Research Letter | Substance Use and Addiction

Nicotine Pouch Sales Trends in the US by Volume and Nicotine

Concentration Levels From 2019 to 2022
Anuja Majmundar, PhD, MBA; Christian Okitondo, MS; Ashley Xue, MS; Samuel Asare, PhD; Priti Bandi, PhD; Nigar Nargis, PhD

Introduction Author affiliations and article information are

listed at the end of this article.
Nicotine pouches, dissolvable microfiber pouches prefilled with nicotine salt powder but not
containing tobacco leaf, are gaining popularity in the US.1 Nicotine concentration levels in these
products are comparable to snus and moist snuff2 and often exceed levels found in nicotine
replacement therapy products,3 creating the potential for nicotine dependency instead of quitting
among individuals who use nicotine and nicotine initiation or experimentation among those who are
nicotine-naive.4 In this study, we assessed US nicotine pouch unit sales trends by volume and
nicotine concentration levels.

Methods
We analyzed data comprising weekly NielsenIQ Retail Scanner point-of-purchase sales from August
10, 2019, through March 26, 2022, for 2182 local trade areas in the contiguous 48 states and
Washington, DC. This cross-sectional study was based on data that were not from human
participants; thus, the US Department of Health and Human Services considered this study to be
nonhuman research, which is exempt from review or informed consent. We followed the STROBE
reporting guideline.
Four nicotine pouch brands (Zyn [Swedish Match], Rogue [Rogue Holdings], On! [Helix
Innovations], and Velo [British American Tobacco]) were identified through a review of product
characteristics in the sales data and market research. One unit was defined as 1 pouch given that the
number of pouches per container varied (ranging from 12-20) across brands. Unit sales were
aggregated by month and year overall and by brand and nicotine concentration level per unit. Shares
of unit sales by brand and nicotine concentration level were calculated as a proportion of total
unit sales.
Average monthly percentage change (AMPC) in unit sales and 95% CIs were calculated using
Joinpoint, version 4.9.1.0 (National Cancer Institute), a segmented regression analysis application.
Statistically significant changes included those with 95% CIs that did not cross 0. Two-sided α<.05
indicated significance.

Results
Overall sales increased from 126.06 million units from August to December 2019 to 808.14 million
units from January to March 2022 (AMPC, 8.1; 95% CI, 7.4-8.9) (Figure 1). Zyn led the overall unit
share (58.8%), followed by On! (24.6%), Velo (12.1%), and Rogue (4.8%) during the study period
(Figure 1). Zyn sales peaked in September 2021 and increased more than other brands from October
2021 to March 2022 (AMPC, 18.0; 95% CI, 8.9-27.8). However, Rogue sales increased more rapidly
than all other brands (AMPC, 37.0; 95% CI, 31.3-42.9).
Nicotine pouches with 6 mg (1365.19 million units), 4 mg (470.36 million units), and 3 mg
(449.61 million units) nicotine concentration levels were most commonly sold during the study
period. Sales of products with 8 mg nicotine concentration level (AMPC, 17.6; 95% CI, 13.8-21.6)

Open Access. This is an open access article distributed under the terms of the CC-BY License.

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 JAMA Network Open | Substance Use and Addiction Nicotine Pouch Sales Trends by Volume and Nicotine Concentration Levels

increased more rapidly than products with lower concentration levels (2 mg: AMPC, 12.3 [95% CI,
10.9-13.7]; 3mg: APMC, 7.9 [95% CI, 6.1-9.7]; 4 mg: AMPC, 9.4 [95% CI, 7.3-11.6]; 6 mg: AMPC, 8.6
[95% CI, 6.1-11.1]; 7 mg: AMPC, 9.7 [95% CI, 4.9-14.6]) (Figure 2).

Discussion
Similar to nicotine pouch sales trends from 2016 to 2020,1 the trajectory of nicotine pouch sales
continued to rise through March 2022. Increasing sales of products with the highest (8 mg) nicotine
concentration level raise concerns about abuse liability among individuals who use nicotine.

Figure 1. Nicotine Pouch Unit Sales in the US by Brand From 2019 to 2022

200
On!
Rogue
180
Velo
Zyn

160

140
Nicotine pouches, 1 000 000 units

120

100

80

60

40

20

Sep Aug Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
2019 2020 2021 2022

One unit represented 1 nicotine pouch. Rogue nicotine pouches were sold in the US starting November 2019. Sales of Velo nicotine pouches included Velo Max products.

Figure 2. Mean Monthly Unit Sales of Nicotine Pouches in the US by Nicotine Concentration Levels
From 2019 to 2022

140
Year
120 2019 2020 2021 2022
Unit sales, mean, 1 000 000 units

100

80

60

One unit represented 1 nicotine pouch. Mean monthly

40 unit sales were estimated from annual sales divided
by months of data available for a given year. Nicotine
20 pouches with 2 mg concentration levels were offered
by On! and Velo; 3 mg, by On! and Rogue; 4 mg, by On!
0 and Velo; 6 mg, by Rogue and Zyn; and 8 mg, by On!.
2 3 4 6 7 8 Approximately 0.3% of total units did not include
Concentration, mg nicotine concentration levels.

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 JAMA Network Open | Substance Use and Addiction Nicotine Pouch Sales Trends by Volume and Nicotine Concentration Levels

Increasing sales of products with the lowest (2 mg) nicotine concentration level found in this study
combined with higher sales of youth-appealing fruit flavors reported previously1 warrant continued
surveillance of the uptake or experimentation trends among tobacco-naive youth. Sales trends are
not generalizable to use patterns. A study limitation was that the data did not represent all nicotine
pouch products and online sales in the US and did not account for intraproduct variation in nicotine
concentration levels.
Nicotine pouch promotions highlight youth-appealing flavors and convenience of using these
products anywhere. No manufacturer has received authorization from the US Food and Drug
Administration to market nicotine pouches as a tobacco product or a cessation drug.5,6 Health
campaigns warning of potential adverse health outcomes of nicotine pouches are needed.

ARTICLE INFORMATION
Accepted for Publication: October 4, 2022.
Published: November 15, 2022. doi:10.1001/jamanetworkopen.2022.42235
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Majmundar
A et al. JAMA Network Open.
Corresponding Author: Anuja Majmundar, PhD, MBA, American Cancer Society Inc, 3380 Chastain Meadows
Pkwy NW, Ste 200, Kennesaw, GA 30144 (anuja.majmundar@cancer.org).
Author Affiliations: Tobacco Control Research, American Cancer Society Inc, Kennesaw, Georgia (Majmundar,
Xue, Asare, Nargis); The University of Georgia, College of Public Health, Atlanta (Okitondo); Risk Factors and
Screening Surveillance Research, American Cancer Society Inc, Kennesaw, Georgia (Bandi).
Author Contributions: Drs Majmundar and Nargis had full access to all of the data in the study and take
responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Majmundar, Nargis.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Majmundar, Nargis.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Majmundar, Okitondo, Xue, Bandi.
Administrative, technical, or material support: Okitondo, Xue, Nargis.
Supervision: Nargis.
Conflict of Interest Disclosures: None reported.
Funding/Support: Dr Majmundar was supported by subgrant 143300400 from the University of Southern
California Tobacco Center of Regulatory Science award funded by the National Cancer Institute and US Food and
Drug Administration.
Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection,
management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and
decision to submit the manuscript for publication.

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