- Nearly half of participants who smoked at the start of the study were not smoking after 10 weeks.
- Weekly cigarette use among participants fell from 15.9% to 8.1%.
- Almost a quarter of users switched completely from other tobacco products to nicotine pouches.
- Researchers found cigarette and smokeless tobacco use “meaningfully decreased” over time.
A U.S. study tracking adult users of nicotine pouches has found that nearly half of those who smoked at the start of the research had stopped smoking by the end of a 10-week period.
Tracking real-world nicotine use
The research, published this month in the medical journal Cureus, followed 346 adult users of ZYN nicotine pouches between November 2017 and April 2018.
Participants were recruited in 11 western states where the product was first sold and recorded their daily use of cigarettes, vapes, smokeless tobacco and other nicotine products through online diaries.
The study was observational and did not include a control group. Instead, researchers monitored how people who were already using nicotine pouches changed their habits over time.
All analyses were descriptive, meaning the researchers looked at patterns and trends rather than trying to prove cause and effect.
Smoking rates nearly halved
At the start of the study, 15.9 per cent of participants reported smoking cigarettes at least once a week. By week 10, that figure had fallen to 8.1 per cent.
The researchers reported that “nearly half of the participants who reported cigarette use at baseline were not smoking in week 10.”
In practical terms, smoking among this group was cut by almost half in just over two months.
Average cigarette consumption also fell steadily. Participants smoked an average of 0.56 cigarettes per day in week one, compared with 0.34 cigarettes per day by the end of the study.
Declines in smokeless tobacco and dual use
Reductions were not limited to smoking. Weekly use of moist snuff fell from 15.0 per cent of participants at the start of the study to 7.5 per cent at week 10.
Researchers also examined whether participants were using nicotine pouches alongside other products, or replacing them completely.
Over the 10-week period, exclusive use of nicotine pouches increased from 50.3 per cent to 65.6 per cent. At the same time, dual and multiple product use declined.
By the end of the study, 24 per cent of participants who had been using nicotine pouches alongside other tobacco or nicotine products reported using only nicotine pouches.
The authors wrote: “Patterns of use among early NP-Z adopters indicate that NPs can be acceptable replacements for other TNPs, particularly cigarettes and oral ST.”
Motivation to quit remained high
Participants’ intention to quit different products was measured using a standard motivation scale.
By week 10, smokers recorded an average score of 5.38 out of seven for their intention to quit cigarettes. This was higher than for any other product type measured, including vapes and smokeless tobacco.
A small number of participants quit all tobacco and nicotine use entirely. By the end of the study, 3.2 per cent had stopped using any tobacco or nicotine product.
Why participants used nicotine pouches
When asked why they used nicotine pouches, many participants said they were trying to reduce or quit smoking.
Among those who were still smoking at week 10, 84 per cent selected “Help reduce cigarette smoking,” while 60 per cent chose “Help me quit smoking.”
Other common reasons included being able to use pouches in places where smoking or vaping was not allowed, and their convenience compared with other products.
Ease of use and social acceptability were also frequently mentioned.
Limitations and caution
Almost half of those who began the study did not complete the full 10 weeks, raising the possibility of selection bias. All data was self-reported, which can be affected by memory errors. Because the research was descriptive, it cannot prove that nicotine pouches directly caused people to quit smoking.
The researchers wrote that the findings “are not representative of the whole US population” as most participants were white, male and aged over 25. Also, as all participants were early adopters of one nicotine pouch brand and were already using the product before the study began, the results are “only generalisable to U.S. adults who were early adopters.”
Implications for harm reduction
Despite these caveats, the authors argue that their findings support the potential role of nicotine pouches in tobacco harm reduction.
In their conclusion, they said: “Most participants were not smoking cigarettes at the time of the survey, but those who were expressed a high intention to quit smoking, and nearly half did at the end of the 10-week observation period.”
They added that the results “suggest that NP-Z can serve as a harm reduction option for people who smoke or use oral ST and would otherwise continue using their respective TNPs.”
The researchers called for larger and longer-term studies to assess whether these changes last and whether nicotine pouches can help more smokers switch away from cigarettes over time.
As national surveys have only recently begun tracking nicotine pouch use, they said continued monitoring will be essential to understand the products’ long-term impact on public health.
