Food and Drug Administration. Health Effects of Tobacco Use. August 29, 2021. Updated March 23, 2022. https://www.fda.gov/tobacco-products/public-health-education/health-effects-tobacco-use

World Health Organization. Tobacco EURO. Accessed August 7, 2023. https://www.who.int/europe/health-topics/tobacco#tab=tab_1

Campaign for Tobacco Free Kids. U.S. Racketeering Verdict: Big Tobacco Guilty as Charged. Accessed August 7, 2023. https://www.tobaccofreekids.org/what-we-do/industry-watch/doj

Truth Initiative. Spinning a new tobacco industry: How Big Tobacco is trying to sell a do-gooder image and what Americans think about it. November 2019. Accessed April 10, 2024. https://truthinitiative.org/sites/default/files/media/files/2019/11/Tobacco%20Industry%20Interference%20Report_final111919.pdf

Lee J, Suttiratana SC, Sen I, Kong G. E-cigarette marketing on social media: a scoping review. Curr Addict Rep. 2023;10(1):29-37. doi:10.1007/s40429-022-00463-2

Campaign for Tobacco-Free Kids. Global Issues; Nicotine Pouches. Updated August 30, 2023. Accessed April 15, 2024. https://www.tobaccofreekids.org/what-we-do/global/nicotine-pouches

Duan Z, Henriksen L, Vallone D, et al. Nicotine pouch marketing strategies in the USA: an analysis of Zyn, On! and Velo. Tob Control. 2024;33(2):154-163. doi:10.1136/tc-2022-057360

Ling PM, Hrywna M, Talbot EM, Lewis MJ. Tobacco-derived nicotine pouch brands and marketing messages on internet and traditional media: content analysis. JMIR Form Res. 2023;7:e39146. doi:10.2196/39146

Dorotheo EU, Arora M, Banerjee A, et al. Nicotine and cardiovascular health: when poison is addictive - a WHF Policy Brief. Glob Heart. 2024;19(1):14. doi:10.5334/gh.1292

U.S. Department of Health and Human Services. The Health Consequences of Smoking: Nicotine Addiction: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control, Center for Health Promotion and Education, Office on Smoking and Health, 1988. https://wwwn.cdc.gov/osh_pub_catalog/SelectionDetails.aspx?p=Gx3ZJci7irbyk4gb1vG%2BgQ%3D%3D

Reitsma MB, Kendrick PJ, Ababneh E, et al. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. The Lancet. 2021;397(10292):2337-2360. doi:10.1016/S0140-6736(21)01169-7

Proctor RN. The history of the discovery of the cigarette-lung cancer link: evidentiary traditions, corporate denial, global toll [published correction appears in Tob Control. 2013 Jan;22(1):62]. Tob Control. 2012;21(2):87-91. doi:10.1136/tobaccocontrol-2011-050338

Dreyfuss E. Our kids are living in a different digital world. The New York Times. January 12, 2024. Accessed April 15, 2024. https://www.nytimes.com/2024/01/12/opinion/children-nicotine-zyn-social-media.html

California Cancer Registry. CCR Library. Incidence and Mortality Counts and Age-Adjusted (2000 U.S. Population) Rates per 100,000 Persons by Year, Race/Ethnicity, and Sex, California, 1988-2017, Lung and Bronchus Cancer. Published December, 2019. Accessed May 17, 2024. https://www.ccrcal.org/retrieve-data/data-library/#273-205-statistical-tables-1665511786

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. BRFSS Prevalence & Trends Data. Accessed April 19, 2024. https://www.cdc.gov/brfss/brfssprevalence/

Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults in the United States. Centers for Disease Control and Prevention. Updated May 4, 2023. Accessed April 25. 2024. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm

World Health Organization. Tobacco use declines despite tobacco industry efforts to jeopardize progress. Updated January 16, 2024. Accessed April 10, 2024. https://www.who.int/news/item/16-01-2024-tobacco-use-declines-despite-tobacco-industry-efforts-to-jeopardize-progress

Truth Initiative. What is Zyn and what are oral nicotine pouches? May 23, 2023. Accessed April 10, 2024. https://truthinitiative.org/research-resources/emerging-tobacco-products/what-zyn-and-what-are-oral-nicotine-pouches

Majmundar A, Okitondo C, Xue A, Asare S, Bandi P, Nargis N. Nicotine pouch sales trends in the us by volume and nicotine concentration levels from 2019 to 2022. JAMA Netw Open. 2022;5(11):e2242235. doi:10.1001/jamanetworkopen.2022.42235

Zyn. Questions. Accessed April 11, 2024. https://us.zyn.com/questions/

Robichaud MO, Seidenberg AB, Byron MJ. Tobacco companies introduce 'tobacco-free' nicotine pouches. Tob Control. 2020;29(e1):e145-e146. doi:10.1136/tobaccocontrol-2019-055321

Gaiha SM, Lin C, Lempert LK, Halpern-Felsher B. Use, marketing, and appeal of oral nicotine products among adolescents, young adults, and adults. Addict Behav. 2023;140:107632. doi:10.1016/j.addbeh.2023.107632

FAQ: Ingredients, How To Use, Freshness and more | ZYN Nicotine Pouches. ZYN. Accessed April 12, 2024. https://us.zyn.com/questions/

Campaign for Tobacco Free Kids. Tobacco Company Quotes on Marketing to Kids. Accessed April 11, 2024. https://assets.tobaccofreekids.org/factsheets/0114.pdf

Centers for Disease Control and Prevention. Nicotine: Systemic Agent. National Institute for Occupational Safety and Health. Updated May 12, 2011. Accessed April 10, 2024 https://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750028.html

American Heart Association. How Smoking and Nicotine Damage Your Body. Updated January 5, 2024. Accessed April 10, 2024. https://www.heart.org/en/healthy-living/healthy-lifestyle/quit-smoking-tobacco/how-smoking-and-nicotine-damage-your-body

McGrath-Morrow SA, Gorzkowski J, Groner JA, et al. The effects of nicotine on development. Pediatrics. 2020;145(3):e20191346. doi:10.1542/peds.2019-1346

U.S. Surgeon General. Surgeon General’s Advisory on E-cigarette Use Among Youth. Accessed April 10, 2024. https://e-cigarettes.surgeongeneral.gov/documents/surgeon-generals-advisory-on-e-cigarette-use-among-youth-2018.pdf

Kutlu MG, Gould TJ. Nicotine modulation of fear memories and anxiety: Implications for learning and anxiety disorders. Biochem Pharmacol. 2015;97(4):498-511. doi:10.1016/j.bcp.2015.07.029

Zhao-Shea R, DeGroot SR, Liu L, et al. Increased CRF signalling in a ventral tegmental area-interpeduncular nucleus-medial habenula circuit induces anxiety during nicotine withdrawal. Nat Commun. 2015;6(1):6770. doi: 10.1038/ncomms7770

U.S. Department of Health and Human Services. Know the Risks. Accessed April 11, 2024. https://e-cigarettes.surgeongeneral.gov/knowtherisks.html

Etter JF, Ussher M, Hughes JR. A test of proposed new tobacco withdrawal symptoms. Addiction. 2012;108(1):50-59. doi:10.1111/j.1360-0443.2012.03981.x

Hughes JR. Effects of abstinence from tobacco: Valid symptoms and time course. Nicotine Tob Res. 2007;9(3):315-327. doi:10.1080/14622200701188919

Gholap VV, Kosmider L, Golshahi L, Halquist MS. Nicotine forms: why and how do they matter in nicotine delivery from electronic cigarettes? Expert Opin Drug Deliv. 2020;17(12):1727-1736. doi:10.1080/17425247.2020.1814736

Blum, D. Can nicotine pouches like Zyn harm your health? What we know about the new products, addiction and cancer. The New York Times. January 25, 2024. Updated January 29, 2024. Accessed April 15, 2024. https://www.nytimes.com/2024/01/25/well/live/zyn-nicotine-pouches-health-risks.html

Baumgaertner E. Juul wanted to revolutionize vaping. It took a page from big tobacco’s chemical formulas. Los Angeles Times. November 20, 2019. Accessed April 10, 2024. https://www.latimes.com/politics/story/2019-11-19/juul-vaping-chemical-formulas-based-in-big-tobacco

Prochaska JJ, Vogel EA, Benowitz N. Nicotine delivery and cigarette equivalents from vaping a JUULpod. Tob Control. 2022;31(e1):e88-e93. doi:10.1136/tobaccocontrol-2020-056367

Mallock N, Schulz T, Malke S, Dreiack N, Laux P, Luch A. Levels of nicotine and tobacco-specific nitrosamines in oral nicotine pouches. Tob Control. 2024;33(2):193-199. doi:10.1136/tc-2022-057280

American Cancer Society. Health Risks of Smokeless Tobacco. Updated October 28, 2020. Accessed April 22, 2024. https://www.cancer.org/cancer/risk-prevention/tobacco/health-risks-of-tobacco/smokeless-tobacco.html

Stanfill S, Tran H, Tyx R, et al. Characterization of total and unprotonated (free) nicotine content of nicotine pouch products. Nicotine Tob Research. 2021;23(9):1590-1596. doi:10.1093/ntr/ntab030

Czaplicki L, Patel M, Rahman B, Yoon S, Schillo B, Rose SW. Oral nicotine marketing claims in direct-mail advertising. Tob Control. 2022;31(5):663-666. doi:10.1136/tobaccocontrol-2020-056446

Dowd AN, Thrul J, Czaplicki L, Kennedy RD, Moran MB, Spindle TR. A cross-sectional survey on oral nicotine pouches: characterizing use-motives, topography, dependence levels, and adverse events. Nicotine Tob Res. 2024;26(2):245-249. doi:10.1093/ntr/ntad179

Clodfelter R, Dutra L, Bradfield B, Bradfield B, Russell S, Levine B, von Jaglinsky A. Annual results report for the California Youth Tobacco Survey. RTI International; 2023. Accessed April 12, 2024. www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/CDPH%20Document%20Library/ResearchandEvaluation/SurveyInstrumentsTrainingManualsAndProtocols/CYTS2023AnnualReport_FINAL.pdf

Dutra L, Ingold-Smith M, Rotermund S, Clodfelter R, Levine B. Annual results report for the California Youth Tobacco Survey: 2022 Results. Published RTI International; 2022. Accessed April 12, 2024. https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/CDPH%20Document%20Library/ResearchandEvaluation/FactsandFigures/CYTS2022AnnualReportFinal.pdf

Rossel S. In the bag; Swedish Match continues to dominate the U.S. nicotine pouch market with its popular Zyn brand. Tobacco Reporter. December 1, 2022. Accessed April 10, 2024. https://tobaccoreporter.com/2022/12/01/in-the-bag-2/

Philip Morris International; 2023 Annual Report. March 8, 2024. Accessed March 28, 2024. https://www.pmi.com/resources/docs/default-source/investor_relation/pmi-2023-annual-report.pdf

Walker JF, Loprinzi PD. Longitudinal examination of predictors of smoking cessation in a national sample of U.S. adolescent and young adult smokers. Nicotine Tob Res. 2014;16(6):820-827. doi:10.1093/ntr/ntu005

U.S. Department of Health and Human Services. E-cigarette use among youth and young adults: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2016. Accessed April 22, 2024. https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf

Centers for Disease Control and Prevention. Youth and tobacco use. Centers for Disease Control and Prevention. Updated November 2, 2023. Accessed April 22, 2024. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm

RJ Reynolds. Younger Adult Smokers: Strategies and Opportunities. February 29, 1984. https://www.industrydocuments.ucsf.edu/docs/rkvk0045

Kim W, Landman K. Zyn, the nicotine pouch at the center of a brewing culture war, explained. Vox. January 30, 2024. https://www.vox.com/health/2024/1/30/24054888/zyn-nicotine-pouch-smokeless-tobacco-snus-snuff-dip-chewing

Patel M, Kierstead EC, Kreslake J, Schillo BA. Patterns of oral nicotine pouch use among U.S. adolescents and young adults. Prev Med Rep. 2023;34:102239. doi:10.1016/j.pmedr.2023.102239

Valinsky J. Zyn nicotine pouches are flying off shelves. Critics say they’re dangerous for kids. CNN. February 9, 2024. Accessed April 10, 2024. https://www.cnn.com/2024/02/08/business/zyn-nicotine-pouches-sales-earnings/index.html

Institute of Medicine (US) Committee to Assess the Science Base for Tobacco Harm Reduction, Stratton K, Shetty P, Wallace R, Bondurant S, eds. Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. Washington (DC): National Academies Press (US); 2001

Carpenter CM, Connolly GN, Ayo-Yusuf OA, Wayne GF. Developing smokeless tobacco products for smokers: an examination of tobacco industry documents. Tob Control. 2009;18(1):54-59. doi:10.1136/tc.2008.026583

Mejia AB, Ling PM. Tobacco industry consumer research on smokeless tobacco users and product development. Am J Public Health. 2010;100(1):78-87. doi:10.2105/AJPH.2008.152603

Miller K. Zyn nicotine pouches are gaining in popularity. But are they actually a healthier alternative to cigarettes? Yahoo Life. February 13, 2024. https://www.yahoo.com/lifestyle/zyn-nicotine-pouches-are-gaining-in-popularity-but-are-they-actually-a-healthier-alternative-to-cigarettes-233001291.html

California Department of Public Health, California Tobacco Control Program. California Tobacco Facts and Figures 2022. Sacramento, CA: California Department of Public Health; May 2023. https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/CDPH%20Document%20Library/ResearchandEvaluation/FactsandFigures/CaliforniaTobaccoFactsAndFigures2022.pdf

Can oral nicotine pouches like Zyn help people quit vaping nicotine? truthinitiative.org. https://truthinitiative.org/research-resources/emerging-tobacco-products/can-oral-nicotine-pouches-zyn-help-people-quit-vaping

Centers for Disease Control and Prevention. How to Quit. Updated October 25, 2023. Accessed August 29, 2023. https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm