Real-World Evidence: Nicotine Pouches Linked to Sharp Drop in Smoking

A growing body of evidence suggests nicotine pouches may play a meaningful role in helping adult smokers move away from cigarettes—and a U.S. study tracking real-world behavior adds weight to that argument. 

In a 10-week observational study of adult nicotine pouch users, nearly half of participants who were smoking at the start were no longer smoking by the end of the study period. Cigarette use, smokeless tobacco use, and multi-product use all declined, while exclusive nicotine pouch use increased. 

 

Following adults where they already are

Rather than testing nicotine pouches in a controlled clinical trial, researchers took a different approach: they observed how adults were actually using them in everyday life. 

The study followed 346 adult users of ZYN nicotine pouches between late 2017 and early 2018, shortly after the product launched in parts of the western United States. Participants—recruited from 11 states—logged their daily use of cigarettes, vapes, smokeless tobacco, and other nicotine products using online diaries. 

Importantly, researchers didn’t attempt to force behavior change. Instead, they tracked how participants’ nicotine habits evolved naturally over time. 

 

Smoking dropped fast—and significantly 

 

At the beginning of the study, about 16% of participants reported smoking cigarettes at least weekly. By week 10, that number had fallen to just over 8%. 

In other words, nearly half of the smokers present at baseline were no longer smoking after a little more than two months. 

Daily cigarette consumption also declined steadily throughout the study. Participants smoked fewer cigarettes per day as the weeks went on, suggesting not just quitting, but gradual reduction among those who hadn’t fully stopped. 

 

Declines weren’t limited to cigarettes 

 

The shift away from cigarettes was part of a broader trend. 

Use of moist smokeless tobacco was cut in half over the same 10-week period, and researchers observed a clear movement away from using multiple nicotine products at once. 

Exclusive nicotine pouch use rose from roughly half of participants at the start to nearly two-thirds by the end of the study. By week 10, almost one in four participants had completely replaced other tobacco or nicotine products with nicotine pouches alone. 

The researchers noted that these patterns suggest nicotine pouches can function as acceptable substitutes, particularly for cigarettes and traditional oral tobacco. 

 

Motivation to quit remained strong 

 

Participants’ intention to quit various products was measured throughout the study, and motivation to quit smoking stood out. 

By the final week, smokers reported higher quit-intention scores for cigarettes than for any other product category, including vaping and smokeless tobacco. Even among those who hadn’t fully quit smoking, most said they were using nicotine pouches specifically to reduce or stop cigarette use. 

A smaller subset—just over 3%—reported quitting all tobacco and nicotine products entirely during the study period. 

 

Why adults turned to nicotine pouches 

 

When asked what drew them to nicotine pouches, participants consistently pointed to practical, real-life reasons: 

• Help reducing or quitting smoking 
• Ability to use them where smoking or vaping isn’t allowed 
• Convenience compared with other products 
• Discreet use and social acceptability 

These factors matter, especially for adult smokers who struggle to quit but want alternatives that fit into daily life without combustion or smoke. 

 

Important limitations to keep in mind

 

The researchers were clear about the study’s limits. Participation dropped over time, data was self-reported, and the study wasn’t designed to prove cause and effect. The sample also wasn’t representative of the entire U.S. population—it skewed older, male, and white, and consisted of early adopters of a single nicotine pouch brand. 

Still, as the authors emphasized, observational data like this is valuable precisely because it reflects how products are used outside of clinical settings. 

 

What this means for harm reduction 

 

Despite its limitations, the study adds to a growing signal: when adult smokers adopt nicotine pouches, cigarette use often declines—sometimes rapidly. 

The researchers concluded that nicotine pouches may serve as a harm-reduction option for people who smoke or use oral tobacco and would otherwise continue using more harmful products. 

As national surveys begin to better track nicotine pouch use, longer-term and larger-scale studies will be critical. But for now, this real-world evidence reinforces an increasingly clear message: offering adults lower-risk alternatives can lead to meaningful reductions in smoking.