pouches, up from 1.1% two years earlier. Rutgers co-author Mary Hrywna said the rise calls for vigilance. “We should always keep a watchful eye on youth tobacco-use behaviors, including use of multiple products, substitution with other products or alternative methods of finding and using flavored tobacco and nicotine products,” she said. “But for people who smoke or use other nicotine products and don’t want to stop using nicotine, switching completely from the more harmful product and moving down the risk continuum with nicotine pouches is likely good for public health.”
The study lands as the US Food and Drug Administration is moving to streamline the regulatory pathway for nicotine pouches. In September, the agency announced a pilot program to fast-track premarket tobacco product applications (PMTA) for pouches, with a focus on the most critical scientific evidence needed to assess whether marketing a product is “appropriate for the protection of public health.” The pilot will allow for more real-time interaction with applicants and aims to reduce lengthy delays that have frustrated both manufacturers and regulators. The FDA said the initiative reflects its acknowledgment of a “continuum of risk” across nicotine products, with combustible cigarettes at the most harmful end and non-combusted products like pouches posing comparatively lower risks.
The pilot comes against a backdrop of uneven progress in FDA authorizations. In January 2025, after a three-year review process, Zyn became the first nicotine pouch brand to receive an FDA marketing granted order. To date, 20 Zyn products have been authorized, but hundreds of other pouch SKU remain on the US market without formal authorization. Industry observers say the pilot could help reduce regulatory uncertainty and give both companies and consumers more clarity about which products meet FDA standards. At the same time, regulators have urged manufacturers to address risks such as accidental ingestion by children, pushing for child-resistant packaging and clearer labeling.
For now, the Rutgers study provides the clearest evidence to date that nicotine pouches may be serving as an off-label cessation tool for smokers and vapers. While public health experts remain divided on whether the benefits outweigh the risks, the data suggest that pouches are being adopted primarily by people already familiar with tobacco, not by non-users. With FDA preparing to fast-track reviews, and with only one brand so far holding an authorization, the coming year could be decisive in shaping how nicotine pouches fit into the US tobacco harm reduction landscape.