Oral nicotine pouches (ONPs) have become increasingly prominent in social media content, marketing campaigns, and public discourse. Sales of ONPs are rising sharply, and evidence from social media posts and anecdotal accounts suggests widespread use among young adults, particularly college students. However, research examining the prevalence of ONP use among college students remains limited. This study therefore seeks to determine the prevalence of ONP use in a large sample of U.S. undergraduate and graduate students, examine demographic and behavioral characteristics associated with use, and identify the primary motivations for using or abstaining from ONPs.
The study surveyed 578 undergraduate and 888 graduate students from a large public Midwestern university. Survey items assessed ONP usage patterns and whether participants used ONPs at least once per month (defined as current use). Current users were asked to report their primary reason for using nicotine pouches. The survey also assessed use of other tobacco products; for undergraduates, alcohol and cannabis use were additionally evaluated. Demographic characteristics and socioeconomic status were collected. For the primary analysis, descriptive statistics were calculated, and t-tests for age and chi-square tests for all other sociodemographic variables were conducted to determine whether ONP use varied by participant characteristics.
The study found that 15.4% of undergraduates and 11.4% of graduate students reported ever using ONPs, with 2.9% and 2.5% respectively reporting monthly use. Among undergraduates, ONP use was highest among Non-Hispanic White students (18.1%) and those identifying as multiracial (37.5%), varied significantly by year in school (lowest among first-years at 6.4%, highest among fourth-years at 22.1%) and socioeconomic status (9.4% in lowest SES vs. 22.1% in highest SES), and was particularly prevalent among fraternity members (41.2%). Undergraduate ONP use was also associated with binge drinking, other tobacco product use, cannabis use, and muscle training activities, but not with age or gender. In contrast, graduate students who used ONPs were significantly younger (M = 25.3 vs. 27.6 years), more likely to be male (21.3% vs. 6.7% for females), and associated with other tobacco use, though not with race/ethnicity. The primary motivation for monthly ONP use in both groups was “I like the buzz” (75.0% of undergraduates, 54.5% of graduates), with only one-third or fewer of these users also citing cessation-related reasons. Other common motivations included enhancing substance effects and reducing vaping for undergraduates, and maintaining alertness while studying for graduates. The most frequently cited reason for non-use across both samples was concern about long-term health effects (62.0% of undergraduates, 48.1% of graduates).
Takeaway: ONPs have become popular on U.S. college campuses, with recreational use (primarily for the “buzz”) concentrated among high-risk subgroups such as fraternity members and polysubstance users, necessitating targeted monitoring and health interventions to prevent escalation on college campuses.