Nicotine Pouch Use Nearly Doubled among US Teens

Researchers Urge Awareness and Regulation Amid Surging Popularity Fueled by Social Media

The use of oral nicotine pouches – small, discreet packets placed between the gum and lip – has seen a dramatic and concerning surge among U.S. high school students, nearly doubling between 2023 and 2024. This finding comes from a significant new study led by researchers at the University of Southern California (USC), published in JAMA Network Open, raising alarms among public health officials about a rapidly growing trend among adolescents.

Analyzing survey data from over 10,000 10th and 12th graders participating in the long-running Monitoring the Future survey, the researchers found that the percentage of teens reporting nicotine pouch use jumped from 3.0% in 2023 to 5.4% in 2024. Increases were also observed in past-30-day and past-12-month usage rates.

“This growing public health issue needs more attention. Like flavored e-cigarettes when they first emerged, use of this new oral nicotine product is becoming more widespread, particularly among adolescents,” warned Dae-Hee Han, PhD, the study’s first author and a postdoctoral scholar at the Keck School of Medicine of USC.

Context: “Zynfluencers” and Regulatory Landscape

This sharp rise coincides with the surging popularity of brands like Zyn, heavily promoted on social media platforms through a wave of young influencers, sometimes dubbed “Zynfluencers.” These online personalities often associate pouch use with positive attributes like confidence, focus, and masculinity, potentially masking the inherent risks of nicotine addiction. This trend has prompted calls for stricter regulation from health organizations such as the American Heart Association and the Campaign for Tobacco-Free Kids.

The regulatory environment surrounding these products is complex. In January 2025, the U.S. Food and Drug Administration (FDA) authorized the marketing of several Zyn flavored nicotine pouch products specifically for adults aged 21 and older. The FDA’s rationale centered on the potential for these products to serve as a less harmful *alternative* for adult smokers currently using combustible cigarettes. However, it’s crucial to note that nicotine pouches are **not** FDA-approved as official smoking cessation products like nicotine gum or patches. Adding another layer of complexity, a separate 2024 USC study found that less than 1% of U.S. adults reported using nicotine pouches, raising significant questions about who constitutes the primary market for these rapidly proliferating products.

Trends in Use: Vaping Declines Slightly, Dual Use Increases

Interestingly, the USC study found that while nicotine pouch use soared, teen vaping (e-cigarette use) saw a slight decrease during the same period. In 2024, 17.6% of surveyed teens reported vaping in the past 12 months, down from 20% in 2023. However, the data also revealed a concerning increase in dual use – teens using both e-cigarettes and nicotine pouches. In 2024, 3.6% reported using both products in the past year, up from 2.1% in 2023. Lifetime use of both products also increased significantly.

The study identified specific demographic groups at higher risk for nicotine pouch use: males, non-Hispanic white teens, and those living in rural areas. Researchers noted this profile mirrors traditional users of smokeless tobacco products like chewing tobacco, suggesting that prevention strategies may need tailoring to these specific groups, potentially differing from anti-vaping campaigns.

Health Concerns and Calls for Action

While marketed as tobacco-free, nicotine pouches deliver nicotine, a highly addictive substance. The long-term health effects of using these products, especially starting in adolescence, remain largely unknown. Documented side effects include mouth sores and gum irritation. More broadly, health experts consistently warn that nicotine exposure during adolescence can harm the developing brain, potentially leading to long-term issues with learning, memory, and attention.

“Parents, teachers, and pediatricians should be aware that teen nicotine pouch use is increasing across the nation,” urged Adam Leventhal, PhD, the study’s senior author and executive director of the USC Institute for Addiction Science. “To reverse this trend, we need to heighten public awareness about pouches and educate youth about them. Policymakers might also consider ramping up regulation of the booming pouch market—including cinnamon, fruit and other attractive flavors—to protect youth.”

Data Interpretation and Future Needs

The researchers highlighted a nuance in data interpretation relevant to the FDA’s authorization decision. While the FDA partly relied on data from the National Youth Tobacco Survey (NYTS), which found a non-statistically significant increase in past-month teen pouch use between 2023 and 2024, both the NYTS and the USC-led Monitoring the Future survey did find significant increases in lifetime use among high school students during that period. The USC researchers argue that tracking lifetime and past-year use is critical for understanding experimental use trends, which the FDA decision did not fully address.

Continued monitoring of nicotine pouch use in 2025 and beyond will be crucial to assess the real-world impact of the FDA’s marketing authorization. The researchers call for future studies focusing on long-term usage trends, initiation patterns, varying nicotine concentrations in products, potential health consequences, and the effectiveness of different prevention and regulatory strategies, particularly for high-risk youth groups.

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Matthew Ma

Marketing at Ecigator

With over a decade of experience in the e-cigarette industry, Matthew Ma is a seasoned expert in both the manufacturing and usage aspects of vaping products. His extensive background has provided him with a deep understanding of the intricacies and evolving dynamics of e-cigarettes.