Nicotine Pouch Awareness, Susceptibility, and Use Among California College Students

Research about perceptions and use of nicotine pouches among young adults is limited. This study assessed changes in awareness, susceptibility, and use of nicotine pouches among college-enrolled young adults. The analysis pooled data from two independent, cross-sectional surveys of California college students (n = 9,606, ages 18-24) in 2022 and 2024. Outcomes were nicotine pouch awareness, susceptibility to use, ever and current use, all dichotomized and modeled as a function of survey year, student demographics, and college type (four-year vs. community college). In 2024, college students' awareness of nicotine pouches was 66.9%, susceptibility was 31.7%, ever use was 15.1%, and current use was 11.5%. All outcomes increased between years. In adjusted models including interactions with survey year, increase in nicotine pouch awareness (aOR = 2.20; 95% CI: 1.81, 2.67) was significantly higher among sexual/gender minority (SGM) students (aOR = 1.28; 95% CI: 1.07, 1.71) compared to heterosexual men and was attenuated among students at community colleges (aOR = 0.80; 95% CI: 0.67, 0.95) compared to four-year colleges. Ever use of nicotine pouches nearly doubled (aOR = 1.97; 95% CI: 1.71, 2.28). Increase in current use (aOR = 3.28; 95% CI: 2.32, 4.65) was attenuated among Hispanic/Latinx students (aOR = 0.66; 95% CI: 0.44, 0.99) compared to non-Hispanic/Latinx White students. Increasing awareness, susceptibility, and use of nicotine pouches among California college students raise important considerations for tobacco control. Prevention and cessation efforts should be informed by an escalated increase in awareness among students identifying as SGM and students attending a four-year university (vs. community college).