This study examined nicotine pouch use during smoking quit attempts in Great Britain between June 2021 and July 2026. It used a monthly cross-sectional survey of 7,995 adults who had tried to quit in the past year. Pouch use rose from 2.4% to 6.7% of quit attempts, and from 2.2% to 18.9% among 18-24-year-olds. Quit success was 33.5% with pouches versus 27.0% without, but the adjusted odds ratio was 1.15 (95% CI 0.80-1.65). Among those not also using e-cigarettes, pouch use was linked to higher quit success (adjusted OR 1.91, 1.23-2.97). Quit success was self-reported, and the cross-sectional design cannot show that pouches caused quitting.
Why it is interesting: Nicotine pouches featured in nearly one in five quit attempts by 18-24-year-olds in Great Britain by July 2026. Their overall link with quitting was uncertain, but differed by whether people also used e-cigarettes.
Abstract — the authors' own words, CC BY
Objective:
To examine trends in use of nicotine pouches as a smoking cessation aid, characteristics of people using pouches during smoking quit attempts, the characteristics of quit attempts involving pouches, and the real-world association between pouch use and quit success. Design:
Monthly cross-sectional survey. Setting:
Great Britain. Participants: 7,995 adults (≥18 years) who reported making a serious attempt to stop smoking in the past year, surveyed between June 2021 and July 2026. Main outcome measures: Participants reported use of nicotine pouches during the most recent smoking quit attempt (yes/no). Quit success was defined as reporting that the participant was still not smoking following the attempt. Associations between pouch use and quit success were estimated using logistic regression, adjusting for sociodemographic characteristics, use of other cessation aids, characteristics of the quit attempt, strength of urges to smoke, and survey year. Results:
Among adults who attempted to quit smoking, the proportion using pouches as a cessation aid increased from 2.4% [95%CI 1.3-4.1%] in June 2021 to 6.7% [4.6-9.6%] in July 2026 (prevalence ratio [PR]=2.83 [1.37-5.81]), with particularly large increases among 18-24-year-olds (2.2% to 18.9%; PR=8.75 [4.15-26.79]) and men (1.8% to 11.0%; PR=6.05 [3.19-14.31]). In 2024-26, 43.8% of those using pouches as a cessation aid were aged 18-24 and 69.5% were men. Pouch users also commonly reported using e-cigarettes (49.6%) or over-the-counter nicotine replacement therapy (37.9%) during the same quit attempt. Unadjusted quit success was 33.5% [27.1-39.9] among pouch users compared with 27.0% [25.9-28.1] among those who did not use pouches (OR=1.36 [1.02-1.82]). After adjustment, the association was attenuated (ORadj=1.15 [0.80-1.65]), with the 95%CI compatible with both a modest adverse association and a modest to large benefit. The association differed according to concurrent e-cigarette use (pinteraction=0.002): among those not using e-cigarettes as a cessation aid, pouch use was associated with higher quit success (ORadj=1.91 [1.23-2.97]), whereas evidence of an association among e-cigarette users was uncertain (ORadj=0.63 [0.36-1.11]). Conclusions:
Use of nicotine pouches as a smoking cessation aid increased substantially in Great Britain between 2021 and 2026, particularly among younger adults and men. Pouches were frequently used alongside other cessation aids. While the overall association with quit success was uncertain, pouch use was associated with higher quit success among those not using e-cigarettes. If causal, this suggests a potential role for pouches among people not already using an established cessation aid.
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