Introduction

Oral nicotine pouches are small, permeable bags, typically filled with nicotine and other constituents such as flavourings, that are designed to be placed between the lip and the gum [1–3]. Unlike Swedish snus, they do not contain tobacco leaf. Nicotine pouches vary in nicotine content [2,3] and in the United Kingdom (UK) there is currently little specific regulation on nicotine pouches, meaning that there is no legal limit on the amount of nicotine in a pouch and no restriction on sales to children. However, the proposed 2024−25 Tobacco and Vapes Bill will include nicotine pouches under similar legislation to tobacco cigarettes and e-cigarettes, thus prohibiting their sale to under-18s and regulating advertising/sponsorship. The Bill will also provide the government with new powers to restrict the flavours, packaging, and display of nicotine products, as well as the amount of nicotine that may be included.

Pouches are currently advertised in the UK across many channels. including on social media, through motorsports sponsorship, at music concerns and festivals, and in train stations [4]. Nicotine pouches are also sold in a variety of flavours, such as fruit flavours, mint flavours, and spice flavours (such as cinnamon and chilli) [1,3]. Numerous brands also exist and almost all are owned by tobacco or vape companies (e.g., Zyn, Velo, On!, Nordic Spirit, Tacja) [3]. In 2023, the market share was dominated by Nordic Spirit and Velo [3,5], which are owned by Japan Tobacco International and British American Tobacco, respectively.

Use of nicotine pouches is rising. Online sales of nicotine pouches grew by 82% in 2023 [5] and the UK nicotine pouch market size was estimated at £217 million in 2023 and is predicted to rise further [6]. Among adults, in 2024, prevalence of current nicotine pouch use was 0.9% and prevalence of ever nicotine pouch use was 5.4%, both with increases since 2020 [7,8]. Nicotine pouch use is more common among men, younger age groups, people from London, people who currently or formerly smoke, people who vape e-cigarettes, and people who use nicotine replacement therapies [7,9].

Industry sales data from 2023 suggest that the most popular nicotine pouch brands were Velo and Nordic Spirit, followed by Loop, On!, and Zyn [5]. The most commonly purchased nicotine pouch flavours were mint followed by berry, fruit, and citrus, and ‘extra strong’ and ‘slim’ pouches were also commonly purchased [5]. To our knowledge there are currently no independent, published survey data in the UK on the types of nicotine pouches used, or the frequency of use, among adults in the UK. Research in this area is important in light of the proposed Tobacco and Vapes Bill, as it can help inform potential government restrictions on flavours, packaging, and nicotine content, which the Bill would grant new powers to enforce.

This study therefore addresses the following research questions:

1. What are the characteristics of adults (≥18 years) who have ever used nicotine pouches in the UK?
2. Among adults who have ever used nicotine pouches, what are the most popular types of products (nicotine content, flavours, brands) used and how frequently were pouches used?

Materials and methods

Results

Overall, 28.4% (n = 842) of adults had never heard of nicotine pouches, 58.3% (n = 1730) had heard of pouches but had never used them, 10.1% (n = 299) had tried pouches but did not currently use them, 2.9% (n = 85) currently used pouches, and 0.4% did not know (n = 11) (S1 Table, Supplementary Materials).

Table 1 shows the proportion of adults who reported ever using nicotine pouches, by demographic and smoking/vaping subgroups. For both adjusted and unadjusted models, there were associations between having ever used a nicotine pouch and age group, gender, vaping status, and smoking status, such that ever use of nicotine pouches declined with age, was most common among those who identified as male, and those who currently vaped or currently smoked. Participants who currently vaped had seven times greater odds (AOR = 7.19, 95%CI = 4.80–10.75) of ever using pouches than people who had never vaped. Likewise, participants who currently smoked had six times greater odds (AOR = 5.80, 95%CI = 3.82–8.80) of ever using pouches than people who had never smoked. Differences in ever use of pouches by ethnicity or perceived financial status were not significant, but confidence intervals included the possibility of important associations.

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Table 1. Sample characteristics and prevalence of nicotine pouch use by demographic and vaping and smoking subgroups among UK adults in 2024 (N = 2,967).

https://doi.org/10.1371/journal.pone.0332962.t001

Table 2 shows the product and use characteristics of people who had ever used a nicotine pouch. Around half (49.7%) of participants reported using Nordic Spirit, with Velo (18.8%) and Zyn (16.9%) being the second and third most popular brands. Over half used mint/menthol (60.7%), with tobacco (29.2%) and fruit (25.5%) being the second and third most popular flavours; few used another flavour or did not know what flavour they had used. A third (34.6%) of participants reported using a nicotine content of 11–20 mg and just under a third (28.4%) did not know the nicotine content of the pouch that they used. Around a fifth (19.5%) of those who had ever used a nicotine pouch reported using them every day, with an additional fifth (21.9%) reporting using them a few times a week and around a quarter reporting only having tried them once or twice (25.5%).

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Table 2. Product and use characteristics of people who had ever used a nicotine pouch among adults in the UK in 2024 (N = 384).

https://doi.org/10.1371/journal.pone.0332962.t002

Discussion

Consistent with national surveys of adults [7,9], our study found that nicotine pouch use was more common among men, younger age groups, and people who currently or formerly smoke or vape. Also consistent with national surveys, use was rare among people who have never smoked and or vaped [7,9]. Future research should investigate if pouches are being used for smoking and or vaping cessation, or as a substitute or supplement to these other forms of nicotine use.

Consistent with industry market data from 2023 [5], in 2024 the majority of adults who used nicotine pouches used mint flavour (61%) and the most popular brand was Nordic Spirit (50%). Market data show that “extra strong” pouches were the most commonly sold [5], which broadly aligns with our data suggest that the nicotine strength 11–20 mg was the most commonly used (35%)—pouches described as “extra strong” by Nordic Spirit and Velo are 11 mg and 18 mg, respectively. However, many people did not know the strength of the nicotine pouch that they used (28%); this may be because people who have used them only once or twice were unaware of the strength or because nicotine strength descriptors vary from brand to brand (e.g., “extra strong” can mean 9 mg for some brands and 60 mg for others). Standardising the description of nicotine pouch strength across brands might be helpful to enable consumers to make informed decisions about their use and reduce the potential for dependency. However, the nicotine content in the pouch does not necessarily directly relate to the amount of nicotine absorbed by the user. Pharmacological studies show that the nicotine delivery of pouches also depends on several other factors including the form of nicotine used and the wetness and alkalinity of the pouch [2,11]. Therefore, two different brands of pouches with the same nicotine content could deliver vastly different amounts of nicotine to the user [12].

Several different patterns of nicotine pouch use frequency emerged, with around a quarter of those reporting ever use having only tried nicotine pouches once or twice (26%) and around half reporting use at least once a week (49%). Additional research with larger samples is required to explore the characteristics of people who use nicotine pouches regularly and the motivations for these use patterns.

This study has limitations. First, although we used quota sampling to achieve a sample nationally representative of age, biological sex, and ethnicity, our sample was skewed towards people with higher socioeconomic status and prevalence of current smoking and vaping were higher than in national surveys [7,8]. Moreover, our estimates of ever (13.0%) and current (2.9%) use of nicotine pouches were higher than in national surveys from 2024 (5.4% and 0.9%, respectively [7,8]). These differences are likely explained by our sampling methods, whereby we recruited adults from Prolific Academic’s panel into a study assessing the impact of nicotine pouch packaging, which was likely to attract people who knew about, or use, these nicotine pouches. Therefore, findings should not be used as a population prevalence estimate of nicotine pouch use in the UK. Second, due to low sample sizes of people who currently used nicotine pouches, we could not explore the characteristics of this group. Additional studies with larger numbers of current users of nicotine pouches is therefore required. Third, the survey relied on forced-choice responses and did not collect qualitative data or data on motivations for use, which would have added additional depth and should be explored in future research.

This study also has strengths. To our knowledge, this is the first survey to provide data on the types of nicotine pouch products most commonly used by adults in the UK, as well as the characteristics of users. Our sample of 384 adults who had ever used nicotine pouches allowed us to explore brand, flavour, nicotine content, and frequency of use.

Conclusions

To conclude, among a sample of adults from the UK, nicotine pouches were predominantly used by those who currently or formerly smoke or vape and were also most popular among males and younger age groups. Among adults who had ever used nicotine pouches, mint was used by the majority and the most popular nicotine content was 11–20 mg although many were uncertain about the nicotine content of their pouches. Frequency of use varied substantially, with around a quarter of adults who had ever used nicotine pouches having only tried them once or twice and around half reporting regular (i.e., at least weekly) use.

Supporting information