Nicotine pouches are still a fringe product among Australian teenagers — but the teens who try them are almost never using pouches alone. A new study from the University of Sydney's Matilda Centre found that among adolescents who had used nicotine pouches, 82% had also vaped and 71% had smoked cigarettes.

The study, published in the Australian and New Zealand Journal of Public Health on 8 September 2026, is one of the largest recent surveys of how Australian teens combine vapes, cigarettes and pouches — and it lands in a market where pouches are already prescription-only.

What the study found

Researchers at the Matilda Centre for Research in Mental Health and Substance Use surveyed 1,848 students aged 14–18 across 20 schools in New South Wales, Queensland and Western Australia — one of the largest and most recent datasets on lifetime nicotine product use among Australian adolescents, collected after the 2024 vaping reforms.

The headline numbers:

• More than 12% of teens had used e-cigarettes at some point, almost 6% had used tobacco cigarettes, and 3.5% had used nicotine pouches.
• More than 2% had used all three — and use of each product was interrelated.
• Pouches were rarely used in isolation. Among teens who had used nicotine pouches, 82% had also vaped and 71% had smoked.
• A clear gender gap: 4.8% of males reported pouch use versus 1.5% of females — nearly three times the odds after adjustment. Male cigarette use was also higher (6.9% vs 4.1%).

Lead author Dr Lauren Gardner, a senior research fellow at the Matilda Centre, said the teenage years are "the period when the brain is most susceptible to addiction, which they can then carry for life," and that teenage boys may benefit from targeted support.

Why it matters

The pouch-relevant finding is the overlap. Regulatory debates usually treat vapes, cigarettes and pouches as separate markets with separate rules — but this data shows teenage users move across all of them. That supports the argument, made in the study's commentary by Associate Professor Raglan Maddox of the Australian National University, that prevention has to address nicotine products as a group rather than one at a time.

It also matters for Australia specifically. Nicotine pouches there can only be sold through pharmacies on prescription, under rules tightened in July 2026. A measured 3.5% lifetime-use rate among high school students — in a market with some of the strictest pouch access rules anywhere — is a data point regulators on both sides of the debate will read differently: critics of the restrictions will note prohibition has not produced zero use, while public health researchers will point to the dependence risks of any teen nicotine use.

The caveats are real and the lead author states them clearly. The survey measures lifetime use, so it can't distinguish experimentation from ongoing use, and it can't establish the order in which teens tried products. Cross-sectional data cannot show that pouches led anyone to vaping or smoking — only that the behaviours cluster.

What's next

The research team is extending the approach through its OurFutures prevention program, which targets shared risk factors across all nicotine products — peer pressure resistance, marketing literacy and help-seeking — rather than treating vaping or pouches separately. Lead author Dr Gardner called for prevention strategies that address "shared risk factors for nicotine use more broadly."

For the pouch industry, the study is a reminder that youth nicotine use is measured across the whole product category — and that any growth in teen pouch use, even from a low base, feeds directly into arguments for tighter access rules in markets still deciding how to regulate pouches.

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SOURCES:

• Gardner LA et al. "Patterns of lifetime e-cigarette, tobacco cigarette and nicotine pouch use among Australian adolescents in the period after the 2024 vaping reforms: A cross-sectional survey." Australian and New Zealand Journal of Public Health (2026). DOI: 10.1016/j.anzjph.2026.100591
• University of Sydney via MedicalXpress: "Once teens pick up any nicotine product, they're more likely to try others" (8 Sep 2026). medicalxpress.com
• The West Australian: "Aussie teens hooked on deadly mix of nicotine, study finds" (13 Sep 2026). thewest.com.au