United States: Increased use of nicotine pouches and persistent high rates of vaping among young people

The latest survey data Monitoring the Future 2025[1] Studies in the United States show that while the use of certain addictive substances among adolescents continues to decline, the use of nicotine products remains a significant public health issue. Indeed, approximately one in five young people reported using a product in the 30 days preceding the survey, with a large proportion using e-cigarettes and a notable increase in the use of nicotine pouches.

The investigation Monitoring the Future The U.S. National epidemiological study is a national epidemiological study conducted annually in the United States with a representative sample of students in grades 7, 9, and 12, corresponding to age cohorts of 12–13, 14–15, and 17–18. Data are collected in the spring and early summer using standardized self-report questionnaires, allowing for monitoring of the prevalence of use of various psychoactive substances, including conventional cigarettes, electronic cigarettes (e-cigarettes), and other nicotine-containing products. The 2025 results are based on responses from more than 24,000 students attending public and private schools.

Use of tobacco and nicotine products: overall stagnation, linked to high vaping rates

The 2025 survey data show that, despite historically low levels of smoking among adolescents, overall use of nicotine products remains high and is no longer declining. This stagnation is primarily due to e-cigarette use, which is now by far the most common form of nicotine consumption among young people. In 2025, 9% of eighth-grade students reported using an e-cigarette in the past twelve months, compared to 14% of ninth-grade students and 20% of twelfth-grade students. These levels remain close to those observed before the pandemic, confirming the long-term establishment of vaping among adolescents. Regarding recent use, 15.7% of adolescents reported vaping in the 30 days preceding the survey, reflecting regular exposure to nicotine at a key age for brain development.

Conversely, the consumption of manufactured cigarettes continues its long-term downward trend, but has now plateaued. In 2025, 21% of final-year high school students reported having smoked cigarettes in the past 30 days, compared to 1.4% in ninth grade and fewer than 1% in seventh grade. These results confirm that the decline in combustible tobacco smoking is not accompanied by a corresponding decrease in nicotine consumption among young people. E-cigarettes are emerging as the primary means of initiating and maintaining nicotine addiction during adolescence.

Increased use of nicotine sachets: a worrying trend

The survey also highlights a marked increase in the use of nicotine sachets among adolescents, a phenomenon that is intensifying in all age groups studied. Among final-year high school students (ages 17-18), 4.4% reported using nicotine sachets in the past 30 days, compared to 1.2% in 2023 and 0.8% in 2021. Similarly, among ninth-grade students (ages 14-15), 3.1% reported recent nicotine sachet use in 2025, compared to 0.9% in 2023, while among seventh-grade students (ages 12-13), usage increased from 0.6% in 2023 to 1.8% in 2025. These figures confirm that the adoption of nicotine sachets is not limited to older high school students, but also affects middle school students, with an even greater relative increase among the youngest.

When the analysis is extended to annual usage, the cumulative prevalence reinforces this emerging trend. Among final-year students, 6.7% report having experimented with nicotine sachets in the past 12 months, compared to 2.1% in 2023. Third-year students have an experimentation rate of 4.5% in 2025, up from 1.3% in 2023, and seventh-year students reach 2.9% annual experimentation, compared to 0.8% two years earlier.

The increase in these uses, even if starting from lower levels than those of e-cigarettes, represents a diversification of nicotine consumption patterns and a broadening of the sources of exposure to nicotine addiction among adolescents. These trends highlight the need to adapt prevention and regulatory strategies to incorporate these emerging products.

Teenagers exposed to unauthorized nicotine products

The continued high level of e-cigarette use, combined with the rapid growth of new products such as nicotine pouches, primarily reflects a shift in consumption patterns. This trend remains concerning, as early initiation of nicotine promotes the development of lasting addiction and exposes adolescents to detrimental effects on brain development and cognitive function, with potential long-term health consequences that are not yet fully understood.

The rapid diversification of products, their attractive presentation, and their normalization as alternatives presented as less harmful or even risk-free are muddying public health messages and undermining the gains made in denormalization. In the United States, this situation is exacerbated by the difficulties faced by the Food and Drug Administration (FDA), which is confronted with a very high volume of applications for marketing authorization that it is unable to process within timeframes compatible with market dynamics. In this context, many manufacturers are marketing e-cigarettes and nicotine products without prior authorization, in violation of the federal regulatory framework, contributing to the widespread distribution of illegal products among young people.

The increased use of nicotine pouches across all age groups, including the youngest, illustrates the industry's ability to exploit the operational limitations of regulatory authorities and to constantly renew its strategies for introducing nicotine. These findings argue for a strengthened and coherent approach to combating smoking and nicotine addiction, fully integrating all nicotine-containing products into prevention, regulatory, and epidemiological surveillance systems. Reducing the attractiveness of these products, particularly through strict regulation of flavors, marketing, and packaging, appears to be a key lever for limiting initiation among young people, as the public health authors emphasize.

©Generation Without Tobacco

AE

[1] Miech, RA, Johnston, LD, Patrick, ME, & O'Malley, PM (2025). Monitoring the Future national survey results on drug use, 1975–2025: Overview and key findings for secondary school students. Monitoring the Future Monograph Series. Ann Arbor, MI: Institute for Social Research, University of Michigan.