Nontherapeutic nicotine gums, tablets, or gummies are popular among adolescents, suggests a survey of high school students in Southern California. The survey findings, published in Pediatrics, revealed that use of such oral nicotine products was second only to e-cigarettes among 9th and 10th graders.
“Nontherapeutic nontobacco nicotine gums, lozenges, tablets, and gummies have several attributes that might attract youth,” wrote Alyssa F. Harlow, Ph.D., of the University of Southern California and colleagues. In addition to being marketed in many fruit flavors, “the act of putting a piece of gum or gummy in the mouth might feel intuitive and less risky for an adolescent, in contrast to nicotine or tobacco products that are inhaled,” they continued. “Importantly, oral nicotine products are discreet and easily concealed; without packaging, and in some cases, even with packaging, many products are indistinguishable from regular gum or candy, making them easy to hide from parents, teachers, or other authority figures.”
Harlow and colleagues examined data from an ongoing behavioral health survey being conducted among adolescents across seven school districts in Southern California. The study focused on data collected from 3,516 students from September 30 to December 14, 2021, when students from the first recruitment wave were in 10th grade and those from the second recruitment wave were in ninth grade. The survey asked students if they had ever used nicotine pouches, other nontobacco oral nicotine products, combustible cigarettes, e-cigarettes, snus, cigars, little cigars or cigarillos, and hookahs or waterpipes. Students were also asked if they had used the products in the past six months.
E-cigarette use was the most prevalent among these students, with 9.6% reporting ever using and 5.5% using in the past six months. Oral nicotine products such as gums and tablets were second most prevalent, with 3.1% of students reporting ever use and 1.4% past six month use.
Harlow and colleagues found that the use of any oral nicotine product (chewables or pouches) was about 2.5 times more prevalent in Hispanic teens compared with other races and ethnicities, 1.9 times as prevalent in participants identifying as female compared with those identifying as male, 2.8 times as prevalent in participants identifying as transgender or nonbinary compared with those identifying as male, and 1.6 times as prevalent in participants identifying as a sexual minority compared with those identifying as heterosexual.
Harlow and colleagues noted that over 99% of the adolescents who reported using oral nicotine products also reported a history of using other nicotine products, but the survey did not identify which products were initiated first.
“Given that use of other noncombustible nicotine products such as e-cigarettes increases risk of subsequent initiation of combustible cigarette smoking and cannabis use, there is reason to be concerned about whether nontobacco oral nicotine product use increases risk of using other harmful substances,” they wrote. “Adolescent non-tobacco oral nicotine product use surveillance should be a public health priority.”
To read more about this topic, see the Psychiatric News article “Minimum Age Raised to 21 for Tobacco, Nicotine Purchase.”
(Image: iStock/fatido)
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