<p class="abstract">Due to the novel nature of oral nicotine pouches, limited studies have been conducted on the usage of these products in real-world settings. Consumption patterns and use behaviour of current nicotine pouch users need to be investigated to monitor the use and support the assessment of reduced risk products. Here we report the findings of an online survey completed by 550 participants across Sweden, Denmark, Germany and Switzerland who were current nicotine pouch users. The key areas of research were oral nicotine use history, mouth hold duration, nicotine strength, average daily consumption (ADC) and flavour preferences. Across all countries, most participants used oral nicotine pouches for 12 months or less. Longer use of nicotine pouches was reported in Sweden. Pouches containing 6‒15 mg nicotine were used most frequently in all countries, and particularly 11‒15 mg pouches in Sweden and Denmark. Average ADC across all countries was 1-5 pouches, closely followed by 6-10 pouches in Sweden and Denmark. Menthol was the most preferred flavour in all countries, followed by fruity and other food flavours. These findings reflect the differing product use patterns across nascent and mature markets as well as the need to investigate how different experience of product types can affect the use of new categories. Further research is required with a larger sample over time to understand product use patterns more clearly, including transition from and into other product categories.</p>

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