Oral nicotine pouch use motives and dependence among individuals who use both cigarettes and e-cigarettes

The motives for oral nicotine pouch (ONP) use among individuals who smoke cigarettes and use e-cigarettes are not well understood beyond cessation-related reasons. This study compared a range of ONP use motives among adults who concurrently smoke and use e-cigarettes and examined the associations between the motives and ONP dependence.

Cross-sectional self-report data were collected from 297 adults (mean age = 33.8 years, SD = 5.1; 35% women) who reported past-30-day cigarette smoking, e-cigarette use, and ONP use.

Motives such as using ONPs in places or situations where smoking or vaping is not possible, for stimulation, fun, or flavors were endorsed more strongly than motives related to quitting smoking or vaping. After accounting for demographic variables and e-cigarette and cigarette dependence as covariates, cessation-related motives explained 6-8% of the variance in ONP dependence, while use of ONP for stimulation, to get along with friends, and to increase energy for physical activity, each explained 13-15%. The composite motive score was significantly and positively associated with higher ONP dependence.

ONP use among those engaging in dual use of cigarettes and e-cigarettes is driven by motives not limited to cessation, some of which are more strongly associated with ONP dependence.