As regulators continue to assess the role of nicotine pouches within tobacco control frameworks, evidence on how these products are actually used over time remains limited. A recently published prospective study in Cureus helps address this gap by examining real-world patterns of nicotine pouch use across a ten-week period.
The study is important not because it settles regulatory questions, but because it contributes structured behavioural data to a field often dominated by cross-sectional surveys and short-term laboratory measures. It also warrants careful interpretation, as it was conducted by researchers affiliated with Philip Morris International and its subsidiary Swedish Match, a fact that must be transparently acknowledged when considering its findings.
Study design and scope
The research followed adult participants over ten weeks, tracking nicotine pouch use frequency, product selection, and changes in behaviour over time. Participants were existing nicotine users, with prior experience of smoking, smokeless tobacco, or other nicotine products. Importantly, the study did not recruit nicotine-naïve individuals.
As a prospective design, the study differs from many snapshot surveys by observing within-person changes rather than relying solely on recall or single-time-point responses. This allows for more robust insight into persistence of use, substitution behaviour, and product adaptation.
Key observations on use patterns
Across the observation period, participants demonstrated relatively stable use patterns once initial familiarisation occurred. Frequency of daily use, number of pouches consumed, and preferred nicotine strengths tended to plateau rather than escalate.
A notable finding was that participants did not show systematic upward titration of nicotine strength over the ten weeks. Instead, most settled into a consistent strength range aligned with prior nicotine exposure. From a regulatory perspective, this challenges assumptions that nicotine pouches inevitably lead to escalating consumption once adopted.
The study also reported that many participants reduced or discontinued use of other nicotine products during the observation period, suggesting substitution rather than addition. While the study was not designed to assess cessation outcomes, these behavioural shifts are relevant to discussions of harm reduction.
Tolerability and discontinuation
Reported adverse effects were generally mild and most commonly related to local oral sensations such as irritation or discomfort. A proportion of participants discontinued pouch use during the study, often citing tolerability or personal preference rather than dependence-related concerns.
This finding is particularly relevant for regulators. Products that are poorly tolerated tend to be self-limiting in use, which has implications for both risk assessment and population-level impact. It also reinforces the importance of product standards that address not only toxicology but real-world user experience.
What the study does and does not show
The authors are explicit that the study does not assess long-term health outcomes, cardiovascular risk, or cessation efficacy. Nor does it attempt to generalise findings to youth or non-users of nicotine. These limitations are critical.
At the same time, the study does provide empirical behavioural data that help fill a gap between laboratory assessments and population surveys. Understanding how adults adapt to nicotine pouches over weeks, not days, adds depth to regulatory evaluations that rely on realistic use conditions.
Interpreting industry-funded evidence
GINN’s position is that industry-funded research can inform regulatory assessment when transparently disclosed and critically evaluated, but it should never stand alone. This study should be read alongside independent toxicological, clinical, and epidemiological evidence, and weighed within the broader literature.
Its value lies in its contribution to understanding use dynamics, not in claims about public-health impact. Regulators remain responsible for integrating such evidence into risk-proportionate frameworks that prioritise youth protection, product standards, and accurate communication of relative risk.
A GINN perspective
From a regulatory standpoint, this prospective study reinforces several points that are increasingly evident across nicotine research. Adult users tend to stabilise their use rather than escalate it. Product tolerability influences persistence. And nicotine pouches are most often used by individuals with prior nicotine exposure, frequently as substitutes for higher-risk products.
These observations do not argue for deregulation. They argue for precision, regulation that reflects how products are used in practice, not how they are assumed to be used.
As evidence continues to accumulate, studies like this, properly contextualised, can help inform more credible, proportionate, and effective nicotine policy.
Source
Nicotine Pouch Patterns of Use in a 10-Week Prospective Study
Cureus
https://www.cureus.com/articles/421245-nicotine-pouch-patterns-of-use-in-a-10-week-prospective-study
