BACKGROUND-AIM:
With the recent popularity in nicotine pouch use, there’s an emerging need for comprehensive analyses on use patterns and the socioecological factors that influence these patterns. This study aims to identify subgroups of young nicotine pouch users and examine associated sociodemographic, risk-behavioral, health-related, social and use-related factors.

METHODS:
Data were drawn from a nationally representative cross-sectional survey conducted in 2024 among Danish young people aged 15-29 years. The analytical sample included 998 persons who reported current use of nicotine pouches. Latent class analysis was used to identify user subgroups based on use characteristics indicators: frequency, quantity, nicotine strength, duration per pouch, and sleeping with pouches. Multinomial logistic regression models examined associations between class membership and socioecological factors, including demographics (age, gender), risk behavior (use of other tobacco/nicotine products, binge-drinking, lifetime hash use, risk-willingness), health status (mental and physical health), social (peer use, friends/parental attitudes), and use-related factors (perceived harm/addictiveness, cessation behavior, pouch use in school, motives for use). All measures were self-reported, except for gender and age.

RESULTS:
Three distinct latent classes of nicotine pouch users were identified: occasional use (35.9%), daily, moderate use (55.7%), and daily, heavy use (8.4%). Compared with occasional users, daily heavy users were less likely to be female (RRR=0.46, 95% CI: 0.24-0.90) and more likely to be aged 25-29 years (RRR=2.45, 95% CI: 1.11-5.39), Both daily user groups reported lower risk of recent binge drinking episodes, poorer physical health, and higher exposure to peer pouch use. They were more likely to express concerns about addictiveness, report dependence, think about quitting, and use pouches during school hours. Motives for use also differed; daily users more often used nicotine pouches for smoking cessation or due to dependence, whereas occasional users were more likely to use them for pleasure or mood enhancement. Few differences emerged between daily moderate and daily heavy users, although heavy users were older, more likely to use e-cigarettes, reported greater parental approval of pouch use, and pouch use during school hours.

CONCLUSIONS:
Three distinct subgroups of nicotine pouch users were identified, with daily, moderate use being the most prevalent subgroup, reflecting substantial heterogeneity in use patterns, motives, and associated behaviors. These findings highlight the need for differentiated intervention and cessation strategies targeting varying levels of use intensity and user profiles.