Oral Nicotine Product Use in Emerging Adults: Intersection with Sociodemographics, Other Nicotine Use, Withdrawal, and Dependence.

BACKGROUND

Sales, marketing, and use of nicotine pouches have grown substantially in the US, yet understanding of emerging adults' use of these products is limited.

OBJECTIVES

The present study examined sociodemographic characteristics associated with pouch use, pouch use frequency and e-cigarette attempts, and nicotine withdrawal and dependence, cannabis, and alcohol use among students using different combinations of nicotine products.

METHODS

Participants (N = 4,375; Mage = 19.34, Range 18-30; 76% female; 62% White) from six US colleges/universities completed an online survey.

RESULTS

Lifetime pouch use was 10.9% (n = 475); 34% (n = 183) reported past 30-day use. A binary logistic regression showed that male sex (vs. female); conservative (vs. liberal); Northeast or Mountain West (vs. Mid-Atlantic) US region; and a history of e-cigarette or combustible use were associated with a greater likelihood of lifetime pouch use. Identifying as a sexual minority (vs. heterosexual); middle class (vs. wealthy); or as a racial/ethnic minority (vs. white) was associated with a lower likelihood of use. A chi-square showed past 30-day pouch use was associated with using oral nicotine products for e-cigarette or combustible cessation. One-way ANOVAs showed more e-cigarette quit attempts among students with past 30-day pouch use (vs. no history). ANOVAs indicated that students reporting past 30-day nicotine polyproduct use (pouch/e-cigarette/combustible) had more binge drinking days and withdrawal compared to students who only used e-cigarettes, but no differences in dependence.

CONCLUSIONS

Students may benefit from programming addressing risks of polyproduct use, support in managing withdrawal symptoms, and information about pouches in campus-based intervention programs.