United States Youth Perspectives on Zyn Oral Nicotine Pouches

Oral nicotine pouches (ONPs) such as Zyn are a rapidly growing nicotine delivery product among US youth. Although marketed as harm reduction tools for adult smokers, little is known about how young people perceive and use ONPs.

We conducted a nationwide text message survey through MyVoice in March 2025. A total of 704 youth aged 14-24 years were asked five open-ended questions about awareness, reasons for use, attitudes, risks, and the role of physicians in addressing Zyn use. Responses underwent qualitative content analysis by a four-member research team, with summary statistics calculated for demographics and code frequencies.

A total of 622 (88%) of participants responded. Average age was 20 years (SD = 3). Most identified as female (56%) and non-Hispanic White (48%), and 30% received Supplemental Nutrition Assistance Program benefits. Few youth (3%) reported personal Zyn use and 37% reported peer use. Three main themes emerged from the data: 1) youth are exposed to Zyns through a variety of means, including friends and online sources, with peer pressure emerging as a leading factor driving use in our sample, 2) youth express ambivalence about Zyn use, and 3) youth are aware of Zyn health risks and support physician screening and counseling about Zyn use.

Youth concurrently recognize risks and perceived benefits of Zyns, suggesting that ambivalence is a factor in ONP uptake. Health-care providers have the opportunity to meet the needs of youth by screening for ONP use, clarifying misconceptions about the positives of ONPs, and integrating ONP-specific guidance into cessation interventions.