Oral nicotine pouch use in Great Britain: a repeat cross-sectional study, 2020-25
Abstract
BACKGROUND
Global oral nicotine pouch sales have grown rapidly in recent years, but population-level patterns of use remain poorly described. The aim of this study is to examine recent trends in nicotine pouch use in Great Britain.
METHODS
We used data from the Smoking Toolkit Study, a representative monthly cross-sectional survey of tobacco and nicotine use in Great Britain, collected between October, 2020, and March, 2025 (recruiting around 2450 participants per month). Participants were aged 16 years or older (16-17-year-olds included from January, 2022). Nicotine pouch use was self-reported through questions on current use of various nicotine and tobacco products. We estimated trends in the prevalence of current nicotine pouch use, overall and stratified by sociodemographic characteristics and other nicotine product use, as well as trends in the use of pouches to aid quitting smoking. All reported percentages are survey-weighted.
FINDINGS
A total of 127 793 individuals were included in this study. Among adults, nicotine pouch use increased from 0·1% (95% CI 0·1-0·2) in October, 2020, to 1·0% (0·8-1·2) in March, 2025. From 2022, increases were concentrated among young people: in 16-24-year-olds, use rose from 0·7% (0·4-1·4) in January, 2022, to 4·0% (2·9-5·5) in March, 2025, with no meaningful change in those aged 35 years and older. Use was higher among men, especially 16-24-year-old men (7·5%, 6·0-9·4 in March, 2025) and those who smoke or vape, but similar across…
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