Oral nicotine pouch continuity programmes and US college students' intention to use.

INTRODUCTION: Oral nicotine pouch (ONP) use is increasing among young populations. Many ONP brands are using continuity programmes (also called 'rewards' or 'loyalty' programmes), a marketing strategy that offers points for purchase that can be redeemed for prizes. No research has examined whether awareness of ONP continuity programmes is associated with US young adult intention to use or use of these products. METHODS: Undergraduate and graduate students (N=764) from a southern US university completed an online survey. Items asked about intention to use and ever use of ONPs. Participants were also asked about their awareness of and participation with ONP continuity programmes. Relationships between awareness of continuity programmes, controlling for covariates, were examined with ever use and intention to use ONPs in the future. RESULTS: Zyn Rewards (27.7%) was the most recognised ONP continuity programme. Participants most often first learnt about continuity programmes through word of mouth (31.9%) and social media influencers (27.5%). Only 1.2% ever participated in an ONP continuity programme. Gender, fraternity/sorority membership and socioeconomic status were all associated with intention to use ONPs. Awareness of an ONP continuity programme was associated with higher odds of intention (adjusted OR (aOR)=4.79 (2.73 to 8.39)) and ever use (aOR=3.99 (2.62 to 6.08)) of ONPs. DISCUSSION: US college students are aware of ONP continuity programmes, and awareness is associated with intention to use and ever use of ONPs. State and federal agencies are authorised to regulate tobacco marketing, and consumer protections should monitor social media influencers' promotion of ONP continuity programmes.