OBJECTIVE To document prevalence of reasons for nicotine pouch (NP) use and associations with use patterns among US youth. METHODS Data were from US youth reporting ever NP use in the nationally representative 2025 Monitoring the Future survey. We estimated (1) prevalence of 10 reasons for NP use (yes/no) and (2) association of each reason with past 30-day NP use (yes/no) and frequency (1–30 days). For comparison, we contrasted reasons for NP and e-cigarette use among youth reporting NP use (n = 57) or e-cigarette use (n = 397) on at least 10 of the past 30 days. RESULTS Among 484 respondents reporting ever NP use (6.1% of youth surveyed on NP use and reasons), the most common reasons were experimentation (32.3%), nicotine buzz (30.5%), relaxation (22.7%), appealing flavors (17.4%), convenience (16.5%), socializing (16.0%), boredom (11.7%), and ability to conceal use (11.0%). To quit smoking (6.2%) and feeling addicted (2.1%) were less common. Flavors, convenience, and feeling addicted were positively associated with both past 30-day NP use (prevalence ratios [PRs] range = 1.50–2.35) and frequency (incidence rate ratios [IRRs] range = 1.60–2.55). Nicotine buzz, relaxation, socializing, concealment, and to quit smoking were only associated with past 30-day use (PRs range = 1.57–1.85). Experimentation was inversely associated with frequency (IRR = 0.42). The prevalence of reasons overlapped between NPs and e-cigarettes, with relaxation, convenience, nicotine buzz, and flavors most prevalent among youth regularly using each product. CONCLUSIONS Prevention and regulatory strategies addressing NP use reasons, particularly flavors and convenience, are warranted. Existing effective strategies targeting youth nicotine vaping may be applicable to NP use.
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Chang et al. (2026) studied this question.
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