A new peer-reviewed study using the federal Population Assessment of Tobacco and Health (PATH) Study has produced the clearest picture yet of who actually uses oral nicotine products in the US — and nicotine pouch users look nothing like traditional smokeless tobacco users.

The paper, published in Nicotine & Tobacco Research on 6 October 2026 by researchers at the University of Southern California, compared past-30-day users of non-tobacco oral nicotine products (nicotine pouches, gums, lozenges) with users of oral tobacco (snus and other smokeless products) in a nationally representative sample of 29,705 US adults from PATH wave 7 (2022–2023).

The numbers

Past-30-day prevalence among US adults was low across the board:

• Nicotine pouches: 1.4%
• Other oral nicotine products (gums, lozenges): 0.66%
• Snus: 0.95%
• Other smokeless tobacco: 2.4%

How pouch users differ from smokeless users

The demographic gap is the story. Adults using nicotine pouches were much more likely than smokeless-tobacco users to be:

• 18–24 years old — 36.6% of pouch users vs 16.8% of smokeless users
• Female — 21.8% vs 8.6%
• College-educated — 35.2% vs 15.9%
• Living in the Western US — 29.5% vs 16.0%
• Current vapers — 37.4% vs 21.7%

Only about 15.7% of snus users had a college degree, versus 35.2% of pouch users.

The contrast with gums and lozenges is just as telling: nearly half (48.7%) of other oral nicotine product users were female, and 53.5% of them smoked cigarettes — that group overlaps heavily with smoking, while pouch users (29.8% cigarette smoking) sit between the two.

Why it matters

The authors' conclusion, in their own words: oral nicotine product use "may be expanding to populations who may otherwise not have used oral tobacco, including younger, female, and higher socioeconomic status populations."

That finding cuts both ways in the policy fight. For regulators, a product attracting young adults — especially 18–24s — who would never have picked up a snus can is exactly the pattern behind flavour-restriction and marketing proposals now moving through the EU and US statehouses. For the industry, it supports the argument that pouches are a distinct modern category, not a rebrand of dipping tobacco — with an entirely different customer base than the legacy smokeless market ZYN inherited from Swedish Match.

One caveat worth keeping straight: this is cross-sectional data (a snapshot from 2022–2023), not a cause-and-effect study, and adult pouch prevalence remains low in absolute terms at 1.4%.

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SOURCES:

• Harlow AF, Han D-H, Sussman S, Leventhal AM. "Prevalence and Characteristics of Oral Nicotine and Tobacco Product Use among US Adults." Nicotine & Tobacco Research (2026). DOI: 10.1093/ntr/ntag218 — published 6 October 2026
• All figures cited from the article's abstract as retrieved via Crossref