Currently submitted to: Online Journal of Public Health Informatics
Date Submitted: Mar 24, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Online Discourse of Oral Nicotine Pouches on Twitter: Cross-Sectional Study
ABSTRACT
Background:
Oral nicotine pouches (ONPs) are a relatively new tobacco-free nicotine product that has gained increasing attention, including extensive discussion on social media.
Objective:
This study aims to examine public online discussions of ONPs on Twitter (now X).
Methods:
A total of 4,393 tweets posted between March 11, 2021, and March 14, 2023, were collected through Twitter streaming Application Programming Interface (API) using ONPs-related keywords, such as “nicotine pouch”. After excluding irrelevant content, duplicates, and commercial posts, 2,021 ONPs-related tweets were obtained, which were manually coded to identify main topics. The sentiment was manually coded for user experiences with ONPs.
Results:
The volume of ONPs-related tweets increased over the two-year study period. The most prevalent topic was User Experience (628/2,021, 31.1%), followed by Information Sharing (603/2,021, 29.8%), and Encouraging Use (312/2,021, 15.4%). General Questions (224/2,021, 11.1%) and Other (254/2,021, 12.6%) were less frequently discussed. Among User Experience tweets, 78% (490/628) expressed positive sentiment, 13% (82/628) negative sentiment, and 9% (56/628) neutral sentiment towards ONPs.
Conclusions:
ONPs were generally portrayed positively on Twitter, with conversations centered on personal experiences, information sharing, and peer encouragement. These findings revealed online discussion of ONPs on social media, which may help inform communication strategies and regulatory considerations as the use of ONPs continues to expand.
Citation
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