Adolescent use of nicotine pouches in four Latin American countries: A cross-sectional survey

Abstract

Background and Aim: Nicotine pouches are novel products with rapid global sales growth. Our aim was to explore use and perceptions of nicotine pouches among adolescents in Latin America. Design: Cross-sectional school surveys between March and August 2025. Setting: Sixteen cities, four each in Argentina, Guatemala, Mexico and Peru. Participants: Adolescents aged 12-17 years (n=12,785). Measurements: Use of, and susceptibility to, nicotine pouches, through survey questions about frequency of use, brands and flavours used, access, and harm compared to cigarettes and e-cigarettes. Results: Self-reported ever use was 6.0%, highest in Peru (9.1%) and lowest in Argentina (3.2%). Ever use was higher among males, those with higher family affluence scores, and those who had ever vaped or smoked tobacco. The rate of current (past 30 day) nicotine pouch use was 2.4%. Those reporting current use typically used pouches infrequently (1-3 days in the last month). The most commonly used brands were Velo (24.4%) and Zyn (18.1%), with pouches most likely to be given to them by someone (26.3%) or giving someone else money to buy them (15.8%). Fruit (20.3%) and mint/menthol (17.3%) were the most common flavours reported. More than one-third of the sample indicated that nicotine pouches were more harmful (somewhat/a lot) than cigarettes (38.7%) and e-cigarettes (36.7%). Summary: Nicotine pouch use among adolescents in four Latin American countries appears to be relatively uncommon but higher than in previous youth surveys. Access to nicotine pouches appears to be largely informal, fruit and mint/menthol flavours are most common, and many adolescents appear uncertain about harm compared with cigarettes and e-cigarettes.