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Alalwan MA, Mays D, Berman ML, El-Hellani A, Keller-Hamilton BL, Brinkman MC, Wagener TL, Tackett AP. Oral nicotine pouch manufacturer's reduced exposure claims require evidence and regulatory oversight. Tob Control 2024:tc-2024-058610. [PMID: 38702185 DOI: 10.1136/tc-2024-058610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Affiliation(s)
- Mahmood A Alalwan
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Darren Mays
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Micah L Berman
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
- Division of Health Services Management and Policy, The Ohio State University College of Public Health, Columbus, Ohio, USA
- The Ohio State University Moritz College of Law, Columbus, Ohio, USA
| | - Ahmad El-Hellani
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
- Division of Environmental Health Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Brittney L Keller-Hamilton
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Marielle C Brinkman
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Theodore L Wagener
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Alayna P Tackett
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
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Hrywna M, Ozga JE, Stanton CA, Chaffee BW, Delnevo CD, Fucito LM, Jabba SV, Morean ME, Tackett AP. Prioritizing Common Terminology and Measures to Advance Research on Oral Nicotine Product Use. Nicotine Tob Res 2024; 26:645-648. [PMID: 37846819 PMCID: PMC11033571 DOI: 10.1093/ntr/ntad206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/16/2023] [Accepted: 10/12/2023] [Indexed: 10/18/2023]
Affiliation(s)
- Mary Hrywna
- Rutgers Institute for Nicotine & Tobacco Studies, New Brunswick, NJ, USA
- Department of Health Behavior, Society, & Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Jenny E Ozga
- Behavioral Health and Health Policy, Westat, Rockville, MD, USA
| | | | - Benjamin W Chaffee
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA
- Division of Oral Epidemiology and Dental Public Health, School of Dentistry, University of California San Francisco, San Francisco, CA, USA
| | - Cristine D Delnevo
- Rutgers Institute for Nicotine & Tobacco Studies, New Brunswick, NJ, USA
- Department of Health Behavior, Society, & Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Lisa M Fucito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sairam V Jabba
- Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA
| | - Meghan E Morean
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Alayna P Tackett
- Department of Internal Medicine, Division of Medical Oncology, The Center for Tobacco Research, The James – Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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3
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St Helen G. Commentary on Keller-Hamilton et al. : Oral nicotine pouches provide a less controversial route for tobacco harm reduction than electronic cigarettes. Addiction 2024; 119:476-477. [PMID: 38263511 DOI: 10.1111/add.16437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/03/2024] [Indexed: 01/25/2024]
Affiliation(s)
- Gideon St Helen
- Clinical Pharmacology Research Program, Division of Cardiology, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, USA
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4
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Chen DTH, Grigg J, Filippidis FT. European Respiratory Society statement on novel nicotine and tobacco products, their role in tobacco control and "harm reduction". Eur Respir J 2024; 63:2301808. [PMID: 38316440 DOI: 10.1183/13993003.01808-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/27/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Daniel Tzu-Hsuan Chen
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK
| | - Jonathan Grigg
- Centre for Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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Grandolfo E, Ogden H, Fearon IM, Malt L, Stevenson M, Weaver S, Nahde T. Tobacco-Free Nicotine Pouches and Their Potential Contribution to Tobacco Harm Reduction: A Scoping Review. Cureus 2024; 16:e54228. [PMID: 38496069 PMCID: PMC10944327 DOI: 10.7759/cureus.54228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
Tobacco harm reduction (THR) refers to strategies designed to reduce the health risks associated with tobacco smoking but may involve continued use of nicotine and/or tobacco. Next-generation products (NGPs) are a THR alternative as they do not burn tobacco or produce smoke and deliver nicotine and have fewer and substantially lower levels of harmful chemicals compared to cigarettes. Tobacco‑free nicotine pouches (TFNPs) are an emerging category of nicotine‑containing oral products that do not combust or contain tobacco leaf. Similar to Swedish snus, TFNPs are placed between a user's lip and gum, and nicotine is absorbed through the oral mucosa rather than being inhaled. The aim of this scoping review was to systematically collate and evaluate published scientific evidence (cut‑off of 31 May 2023) identified from bibliometric databases investigating the potential of TFNPs to contribute to THR. Overall, studies examining chemical constituents indicated that the use of TFNPs may result in lower exposure to toxicants than other tobacco or nicotine-containing products, both combustible and non‑combustible. This reduction in toxicant exposure has been demonstrated by multiple human biomarker studies and in vitro toxicological assessments to translate to harm reduction potential in smokers switching to TFNPs. However, further study is warranted. At present, there is some evidence from human behavioral research that TFNPs can support either transitioning away from smoking or reducing cigarette consumption. Furthermore, TFNP use appears very much limited to current users of traditional tobacco products, and youth uptake has been limited. In conclusion, the findings of this review indicate that TFNPs have the potential to support THR efforts and may help inform evidence‑based regulation.
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Affiliation(s)
- Erika Grandolfo
- Group Science and Regulatory Affairs, Imperial Brands PLC, Bristol, GBR
| | - Henry Ogden
- Group Science and Regulatory Affairs, Imperial Brands PLC, Bristol, GBR
| | - Ian M Fearon
- Scientific Research, whatIF? Consulting Ltd., Harwell, GBR
| | - Layla Malt
- Group Science and Regulatory Affairs, Imperial Brands PLC, Bristol, GBR
| | - Matthew Stevenson
- Group Science and Regulatory Affairs, Imperial Brands PLC, Bristol, GBR
| | - Sarah Weaver
- Group Science and Regulatory Affairs, Imperial Brands PLC, Bristol, GBR
| | - Thomas Nahde
- Group Science and Regulatory Affairs, Reemtsma Cigarettenfabriken, Hamburg, DEU
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Rinaldi S, Pieper E, Schulz T, Zimmermann R, Luch A, Laux P, Mallock-Ohnesorg N. Oral nicotine pouches with an aftertaste? Part 2: in vitro toxicity in human gingival fibroblasts. Arch Toxicol 2023; 97:2343-2356. [PMID: 37482550 PMCID: PMC10404181 DOI: 10.1007/s00204-023-03554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023]
Abstract
Nicotine pouches contain fewer characteristic toxicants than conventional tobacco products. However, the associated risks in terms of toxicity and addiction potential are still unclear. Therefore, endpoints of toxicity and contents of flavoring substances were investigated in this study. The in vitro toxicity of five different nicotine pouches and the reference snus CRP1.1 were studied in human gingival fibroblasts (HGF-1). Cells were exposed to product extracts (nicotine contents: 0.03-1.34 mg/mL) and sampled at different time points. Cytotoxicity, total cellular reactive oxygen species (ROS) levels, and changes in the expression levels of inflammatory and oxidative stress genes were assessed. Flavor compounds used in the nicotine pouches were identified by GC-MS. Cytotoxicity was observed in two nicotine pouches. Gene expression of interleukin 6 (IL6) and heme oxygenase 1 (HMOX1) was upregulated by one and three pouches, respectively. ROS production was either increased or decreased, by one pouch each. CRP1.1 caused an upregulation of IL6 and elevated ROS production. Toxicity was not directly dependent on nicotine concentration and osmolarity. A total of 56 flavorings were detected in the five nicotine pouches. Seven flavorings were classified according to the harmonized hazard classification system as laid down in the European Classification, Labelling and Packaging regulation. Nine flavorings are known cytotoxins. Cytotoxicity, inflammation, and oxidative stress responses indicate that adverse effects such as local lesions in the buccal mucosa may occur after chronic product use. In conclusion, flavorings used in nicotine pouches likely contribute to the toxicity of nicotine pouches.
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Affiliation(s)
- Selina Rinaldi
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), 10589, Berlin, Germany.
- Chair of Analytical Chemistry, Joint Mass Spectrometry Centre, University of Rostock, 18059, Rostock, Germany.
| | - Elke Pieper
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), 10589, Berlin, Germany
| | - Thomas Schulz
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), 10589, Berlin, Germany
| | - Ralf Zimmermann
- Chair of Analytical Chemistry, Joint Mass Spectrometry Centre, University of Rostock, 18059, Rostock, Germany
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), 10589, Berlin, Germany
| | - Peter Laux
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), 10589, Berlin, Germany
| | - Nadja Mallock-Ohnesorg
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), 10589, Berlin, Germany
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Mallock-Ohnesorg N, Rinaldi S, Malke S, Dreiack N, Pieper E, Laux P, Schulz T, Zimmermann R, Luch A. Oral nicotine pouches with an aftertaste? Part 1: screening and initial toxicological assessment of flavorings and other ingredients. Arch Toxicol 2023; 97:2357-2369. [PMID: 37389646 PMCID: PMC10404176 DOI: 10.1007/s00204-023-03538-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/06/2023] [Indexed: 07/01/2023]
Abstract
Nicotine pouches are oral products that deliver nicotine without containing tobacco. Previous studies mainly focused on the determination of known tobacco toxicants, while yet no untargeted analysis has been published on unknown constituents, possibly contributing to toxicity. Furthermore, additives might enhance product attractiveness. We therefore performed an aroma screening with 48 different nicotine-containing and two nicotine-free pouches using gas chromatography coupled to mass spectrometry, following acidic and basic liquid-liquid extraction. For toxicological assessment of identified substances, European and international classifications for chemical and food safety were consulted. Further, ingredients listed on product packages were counted and grouped by function. Most abundant ingredients comprised sweeteners, aroma substances, humectants, fillers, and acidity regulators. 186 substances were identified. For some substances, acceptable daily intake limits set by European Food Safety Agency (EFSA) and Joint FAO/WHO Expert Committee on Food Additives are likely exceeded by moderate pouch consumption. Eight hazardous substances are classified according to the European CLP regulation. Thirteen substances were not authorized as food flavorings by EFSA, among them impurities such as myosmine and ledol. Three substances were classified by International Agency for Research on Cancer as possibly carcinogenic to humans. The two nicotine-free pouches contain pharmacologically active ingredients such as ashwagandha extract and caffeine. The presence of potentially harmful substances may point to the need for regulation of additives in nicotine-containing and nicotine-free pouches that could be based on provisions for food additives. For sure, additives may not pretend positive health effects in case the product is used.
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Affiliation(s)
- Nadja Mallock-Ohnesorg
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany.
| | - Selina Rinaldi
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
- Chair of Analytical Chemistry, Joint Mass Spectrometry Centre, University of Rostock, 18059, Rostock, Germany
| | - Sebastian Malke
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Nadine Dreiack
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Elke Pieper
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Peter Laux
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Thomas Schulz
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Ralf Zimmermann
- Chair of Analytical Chemistry, Joint Mass Spectrometry Centre, University of Rostock, 18059, Rostock, Germany
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Berlin, Germany
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Shaikh SB, Newton C, Tung WC, Sun Y, Li D, Ossip D, Rahman I. Classification, Perception, and Toxicity of Emerging Flavored Oral Nicotine Pouches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4526. [PMID: 36901533 PMCID: PMC10002198 DOI: 10.3390/ijerph20054526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Oral Nicotine Pouches (ONPs) are the new form of nicotine pouches that have become a type of emerging smokeless tobacco product sold by various tobacco companies. These smokeless tobacco products are marketed for usage all over as snus containing tobacco-derived nicotine (natural) or as tobacco-free nicotine (synthetic) as substitutes for other tobacco products. Based on perception and socio-behavioral aspects, ONPs have become popular tobacco products among adolescents/young adults, and over 50% of young adult users of ONP use flavored ONPs, such as menthol/mint, tobacco, dessert/candy, and fruity, which are the most popular flavors. Various new ONP flavors are currently popular locally as well as in the online market. Tobacco, menthol, and fruit-flavored ONPs could motivate cigarette smokers to change to ONPs. METHODS We expanded our knowledge on natural/synthetic ONP flavor wheels to available data on ONPs, describing, in detail, their flavors and brands (US and Europe) in both natural and synthetic ONP categories. We classified over 152 snus and 228 synthetic ONPs into the following flavor categories: "Tobacco", "Menthol/Mint", "Fruity", "Candy/Deserts", "Drink", "Aroma", "Spices", and "Mixed Flavors". RESULTS Based on total numbers, we found the most popular ONP flavors, sold as tobacco and menthol, to be among natural ONPs; among synthetic ONPs, fruity and menthol are the most prominent flavors, with varying concentrations of nicotine and other flavoring chemicals, including coolant WS-23. We also showed possible molecular targets and toxicities, due to exposure to ONPs, activating several signaling cascades such as AKT and NF-kappaB, which might possibly lead to apoptosis and epithelial mesenchymal transition (EMT). CONCLUSIONS Considering the marketing of ONP products with various flavor profiles and with most of these products containing tobacco/menthol/fruit flavor, it is likely to have regulation and a marketing disclaimer on some of these products. Further, it would be logical to determine how the market reacts in terms of compliance and non-compliance with flavor restrictions by the regulatory agencies.
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Affiliation(s)
- Sadiya Bi Shaikh
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Chad Newton
- College of Professional Studies, Bethel University, McKenzie, TN 38201, USA
| | - Wai Cheung Tung
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Yehao Sun
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Deborah Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
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Emerging Oral Nicotine Products and Periodontal Diseases. Int J Dent 2023; 2023:9437475. [PMID: 36819641 PMCID: PMC9937772 DOI: 10.1155/2023/9437475] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/29/2022] [Accepted: 01/18/2023] [Indexed: 02/12/2023] Open
Abstract
Oral nicotine pouches are emerging as a new "modern oral" nicotine product. These prefilled pouches contain nicotine, flavorings, and filling agents that dissolve in the mouth. Nicotine can be derived from tobacco leaf or chemical synthesis. Traces of TSNAs and toxic chromium were detected in the pouch products. This raises the concern about general and periodontal health. This review aims to update the current oral nicotine products research relating to periodontal disease and its relevance in periodontal inflammation. Nicotine interacts with host cells and affects inflammatory responses to microbial challenges. It may directly or indirectly deteriorate periodontal tissues by activating nicotinic acetylcholine receptors, repressing PDL fibroblasts cells, increasing cellular ROS and cytokines/chemokines, growth factors, breaking microbiota balance, and dysregulating miRNAs expression. Studies show that appealing flavorings contained in nicotine pouches pose harm to periodontal innate immune responses and increase penetration of nitrosamines. In addition, flavored ONPs increase the risk of dual or poly-tobacco products among young adults, stacking up detrimental effects on the periodontium. Given the recent growth of users, further studies are needed to elucidate the impact of ONPs, even poly-tobacco use, on systemic and periodontal health. Moreover, policymakers should ensure to avoid generating a new wave of nicotine addiction among youths in the U.S.
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Duren M, Atella L, Welding K, Kennedy RD. Nicotine pouches: a summary of regulatory approaches across 67 countries. Tob Control 2023:tc-2022-057734. [PMID: 36750358 DOI: 10.1136/tc-2022-057734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/25/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Nicotine pouches are small, permeable pouches containing nicotine. The nicotine may either be derived from tobacco plants or synthetically produced. Nicotine pouches are available worldwide, but little is known as to how various countries regulate these products. This study summarises nicotine pouch regulatory policies across 67 countries. METHODS This research summarises insights obtained through active policy surveillance work in which we requested information on the availability of nicotine pouches and applicable policies and analysed responses from representatives of 67 countries (representatives included subject matter experts in government or civil society organisations). These countries span all WHO regions. RESULTS We found significant variation in how countries classify nicotine pouches, with many countries' current regulatory approach failing to regulate nicotine pouches that used synthetic nicotine. We found 34 countries regulate nicotine pouches with 23 of these countries' policies encompassing synthetic nicotine. Countries regulating both synthetic and tobacco-derived nicotine pouches generally (1) rely on existing policies for tobacco products and/or medicines or (2) have developed new policies or regulatory classifications that specify nicotine as the substance at issue rather than linking policies solely to tobacco. CONCLUSION Our work offers novel insight into nicotine pouch markets and national regulatory approaches. Policy approaches vary from not regulating nicotine pouches at all to banning both forms of nicotine pouches. Policies used by countries regulating both tobacco-derived and synthetic nicotine pouches offer a roadmap for how other jurisdictions can add effective guardrails to the use of these and other non-medicinal nicotine products.
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Affiliation(s)
- Michelle Duren
- Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lara Atella
- Institute for Global Tobacco Control, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kevin Welding
- Institute for Global Tobacco Control, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ryan David Kennedy
- Institute for Global Tobacco Control, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Sparrock LS, Phan L, Chen-Sankey J, Hacker K, Ajith A, Jewett B, Choi K. Nicotine Pouch: Awareness, Beliefs, Use, and Susceptibility among Current Tobacco Users in the United States, 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2050. [PMID: 36767414 PMCID: PMC9915420 DOI: 10.3390/ijerph20032050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Little is known about awareness, beliefs, and use of nicotine pouches (NPs). Data from 1583 U.S. adult (age ≥ 21 years) current tobacco users were collected in 2021. Respondents self-reported NP awareness, beliefs, use, and susceptibility as well as current tobacco product use and socio-demographics. We used weighted logistic and multinomial regression models to explore the associations between these variables. Overall, 46.6% of U.S. adult current tobacco users were aware of, 16.4% had ever used, and 3.0% currently used NPs. Younger individuals (vs. 61+ years) were more likely to have ever heard of NPs, while Black individuals (vs. White) were less likely to have ever heard of NPs. Individuals younger than 45 years (vs. 61+ years) and those using smokeless tobacco products (vs. non-users) were more likely to have ever used NPs. Additionally, younger than 45 years (vs. 61+ years) and current use of certain tobacco products (e.g., smokeless) were associated with current NP use. Holding favorable beliefs about NPs was associated with susceptibility to and more advanced NP use statuses (p < 0.05). Continuous surveillance of NP use and beliefs is important.
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Affiliation(s)
| | - Lilianna Phan
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD 20892, USA
| | - Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
- School of Public Health, Rutgers Biomedical and Health Sciences, Piscataway, NJ 08854, USA
| | - Kiana Hacker
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD 20892, USA
| | - Aniruddh Ajith
- University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
| | - Bambi Jewett
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD 20892, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD 20892, USA
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Dai Y, Jiang W, Zheng Y, He P, Zhu R, Fei J, Xu W, Liu C, Hong J. Recyclable molecularly imprinted polymers based on Fe3O4@SiO2 and PAMAM dendrimers for the determination of myosmine in cigarettes. Mikrochim Acta 2022; 189:467. [DOI: 10.1007/s00604-022-05529-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 10/04/2022] [Indexed: 11/25/2022]
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