Background: Oral nicotine pouches (ONPs) are novel products that are marketed as “tobacco-free” alternatives to cigarettes and smokeless tobacco (ST). This study examined the effects of ONP packaging features on adult tobacco users’ and non-users’ product perceptions. Materials and Methods: Adult tobacco users (cigarettes, ST, and dual cigarette/ST) and non-users (total N = 301) viewed ONP pack images in a 4 × 3 × 2 between-subject experiment testing the effects of the displayed flavor (cool mint, coffee, dark frost, and smooth), nicotine concentration (none displayed on the package, 3 mg, and 6 mg), and addiction warning label (yes or no). The outcomes were perceived substitutability of ONPs for cigarettes and ST and perceived risks. We modeled the effects of tobacco user status and the experimental factors on these outcomes. Results: All tobacco user groups perceived ONPs to be significantly less harmful and less addictive than non-users. There were significant effects of nicotine concentration on perceived risks. Compared to packages that did not display nicotine concentration, packages displaying 6 mg nicotine concentration produced significantly lower perceived harm (β = −0.23, 95% CI −0.44, −0.02), perceived addictiveness (β = −0.28, 95% CI −0.51, −0.05), risk appraisals of harm (β = −0.50, 95% CI −0.88, −0.12) and risk appraisals of addictiveness (β = −0.53, 95% CI −0.95, −0.11). Conclusions: The study findings demonstrate that the nicotine concentration displayed on ONP packaging can affect adults’ perceptions of ONPs. Further research on the effects of ONP packaging features emphasizing nicotine (e.g., “tobacco free” nicotine claims) on tobacco users and non-users is needed to assess their potential public health impact.

Despite reports suggesting young people are interested in quitting e-cigarettes, little work has examined predictors of quit outcomes. This study aimed to identify factors associated with quit outcomes among JUUL e-cigarette users in a longitudinal sample of young adults. We assessed undergraduate past-30-day JUUL users during autumn 2018 (N = 225); Our outcomes included short-term quit attempts and interest (spring 2019), and long-term quit attempts (spring 2020). We used logistic regression to examine the associations between our outcomes and JUUL use characteristics, other tobacco use, and sociodemographic factors. Findings indicated 76% of users were interested in quitting JUUL, and more than 40% reported a quit attempt. Quit outcomes were not related to sociodemographics. Short-term quit outcomes were more likely among freshmen and less likely among recent cigarillo users. Heavy JUUL users were more likely to report short- and long-term quit attempts, but JUUL device owners were less likely to report short- and long-term quit attempts. Higher nicotine dependence reduced the likelihood of a long-term quit attempt. There is a need for policy level actions that address tobacco control among this population. Findings suggest a range of unique factors that can inform such policies and programs to curb young adult e-cigarette use.

Waterpipe tobacco smoking is a public health concern that poses many of the same health risks as cigarette smoking, especially among young adults—a subpopulation characterized by the highest prevalence of waterpipe tobacco smoking. Nevertheless, it remains understudied relative to other forms of tobacco use. We examined sociodemographic, behavioral and cognitive factors associated with young adults’ motivation to quit waterpipe smoking using a theory-informed approach. We completed a secondary analysis of baseline data on waterpipe tobacco smoking beliefs and behavior collected from 349 US young adults aged 18–30 years. We analyzed sociodemographics, tobacco use and cessation behaviors and perceptions, and theory-related constructs associated with motivation to quit waterpipe tobacco smoking using linear regression. Overall, participants reported low motivation (mean = 2.68, SD = 1.56, scale range 1–7) and high self-efficacy (mean = 5.12, SD = 1.79) to quit waterpipe tobacco smoking. In multivariable analysis, prior quit attempts (β = 1.10, P < 0.01), greater perceived risks of waterpipe tobacco smoking (β = 0.42, P < 0.01) and increasingly negative attitudes toward waterpipe tobacco smoking (β = 0.29, P < 0.01) were associated with higher motivation to quit. These findings highlight the importance of those factors as potential cessation determinants. These findings can help guide the development and refinement of interventions targeting young adult waterpipe tobacco smoking.