Patterns of Emerging Tobacco Product Use Among U.S. Adults, 2019-2022.

Introduction: Quantifying the use of emerging tobacco products such as nicotine pouches (NPs) and heated tobacco products (HTPs) is crucial for informing public health interventions and measuring their potential effects on tobacco use morbidity, mortality and benefits from complete tobacco cessation.

Methods: Using data from the May 2019 and September 2022 cycles of the Tobacco Use Supplement to the Current Population Survey (TUS-CPS), we calculated U.S. population-wide estimates of ever and/or current use of NPs and HTPs by key socio-demographic characteristics, cigarette smoking status and preference of characterizing flavors in NPs. We present weighted frequencies, proportions and associated 95% confidence intervals. Analyses were conducted in 2024.

Results: In both survey cycles, a substantial fraction of adults who ever used HTPs had never smoked cigarettes (52.0% in 2019; 27.4% in 2022). Among those who currently used HTPs or NPs (2022 only), many reported having never smoked cigarettes (42.5% and 41.4%, respectively), while many also reported currently smoking (32.2% and 24.8%, respectively). We observed similar sociodemographic characteristics across use of both HTPs and NPs. Mint was the most common flavor choice among adults who currently used NPs (52.8%).

Conclusions: Continued surveillance of emerging tobacco products such as HTPs and NPs can inform public health approaches and support future research to better quantify the health consequences from these products.