Story at a glance
- National surveillance surveys do not track the use of flavored oral nicotine products among teenagers.
- To fill this information gap, researchers at the University of Southern California conducted a survey of high school students.
- Although overall use was low, certain racial and gender minority groups were more likely to use the products than others.
Amid rising scrutiny of the e-cigarette industry, a new study published in Pediatrics found more teenagers of certain racial or ethnic, sexual or gender minority groups are using flavored nontobacco oral nicotine products like lozenges and gummies.
These products can contain high levels of nicotine but are not approved by the Food and Drug Administration to help individuals quit smoking.
Results of the survey, conducted among 3,516 ninth and 10th graders in California, found e-cigarette use is still the most prevalent form of nicotine consumption among this age group; nearly 10 percent have used the product at least once and 5.5 percent had in the past six months.
However, among the entire sample, 3.4 percent reported ever using non-tobacco nicotine oral products, and 1.7 percent had used these products within the past six months.
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Combustible tobacco products like cigarettes and cigars were ranked as the third most commonly used products.
Individuals who had used combustible or noncombustible tobacco in the past were also more likely to use the flavored oral nicotine products compared with never-users.
Exposure to nicotine at a young age can contribute to poor brain development and lead to learning, memory and attention problems, in addition to nicotine addiction, researchers said.
Despite the harms posed to youth, the products may help adults quit smoking or e-cigarette use.
Flavored oral nicotine products are also easy to hide and conceal, explained lead study author Alyssa F. Harlow of the Keck School of Medicine at the University of Southern California in a press release. The products are also sold in sweet flavors like “cherry bomb” and “fruit medley” that may appeal to teens, she continued.
“Flavors, concealability, design, and digital marketing were all identified as important drivers behind the rise in youth use of JUUL e-cigarettes between 2015 and 2018 and the subsequent rise in youth use of PuffBar and other disposable e-cigarettes,” authors said.
The survey was conducted between September and December 2021 among students at 11 high schools. Hispanic teens, teen girls and members of the LGBTQ+ community were all more likely to have used flavored oral nicotine products.
“Some of these subpopulations are young people who have historically been impacted by tobacco-related disparities,” said Harlow. “It’s important for us to continue monitoring the use of these products among young people to determine the potential influence on those disparities.”
Use of these products at the national level among adolescents remains unclear, as traditional surveys do not query respondents about the new products. As a result, the public health implications are also unknown, Harlow said.
“Adolescent non-tobacco oral nicotine product use surveillance should be a public health priority,” authors concluded.
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