Modeling Novel Oral Nicotine Use Among Adolescents

TL;DR

This study analyzes the rising trend of oral nicotine use among U.S. adolescents, projecting future growth and evaluating intervention strategies using a data-driven model to inform comprehensive prevention efforts.

Contribution

It introduces a novel grade-structured compartmental model to project nicotine use trajectories and assess the effectiveness of various intervention strategies among adolescents.

Findings

Nicotine pouch use among high school students doubled since 2021.

Without intervention, nicotine use is projected to continue growing.

Multi-parameter interventions significantly reduce nicotine use trajectories.

Abstract

Novel oral nicotine products, particularly nicotine pouches, have rapidly gained popularity among adolescents. Among U.S. high school students, nicotine pouch use has doubled since 2021, with 2.4% reporting current use in 2024. We analyzed Florida Youth Tobacco Survey data from 2022-2024 to assess prevalence trends and developed a grade-structured compartmental model to project future trajectories and evaluate intervention strategies. The model accurately captured observed trends across all high school grades and projected continued growth without intervention. We evaluated single and multi-parameter intervention strategies. Single-parameter interventions demonstrated limited effectiveness while multi-parameter strategies showed substantial effects. These findings underscore the need for comprehensive, multi-faceted interventions incorporating prevention education, cessation support, policy enforcement, and peer influence modification. Grade-specific targeting can enhance overall program effectiveness. School-based interventions should be implemented rapidly to address the accelerating epidemic of oral nicotine use among adolescents.