Nontobacco Nicotine Product Use Prevalent Among Minority Teenagers

Nontobacco nicotine products such as flavored nicotine gum, lozenges, tablets, and gummies are the second-most prevalent nicotine products used by adolescents next to e-cigarettes, according to a study published in Pediatrics. While prevalence was less than 5% across all users, use was higher among racial, sexual, and gender minorities.

The nicotine products at issue are not approved for smoking cessation programs. These nontherapeutic products increased in oral tobacco/nicotine market share from .9% in 2018 to 4% in 2019. Because they are new to the market and pose risk, the researchers wanted to know more about their popularity among United States teens.

The researchers used data from an ongoing survey to explore prevalence of 6-month and all-time use of nontobacco oral nicotine products. The data included 3516 ninth and tenth graders in Southern California. In addition to usage, the participants self-reported race, ethnicity, sexual identity, parents’ education level, and perceived socioeconomic status.

Among the teenagers surveyed, 9.6% had used e-cigarettes at some point in their lifetime and 5.5% had used them in the past 6 months. Nicotine gum, lozenges, tablets, and/or gummies were used by 3.1% of the participants; 1.4% in the past 6 months. The groups with the highest prevalence were Hispanics, individuals who reported a sexual identity other than heterosexual, those who identified as female or feminine, and those who identified as transgender or nonbinary.

The researchers said the prevalence rates were low — resembling national trends — but “not negligible.” Because the prevalence was low, the researchers said they had to collapse analyses, which limited more granular analyses. The cross-sectional and self-reported natures of the data may have affected results.

“Surveillance of nontobacco oral nicotine product use among adolescents merits priority for national policies designed to protect pediatric populations and promote health equity,” researchers concluded.


Harlow AF, Vogel EA, Tackett AP, et al. Adolescent use of flavored nontobacco oral nicotine products. Pediatrics. Published August 8, 2022. doi:10.1542/peds.2022-056586