A busy Christmas period meant I missed a new paper on nicotine pouch use by Harry Tatan-Birch, Sarah Jackson, and others. Titled, Oral nicotine pouch use in Great Britain: a repeat cross-sectional study, 2020–25, the research looks at the growing use of pouches in the UK and what it all means for how the harm reduction product might be regulated in the future.
Let’s take a look.
The paper
The first thing to note is that the study is a repeat cross-sectional analysis of UK adults examining trends and patterns of oral nicotine pouch use over the last five years. For those who aren’t exactly sure what a repeat cross-sectional analysis is, here’s a quick breakdown:
- Cross-sectional: The study doesn’t track the same users. Instead, it takes a snapshot of people’s status at a particular time, measuring both exposure (e.g. nicotine pouch use) and outcomes (e.g. smoking status) at once.
- Repeat cross-sectional: That “snapshot” is repeated at different times over the five years, using different studies and study subjects.
This approach is a solid way to test how overall prevalence changes in the population over a few years.
Some of the headline findings from the study include:
- Overall, adult current use rose from around 0.1% in 2020 to about 1% in 2025. This suggests there are around 500k pouch users in Great Britain.
- Use is heavily skewed towards young men.
- Many pouch users also vape or smoke.
- Around 16% of current nicotine pouch users had never regularly smoked cigarettes.
Anyway, let’s dig into the study to find some interesting facts contained within.
Four interesting points from the study
There are lots of interesting data points and observations from the study’s authors, which is not surprising because it compiles research over the course of a number of years.
#1. Market growth
Since their introduction to the market in 2019, pouch use has grown remarkably. Indeed, since 2020, UK prevalence has shot from 0.1% to 1%. That’s a roughly 10-fold increase, which makes pouches an outlier among other novel nicotine products.
While some media outlets will paint this as evidence of aggressive marketing or testament to the addictiveness of a product, what it really confirms is that pouches address a clear market need for nicotine but without excessive health concerns.
#2. Young men lead the market
Per the study, about 72% of pouch users were men between 2022 and 2025. This disparity is high when compared to cigarettes. Similarly, nearly 50% of users were under 25.
Again, how these data are contextualised is up for debate. For me, it’s evidence that young men who want to access nicotine are choosing to do so in the safest way possible. In other words, there is a new nicotine culture that has emerged in recent years, which corresponds to fewer people accessing cigarettes.
#3. Never smoker uptake
As mentioned above, about 16% of surveyed pouch users have never smoked. Again, how this data is parsed is a matter of interpretation. Some will say these are people who would never have used nicotine if pouches were not available, but I don’t buy that interpretation.
Pouches, like vapes before them, offer people choice. Absent harm reduction products, a significant proportion of these people would be cigarette users. Pouches have diverted people away from cigarettes by offering a far less risky alternative.
#4. Regulatory grey area
During the period under question, pouches have occupied a regulatory gap when compared to vapes and cigarettes. The authors of the study suggest that less stringent rules on marketing, flavours, and packaging in Great Britain may have facilitated rapid uptake among younger users.
In my opinion, this is decent evidence that excessive regulations actually halt the uptake of safer products. A true free market lets adults make healthier choices about how they consume nicotine. Much depends on what the goal is: Do we want to reduce smoking? Or do we want to eliminate nicotine use? I say it should be the former.
Final thoughts
The paper provides invaluable data on the popularity of pouches in recent years. It somewhat shatters the alarmist headlines we often read about how rampant pouch use is, even among youths. The authors suggest that pouch use should continue to be monitored and that further research can help understand pouch's role in smoking cessation, because right now, strong links have not yet been established either way.
