Nicotine & Tobacco Research最新文献

Introduction: Oral nicotine pouches (ONPs) are increasingly prevalent among young people and feature widely within social media content. This study systematically analyzes the most viewed videos on TikTok relating to ZYN (the most popular ONP, manufactured by a subsidiary of Philip Morris International) to understand their content sentiment and patterns, as well as the demographics and potential commercial biases of their creators.

Aims and methods: We used an Apify scraper in July 2024 to collect URLs and metadata for the top 100 most viewed videos on TikTok under the #ZYN hashtag. Profiles of content creators, plus their externally linked sites, were examined for commercial connections to ONP entities. We then undertook an inductive manifest content analysis.

Results: The top 100 TikTok videos identified garnered over 400 million views and over 3.8 million shares. A total of 10.3% (n = 9) of content creators had an external link to a website that sold ONPs. Videos predominantly indicated positive sentiment toward ZYN products or other ONPs (79%), and portrayed young men enthusing about the products, often employing humor. ZYN products are featured directly in 71% of videos. Few videos contained disclaimers or warnings about potential risks of ONPs and only 5% portrayed ZYN as a vaping or smoking cessation tool.

Discussion: Our findings suggest the most widely viewed content relating to ZYN on TikTok is overwhelmingly positive in sentiment, commonly featuring young men and often portraying ONP use in a humorous context, minimizing risks. Many content creators actively sell ONP products through TikTok, some overtly and some via external links.

Implications: ZYN oral nicotine pouches are presented positively and primarily for recreational purposes on TikTok. Few videos referenced ZYN for smoking cessation purposes or mentioned the risks of nicotine. 10.3% of the creators linked their profile to an external website selling oral nicotine pouches, which appears inconsistent with TikTok's policies. The use of humor and downplaying or omission of addiction and health risks across most of the sample echoes marketing efforts by the tobacco industry to present oral nicotine pouches as fun and safe.

Background: The public health impact of new nicotine products will depend on their use by different population groups. We assessed the prevalence of nicotine pouch use among youth and adults in Great Britain (GB).

Aims and methods: Cross-sectional annual Action on Smoking and Health Smokefree GB Adult Surveys 2020-2024 (n: 12 247 to 13 266, 18+) and Action on Smoking and Health Smokefree GB Youth Survey 2024 (n = 2872 11-18-year-olds). Weighted proportions and 95% confidence intervals for pouch ever and current use among adults over time, and in 2024 among youth and adults overall, by socio-demographics, mental health, tobacco smoking, vaping, past-12-month gambling, cannabis, and alcohol use; for youth also family members' smoking and vaping. Multivariable logistic regression assessed the association with ever pouch use.

Results: The prevalence of adult ever and current use doubled from 2020 to 2024, reaching 5.4% (95% confidence interval = 5.0 to 5.8) and 1.0% (0.8-1.1). Among youth, 3.3% (2.7-4.0) reported ever use, including 1.2% (0.8-1.6) reporting current use. Ever use was associated with the use of other addictive products. Among adults, ever use was also more common among younger groups (18-24, 25-34, 35-44 vs. 55+), males, and those in rented accommodation or receiving mental health treatment. Among youth, ever use was also more common among those in London than elsewhere in England.

Conclusions: Pouch use in GB is rare with about 1 in 100 youth and adults reporting current use. However, use appears to be increasing and is higher in some groups, including younger adults, males and people with experience of vaping, smoking, and use of other addictive products.

Implications: While currently low, close monitoring of pouch use is indicated. It is currently concentrated among those with experience of nicotine use. However, given the higher levels of use among young adults and teenagers, consideration of regulation may be required to minimize uptake among groups that would otherwise not have used nicotine-containing products.

Introduction: Oral nicotine pouches (ONPs) have steadily gained popularity since first appearing in the US market during 2014, but research on how their features are associated with consumer preference remains limited. We examined how ONP characteristics, including prices, flavors, pouches per can, nicotine concentration, and ingredient claims, are associated with online ratings (1-5 stars), which measured consumer preferences in our analysis.

Aims and methods: Data on 1689 unique ONPs from 19 brands that received reviews were scraped from 4 online stores that shipped to the United States, and we used ordinary least squares regressions to estimate associations between product features and ratings.

Results: On average, products cost $0.20/pouch and contain 19 pouches/can. Nearly half (46%) had 5 to <10 mg nicotine/pouch. The most common flavors were "fruit/sweet" (33%), "mint" (25%), and "wintergreen" (13%), while 21% of products had "ice/freeze" mentions. The brand on! accounted for 15% of products. Nicotine claims included "tobacco-free" (21%), "leaf-free" (26%), "synthetic" (8%), and multiple claims (20%). Product size was associated with lower ratings, while mint flavor was associated with higher ratings (p < .05). Product characteristics were highly correlated with brands, and the negative association between price per pouch and ratings became insignificant after adjusting for brands.

Conclusions: More pouches per can are associated with lower ratings. Sales prices vary across ONP brands, which is related to how consumers rate more expensive products. Future research should investigate how restricting mint flavor, product size, and certain brands may impact consumer preferences for ONPs and their subsequent use.

Implications: We provide novel evidence on how oral nicotine pouch (ONP) features are associated with consumer preferences, measured by online ratings (ranging from 1 to 5 stars). Larger product size (more pouches per can) is associated with lower consumer ratings, while mint flavor is associated with higher ratings. Brands are strongly correlated with ratings, impacting how consumers rate more expensive products. Restricting mint flavor, product size and certain brands may influence consumer preferences for ONPs and their subsequent use, which should be investigated in future research.

Introduction: Nicotine pouches are gaining popularity among young people. Within 5 years of their introduction, Pakistan has become the third-largest market for Velo, a leading brand among nicotine pouches. However, more information is needed to know about the availability and marketing of these products at point-of-sale (POS).

Aims and methods: In August 2023, we surveyed 711 POS across nine districts covering all four provinces of Pakistan. We collected data on the availability of different brands of nicotine pouches and their flavors, nicotine strengths, prices, and pack features. Furthermore, we recorded any POS advertising in a subsample of 382 POS.

Results: In Pakistan, nicotine pouches were available in all four provinces, eight of nine surveyed districts, and 56 of 711 (7.9%) POS. Urban settings had wider availability and more variety than rural settings. Velo, available in six flavors and three different strengths, captured 85% of the market. On average, nicotine pouches cost 133 Pakistani Rupees (standard deviation 18.9, range 100-190 PKR) or 0.44 US dollars. Display stands advertising nicotine pouches were observed in 12.3% (46/382) POS.

Conclusions: Nicotine pouches are widely available across Pakistan. A range of flavors and strengths are being sold at an affordable price, making it attractive, particularly for young people. Continued surveillance of these products is needed. Their perceptions and use, and their impact on the tobacco uptake in youth, also need further research.

Implications: We observed the widespread availability of Velo and the growing nicotine pouch market in Pakistan, underscoring the urgent need for regulation. These products appeal to youth with diverse flavors and affordability, raising concerns about experimentation leading to addiction. Policymakers must prioritize regulating manufacturing, sales, and marketing to limit youth access. Limited research in Asia necessitates longitudinal studies to explore the oral health impact of using these products. Continued monitoring of promotions at POS, along with studies on youth perceptions, usage patterns, and influence on tobacco uptake, is critical for effective policy development.

Introduction: Artificial sweeteners, sucralose and acesulfame-k, are listed as ingredients of oral nicotine pouches (ONPs), a product category with a rapidly growing market share. The exact quantities of these sweeteners in ONPs remain unknown. Artificial sweeteners in ONPs may reduce aversion, facilitate initiation, and encourage consumption behavior.

Aims and methods: Sucralose and acesulfame-k contents in major US-marketed ONP brands (Zyn, on!, and Velo) were determined by liquid chromatography-mass spectrometry. Sweetener effects on aversion and consumption of ONPs were modeled in single- and two-bottle drinking tests, offering mice ONP extracts calibrated to contain nicotine levels similar to the saliva of people who use smokeless tobacco. To examine the contribution of sweet taste perception, consumption behavior was compared between wild-type and sweet taste receptor-deficient mice (Tas1r2-/-).

Results: Acesulfame-k was detected in on!, Zyn, and Velo ONPs (~0.3 to 0.9 mg/pouch), including products marketed as "Unflavored" or "Flavor ban-approved." In Velo ONPs, sweetened with sucralose (~0.6 to 1.2 mg/pouch), higher nicotine strength products contained higher sucralose levels. Tas1r2-/- mice consumed less ONP extracts than wild-type mice in both sexes. ONP extracts with both higher nicotine and sweetener strengths were tolerated by wild-type mice, but produced stronger aversion in Tas1r2-/- mice.

Conclusions: ONPs contain significant amounts of artificial sweeteners acesulfame-k and sucralose, with some brands adding more sweeteners to higher nicotine strength ONPs. In mice, artificial sweeteners, at levels present in ONPs, increase nicotine consumption. Increasing sweetener contents facilitates the consumption of higher nicotine strength ONPs. Sweetness imparted by sweetener addition to ONPs likely reduces the aversive sensory effects of nicotine and other ONP constituents.

Implications: Artificial sweeteners such as acesulfame-k or sucralose reduce aversion and likely facilitate the consumption of ONPs. The marketing of some artificially sweetened ONPs as "Unflavored" or "Flavor ban-approved" suggests that the tobacco industry rejects sweet taste as a determinant for the presence of a characterizing flavor. Sweetness as imparted by artificial sweeteners in tobacco products needs to be addressed by regulators as a component of a characterizing flavor, with the aim to reduce product appeal and initiation by never users, and especially youth attracted to sweet flavors.

Introduction: Nicotine pouches are growing rapidly in popularity. These products have been found to contain high levels of nicotine, raising concerns about the risk of nicotine dependence and addiction. Preventing uptake of nicotine pouches, particularly among adolescents and younger adults, is thus important. However, our understanding of the factors that may be associated with susceptibility to nicotine pouch use is limited.

Aims and methods: This study sought to investigate the relative contribution of a range of factors to nicotine pouch use susceptibility among adolescents and younger adults. An online survey was administered to 817 Australian adolescents and younger adults who were aware of nicotine pouches but had not used the products previously. Regression analyses were conducted to assess the relationship between a variety of potential correlates (eg, attitudes, harm perceptions, exposure to advertising, use among family and friends) and use susceptibility (curiosity, willingness to use, and intentions to use).

Results: Among those surveyed, 66% were curious about nicotine pouches, 55% were willing to try the products if offered by a friend, and 46% intended to try the products in the next 6 months. Key correlates of susceptibility included holding a positive attitude towards nicotine pouches, lower addictiveness perceptions, use among a greater number of close friends, and current or past use of e-cigarettes.

Conclusions: Addressing attitudes and social norms relating to nicotine pouch use may be important in reducing uptake. Given use susceptibility was greater among those who currently use e-cigarettes, interventions that target the use of a range of nicotine products may be most effective at discouraging uptake.

Implications: This study identified several important correlates of susceptibility to nicotine pouch use among Australian adolescents and younger adults. Results assist with identifying those who may be at risk of future nicotine pouch use and have the potential to inform the development of prevention programs that discourage uptake.

Introduction: Nicotine pouches are the fastest-growing oral smokeless tobacco or nicotine product category in the United States, and there are concerns about their potential appeal to youth. Few studies have surveilled discussions about nicotine pouches on TikTok, an audiovisual platform popular among youth. To address this gap, this study conducted a content analysis of TikTok posts related to the leading nicotine pouch brand, ZYN.

Aims and methods: Publicly available posts (N = 665) from 10 ZYN-related hashtags were collected from the TikTok Application Programming Interface (API) between January 2023 and February 2024. The number of likes, comments, shares, and plays was collected for each post and the number of followers for each account profile was recorded. Posts were coded for themes such as product marketing and use, health warnings, and demographics.

Results: The most prevalent theme was humor (n = 581, 87.4%), followed by product use (n = 378, 56.8%), and branded merchandise (n = 378, 56.8%). Young people (ie persons in the video who appeared younger than 30) were identified in 48.3% (n = 321) of posts, and 61.5% (n = 409) of posts featured people who appeared to be male. Cessation (n = 12, 1.8%) was an uncommon theme. Most posts came from noncommercial accounts (n = 420, 63.1%), followed by commercial accounts (n = 158, 23.8%), and content creators/influencers (n = 87, 13.1%).

Conclusions: This study showed that ZYN-related posts on TikTok often featured pro-tobacco themes, such as humor and product use, while rarely mentioning anti-tobacco themes such as cessation. Future research should examine the relationship between exposure to pro-tobacco content on TikTok and tobacco-related attitudes and behaviors.

Implications: This study highlighted the potential role of TikTok in normalizing tobacco and nicotine product use, and in particular ZYN product use, including among youth. While increased enforcement of online tobacco control policies can help reduce exposure to ZYN-related content in youth, prevention programs and interventions that incorporate tobacco-related digital media literacy are needed to inoculate adolescents and young adults from the pro-tobacco content found online.

Introduction: Nicotine pouches have the potential to be used for tobacco harm reduction. Pouches can currently be sold in brightly coloured packaging with conceptual flavor and nicotine descriptors, which may appeal to youth. Therefore, the UK government are considering packaging regulations. We examined the impact of standardized packaging, limiting flavor names and standardizing nicotine descriptors on appeal and harm perceptions of nicotine pouches among adults.

Methods: A 2024 Prolific Academic online experiment among UK Adults (N = 2,967) was used. Participants were randomized to one of four packaging conditions: (1) branded, (2) standardized with usual descriptors, (3) standardized with limited flavor descriptors, and (4) standardized with limited flavor and standardized nicotine descriptors. Logistic regressions examined associations between packaging conditions and (a) no interest in trying the products displayed and (b) harm perceptions relative to cigarettes.

Results: There were no significant differences in reporting no interest in trying nicotine pouches in branded compared to standardized packaging with usual descriptors, standardized packaging with limited flavor descriptors, and standardized packaging with limited flavor and nicotine descriptors. When stratified by vaping/smoking status, participants who currently vaped had lower odds of reporting no interest in standardized packaging with limited flavor descriptors, compared to branded. There were no significant differences in harm perceptions by packaging condition.

Conclusions: Overall, standardizing packaging, limiting flavor descriptors, and standardizing nicotine descriptors had little effect on adults' interest in trying nicotine pouches or their perceptions of relative harm. There were, however, some differences by vaping status.