Australian teenagers who try nicotine pouches are rarely stopping there. New research from the University of Sydney has found that teen nicotine pouch use almost never happens on its own, with the overwhelming majority of adolescents who try pouches also picking up vapes or cigarettes.

A Survey Of Nearly 1,850 Students

The study, published in the Australian and New Zealand Journal of Public Health, surveyed 1,848 students aged 14 to 18 across 20 schools in New South Wales, Queensland and Western Australia. Led by Dr Lauren Gardner of the Matilda Centre for Research in Mental Health and Substance Use, the research is one of the largest and most recent efforts to map lifetime use of vapes, tobacco cigarettes and nicotine pouches among Australian adolescents since the 2024 vaping reforms took effect.

The findings paint a troubling picture of overlap. More than 12 per cent of students reported having used vapes at some point, almost 6 per cent had tried tobacco cigarettes, and 3.5 per cent had used nicotine pouches. Among those who had used pouches, 82 per cent had also vaped and 71 per cent had smoked, a pattern researchers describe as strongly interconnected rather than coincidental.

Teen Nicotine Pouch Use Rarely Stands Alone

Gardner and her colleagues found that youth nicotine product use tends to cluster together. Only a tiny fraction of students who had never vaped or smoked went on to try nicotine pouches, while the vast majority of pouch users had already experimented with at least one other product. Gardner said the pattern points towards shared underlying risk factors rather than pouches acting as an isolated trend among today’s youth nicotine product use.

“Many teens who have used one nicotine product have also tried others, so we need effective prevention strategies that address shared risk factors for nicotine use more broadly, rather than focusing on just vaping or smoking,” Gardner said.

Gender differences were also stark. Boys reported nearly three times the odds of using nicotine pouches compared with girls, and one and a half times the odds of smoking cigarettes. Nicotine pouch use was reported by 4.8 per cent of male students compared with 1.5 per cent of female students, while tobacco use sat at 6.9 per cent among boys against 4.1 per cent among girls.

Why The Teenage Brain Is Especially Vulnerable

Gardner pointed to adolescence as a uniquely sensitive window for nicotine exposure, describing it as the period when the brain is most susceptible to addiction, a vulnerability that can persist for life. That framing echoes long standing concerns about how quickly young people can move from curiosity to compulsive use once nicotine takes hold, regardless of which product introduces it first, and it helps explain why teen nicotine pouch use worries public health researchers so much.

Associate Professor Raglan Maddox, co convener of the Tobacco, Alcohol and Other Drugs Special Interest Group within the Public Health Association of Australia, said the findings show the problem extends well beyond any single product. He pointed to nicotine pouches as simply the latest tactic from an industry that keeps finding new ways to keep young people hooked, and argued that governments must respond to cigarettes, vapes and pouches together rather than tackling them one at a time.

Maddox called for sustained mass media campaigns, continued pharmacy only vape sales, strong enforcement against illegal retailers, and the retention of tobacco price and tax measures as part of a comprehensive response aimed at keeping children and young people from taking up smoking in the first place.

Building Skills That Address The Whole Problem

The research team behind the study runs the OurFutures Vaping Prevention Program, which targets skills that apply across all forms of youth nicotine product use rather than focusing narrowly on vaping. These include assertive communication, managing peer pressure, recognising deceptive marketing tactics, critical thinking and knowing when and how to seek help.

That broader approach reflects a key implication of the study. Because teen nicotine pouch use so rarely occurs in isolation, prevention efforts that only address one product risk missing the wider pattern altogether. Gardner noted that the data reflected lifetime rather than current use, meaning some of what was captured may represent experimentation rather than ongoing habits. Even so, she said the findings offer important insight into how these behaviours are connected.

Previous research has already shown that teenagers who vape are five times more likely to go on to try cigarettes. This latest study builds on that finding by showing adolescents are increasingly experimenting with combinations of nicotine products, not just one at a time, as they move through this experimental stage of life.

Source: dbrecoveryresources