Mark Oates 16 January 2025

 

UVA Health has published a new paper titled Nicotine Pouch Use Among US Military Personnel. As the name suggests, it examines pouch use among serving US troops. Naturally, a raft of negative press releases and articles followed, with screeching headlines such as U.S. Soldiers 10 Times More Likely to Use Addictive Nicotine Pouches.

Read the press release from UVA Health, and you’d get the impression that pouches are the biggest existential threat to soldiers in the US. Take this paragraph, for example:

Nicotine pouch use grew in popularity during the survey period, as 24.7% of soldiers queried in 2023 reported using nicotine pouches compared with 20.2% in 2022. The highly addictive pouches have been linked to cardiovascular risks, lung and stomach problems, gum ulcers, oral health issues and other concerns, including nicotine’s ability to promote the growth of cancer.

None of these health claims are supported. The subject of the study was purely about nicotine pouch prevalence, but UVA Health couldn’t help themselves. Particularly galling is the suggestion that nicotine promotes the growth of cancer, which is speculative at best and most likely total nonsense.

The paternalistic framing of the research is hard to stomach. It’s also a bit silly. The fact that US Military personnel pouches use is growing is not a concern. Instead, it’s something everyone should be happy about, especially if it helps drive down both smoking prevalence or the volume of cigarettes that each individual uses daily.

Let’s look at the reasons behind pouch users’ over-representation in the military.

Soldier holding a nicotine pouch in a military setting.

#1. The military is creating smoke-free environments

Over the last few decades, the military has prioritised creating smoke-free environments. While Designated Tobacco Use Areas (DTAs) exist, they’re outdoors and must be at a minimum of 50 feet from building entrances and air intake ducts.

It shouldn’t come as a shock that pouch use has grown in these spaces. Pouch use is discreet, doesn’t affect others, and promotes smoke-free environments.

#2. Nicotine has performance benefits

As we know from football in the UK, pouches are frequently used by young, athletic, high-performing men. While anti-nicotine groups are loath to admit it, the reason lies in the fact that these products improve focus, memory, attention, mood, and more.

Military personnel are among the fittest and most monitored segments of society. If pouches were adversely affecting their performance, we would know about it. Researchers wouldn’t be reduced to speculative claims of “associations” with poor health outcomes.

It’s obvious that nicotine has utility. Leveraging the benefits without the adverse side effects associated with combustible cigarettes is smart.

#3. Military personnel traditionally embrace nicotine

In 1980, 51% of army personnel used cigarettes. That number has dramatically declined in the intervening decades and dropped to about 26.7% by 2011, according to the Truth Initiative. More recent data suggest it’s held steady in recent years at around 28%.

There are many factors involved here, including demographics, workplace stress, and even organisational culture.

Per the UVA Health survey, 46% of army personnel are dual users (i.e., pouches and cigarettes). The focus here should be on encouraging the transition away from cigarettes, not scaremongering articles that excessively focus on pouches instead of cigarettes.

#4. The army skews young and male

Another reason why comparisons with the general population are kind of pointless is that military personnel are generally young and male. Representatives of this group are more likely to use other forms of tobacco and nicotine, so the numbers will always be lopsided.

Peer use, rather than advertisements, drives the adoption of products like pouches. This effect is amplified in tight-knit groups. Instead of focusing on the number of servicemembers using pouches, health groups should consider why they’re growing in popularity by talking to users.

Final thoughts

UVA Health’s focus on nicotine pouches is reckless. Attacking the safest way of consuming nicotine is incredibly misguided, especially when cigarettes are a bigger problem, both in volume and lethality. Expect more similar articles and research like this as pouches become tobacco control’s newest enemy and, not uncoincidentally, a very reliable source of research funds.