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BACKGROUND: Oral nicotine pouches (ONPs) have rapidly gained popularity in recent years. While ONPs likely expose users to fewer toxicants than cigarettes, they contain nicotine and may initiate, sustain or increase nicotine addiction and dependence. Monitoring the ONP marketplace is essential to inform timely regulatory action. METHODS: We used Nielsen ScanTrack data to analyse ONP sales and prices from 2021 to 2024. Joinpoint regression assessed sales and price trends, and ordinary least squares regression evaluated the association between ONP sales and product characteristics. RESULTS: Monthly ONP unit sales increased significantly, from 327 million in July 2021 to 1046 million in May 2024-more than tripling over this period (p<0.001, average monthly per cent change (AMPC)=3.45). Inflation-adjusted prices also rose, from 19 cents/pouch in June 2021 to 22 cents/pouch in May 2024 (p<0.001, AMPC=0.50). The sales of ZYN, On!, Rogue and VELO account for 99.8% of total sales. ONPs with explicit flavour descriptors outsold those with implicit flavour descriptors by more than eight times. The 'chill' flavour had also gained notable popularity. ONPs with 6 mg and 3 mg nicotine concentrations made up 68% of total sales. Additionally, ONPs with explicit flavour descriptors and higher nicotine concentrations were associated with increased sales. CONCLUSIONS: Policy-makers may need to consider the role of major manufacturers, product flavours, and nicotine content in shaping the market. Continued surveillance is warranted to assess trends in use, particularly among youth and non-tobacco users.
He et al. (Thu,) studied this question.