![]() When offered free, open access to the portfolio of NPs, adults who use tobacco products (without intentions to quit them), either reduced their tobacco consumption by >50% or switched completely. Importantly, we observe considerable switching behavior in a six-week actual use study with ad libitum use of NPs. However, this should be weighed against the switching potential among adults who smoke. Undoubtedly, the potential risks of underage and adult nonusers starting the use of nicotine pouches is important. Thus, despite the availability of flavor options, underage use of nicotine pouches is extremely low. The prevalence of current use of nicotine pouches was 0.8% in 2021 and 1.1% in 2022, among middle and high school students. Encouragingly, the National Youth Tobacco Survey indicates low prevalence of use of nicotine pouches, flavored or otherwise. We agree that youth should not use any tobacco product. The authors’ conclusions regarding potential use by nonusers, including youth, and potential abuse liability, while legitimate issues, are misplaced. ![]() This is notable progress towards harm reduction. In fact, our retail point-of-purchase data consistently demonstrate that the vast majority of NP adopters are adult smokers or dippers. We believe that oral nicotine pouches (NP), including on!® (on!NPs) that we market, are a potential reduced harm option for adults who smoke but cannot or will not quit cigarettes. We are encouraged by the authors’ findings because the trajectory of nicotine pouch sales suggests that adult tobacco consumers might be increasingly trying and switching from harmful tobacco products like cigarettes. We read the publication by Majmundar et al with great interest. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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