Background: Global oral nicotine pouch sales have grown rapidly in recent years, but population-level patterns of use remain poorly described. The aim of this study is to examine recent trends in nicotine pouch use in Great Britain.

Methods: We used data from the Smoking Toolkit Study, a representative monthly cross-sectional survey of tobacco and nicotine use in Great Britain, collected between October, 2020, and March, 2025 (recruiting around 2450 participants per month). Participants were aged 16 years or older (16–17-year-olds included from January, 2022). Nicotine pouch use was self-reported through questions on current use of various nicotine and tobacco products. We estimated trends in the prevalence of current nicotine pouch use, overall and stratified by sociodemographic characteristics and other nicotine product use, as well as trends in the use of pouches to aid quitting smoking. All reported percentages are survey-weighted.

Findings: A total of 127 793 individuals were included in this study. Among adults, nicotine pouch use increased from 0·1% (95% CI 0·1–0·2) in October, 2020, to 1·0% (0·8–1·2) in March, 2025. From 2022, increases were concentrated among young people: in 16–24-year-olds, use rose from 0·7% (0·4–1·4) in January, 2022, to 4·0% (2·9–5·5) in March, 2025, with no meaningful change in those aged 35 years and older. Use was higher among men, especially 16–24-year-old men (7·5%, 6·0–9·4 in March, 2025) and those who smoke or vape, but similar across nations and social grades. Among people using pouches surveyed from January, 2022, to March, 2025, 69% (95% CI 65–74) also used other nicotine products; 56% (52–61) smoked, 39% (34–44) vaped, and 16% (12–19) had never smoked regularly. Among people who attempted to quit smoking in the past year, the proportion using pouches in their most recent quit attempt rose from 2·6% (1·0–6·6) in October, 2020, to 6·5% (4·8–8·8) in March, 2025.

Interpretation: Nicotine pouch use has risen in Great Britain, primarily driven by sharp increases among young people, especially young men. Most users also smoked or vaped, and a growing proportion of smokers used pouches in attempts to quit smoking. These findings underscore the importance of implementing age-of-sale legislation for nicotine pouches and conducting research on their effectiveness for smoking cessation.