Use of nicotine pouches among adults who currently or formerly smoked cigarettes and/or vaped nicotine: findings from the 2022 and 2024 US ITC smoking and vaping surveys
Bibliographic record
Abstract
BACKGROUND: Nicotine pouches (NPs) are one of the fastest growing tobacco product categories in the United States (US). We estimated the prevalence of NP use in 2022 and 2024 among US adults with established nicotine product use. METHODS: Data are from the 2022 (n=2087) and 2024 (n=2083) US ITC Smoking and Vaping Surveys. A nationally representative sample of adults (≥18 years) who smoked cigarettes and/or vaped nicotine or quit smoking and/or vaping completed at least one survey. Using weighted data, generalised estimating equation models were applied to estimate ever-use and current use (≥monthly). Data from both surveys were pooled to examine characteristics related to NP ever-use and current use. RESULTS: Between 2022 and 2024, the prevalence of NP ever-use increased by 42% (16.1%-22.8%, p<0.001), and current use increased by 66% (4.7%-7.8%, p=0.007). NP ever-use increased significantly among all age groups, except adults aged 25-39. Current use increased among all age groups, but only significantly for adults aged 18-24 and 55+. Compared with all other age groups, adults aged 18-24 had an 11.8% greater increase in current use (p=0.045). In the pooled analyses, current NP use was significantly higher among those who were male, were using other smokeless tobacco products (p<0.001), were smoking and vaping (dual use), exclusively vaping or had quit smoking and/or vaping compared with adults who were exclusively smoking (p<0.001). There were non-significant increases in frequency of daily, non-daily and occasional use. CONCLUSIONS: We found a significant increase in NP ever-use and current use between 2022 and 2024 among adults with established nicotine product use, consistent with national sales trends. Further research is needed to determine whether adults are using NPs as a tool to quit smoking or sustain abstinence after quitting.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".