Nicotine pouches have become one of the fastest-growing nicotine categories globally, fueled by their discreet nature, lack of smoke or vapor, and growing perceptions that they represent a cleaner form of nicotine consumption
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For example, items about use of various tobacco products were adapted from the Tobacco Use Supplement to the Current Population Survey items on cigarette smoking to assess the full array of tobacco products.22 Nicotine dependence items in the PATH Study's questionnaires were based in part on the National Epidemiological Survey on Alcohol and Related Conditions Survey.23 Questions on physical health end points were drawn from the National Health and Nutrition Examination Survey (NHANES), including, in some cases, adapting the question stems of the NHANES for items on health conditions that are not asked about in the NHANES.24 Other health-related items in the PATH Study questionnaires came from validated screeners including the Global Appraisal of Individual Needs (GAIN) and Patient Reported Outcomes Measurement Information System (PROMIS).2527 The PATH Study questionnaires also included items from international, state and privately funded tobacco surveillance surveys, such as the ITC Project, the Visual Media Influences on Adolescent and Young Adult Smoking Behaviour surveys and the Minnesota Adult Tobacco Survey
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