Use of Nicotine Pouches Among Daily Smokers

Inclusion Criteria

• Commonly smoke ≥ 5 cigarettes per day (at least 2 days/week) for at least the prior 12 months
• Exhaled CO measurement of ≥ 6 parts per million at baseline
• Must be interested in reducing cigarette consumption by at least 50% and willing to try nicotine pouches
• Able to understand, read and write in English
• Access to e-mail and a smartphone/computer that has reliable internet connection
• Able to understand and give informed consent

Exclusion Criteria

• Plans to quit smoking within the next 30 days
• Currently pregnant, breastfeeding, or planning to become pregnant in the next 6 months
• Recent (past 3 months) unstable illness that may increase risks of participation or ability to participate fully (e.g. hospitalization for a mental health condition or substance use disorder in prior 6 months, stroke or myocardial infarction in the past year)
• Serious current respiratory diseases (e.g. exacerbations of asthma or chronic obstructive pulmonary disease [COPD], requiring oxygen or oral prednisone), kidney disease (e.g. requiring dialysis), liver disease (e.g cirrhosis), or any medical disorder/medication that may affect participant safety or biomarker data
• Use of a nicotine pouch or other non-cigarette nicotine product (e-cigarette, pipe, cigar, chew, snus, hookah, IQOS) for 5 or more days in the past 28 days
• Use of illegal drugs daily or weekly in the past 3 months
• Use of combustible (smoked) recreational or medical marijuana weekly in the past 3 months (less frequent smoked medical marijuana or use of other forms of medical marijuana are ok)
• Other member of the household currently participating in the study
• Any other condition that in the opinion of the investigator would make it unlikely that the participant could comply with the study protocol