FDA authorisation of Zyn nicotine pouches: cross-sectional analysis of public discourse on X

Abstract

Background:

On January 16, 2025, the U.S. Food and Drug Administration (FDA) authorized marketing of 20 Zyn oral nicotine pouch products, the first U.S. authorization of this category. Public interpretation may shape perceptions of safety and nicotine use. This study examined discourse on X following authorization.

Methods:

Posts containing “Zyn” or “#Zyn” were collected from X from January 16-23, 2025. After excluding reposts, quote posts, non-English posts, and unrelated content, 549 posts were analyzed. Using an inductive approach, four coders classified posts into ten themes and coded sentiment as supportive, opposed, or neutral. Negative binomial regression models estimated associations between themes and engagement, reported as incidence rate ratios (IRRs) for views, likes, replies, reposts, and quotes.

Results:

Most posts were neutral (58.1%), followed by supportive (28.6%) and opposed (13.3%). The most prevalent themes were News (68.7%) and Public Health Benefits (41.0%), followed by Government Distrust (16.0%) and Potential Harms (11.1%). Supportive posts emphasized harm reduction, whereas opposed posts highlighted regulatory distrust and concerns about addiction and youth uptake. Flavor Discussion (9.5%) was strongly associated with higher engagement across metrics (all p < 0.01). Posts addressing potential harms or policy inconsistencies generated lower engagement on selected metrics.

Conclusion:

Discourse was dominated by informational sharing and harm reduction framing, alongside regulatory skepticism. The strong association between flavor discussion and engagement indicates that flavor-related content was highly visible in the immediate X discourse surrounding the FDA authorization. Clear communication about FDA marketing authorization is needed to prevent misinterpretation as endorsement of safety.

INTRODUCTION

The use of nicotine products, including oral nicotine pouches (ONPs), is a growing public health concern.^{[1, 2]} Here, ONPs refers specifically to oral nicotine pouches, not the broader category of oral nicotine products. ONPs are small, smokeless pouches placed between the upper lip and gum for about 30 to 60 minutes, allowing nicotine absorption through the oral mucosa.^[3] They are marketed as tobacco-free and smoke-free alternatives to traditional cigarettes and other nicotine products.^[4]

Use of ONPs has increased in recent years, although overall prevalence remains relatively low. In 2022, 2.9% of U.S. adults had ever tried an ONP and 0.4% reported current use.^[5] In 2024, nicotine pouches were the second most commonly used tobacco product among U.S. middle and high school students, with 1.8% reporting current use.^[6] Past-year use doubled among 12th-grade students from 3% in 2023 to 6% in 2024 and increased among 10th-grade students from 2% to 3%.^[7] Zyn (or ZYN), an ONP brand manufactured by Swedish Match, a subsidiary of Philip Morris International, has emerged as the market leader; by the end of 2023, grocery and convenience stores sold an estimated 85 million Zyn units monthly.^[8-9] Zyn and other ONPs generate nearly $2 billion annually in the U.S. alone.^[10] As of May 2026, pouches sold in the U.S. were available in 3 mg and 6 mg nicotine strengths and multiple flavors, including Cool Mint, Citrus, and Coffee.^[3] In non-U.S. markets, Zyn pouches were available in strengths ranging from 1.5 mg to 16.5 mg in flavors such as Red Berry Fizz, Menthol Ice, and Blueberry Frost.^[3]

On January 16, 2025, the U.S. Food and Drug Administration (FDA) authorized marketing of 20 Zyn nicotine pouch products, marking the first formal authorization of nicotine pouch products in the U.S. and including several flavored products.^[11] The decision does not constitute FDA approval but permits legal marketing in the U.S. based on the agency’s determination that these products are appropriate for the protection of public health. The regulatory status of these products has continued to evolve. On June 30, 2026, FDA issued modified risk granted orders for the same 20 ZYN nicotine pouch products, allowing them to be marketed with a specific risk-modification claim that using ZYN instead of cigarettes puts users at lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and chronic bronchitis.^[12] The modified risk tobacco product (MRTP) orders are product-specific and distinct from the January 2025 premarket tobacco product application (PMTA) marketing authorization; they permit a specific modified risk claim for authorized products but do not mean that ZYN products are safe, risk-free, appropriate for youth, or appropriate for people who do not use tobacco or nicotine products.^[12] The authorization followed heightened regulatory and political scrutiny of nicotine pouches; in April 2024, the FDA announced warning letters and civil money penalty complaints related to underage sales of Zyn nicotine pouches and also warned online retailers for selling unauthorized flavored Zyn products.^[13] Zyn also drew federal political scrutiny in early 2024, including calls by U.S. Senator Chuck Schumer for regulators to investigate youth appeal and social media-driven marketing practices, a context that likely contributed to how the authorization was interpreted and discussed online.^[14] Although some analyses suggest that ONPs contain fewer harmful constituents than combustible cigarettes, independent studies have identified variability in nicotine content, labeling accuracy, flavoring agents, and additives that warrant further evaluation.^[15-18] Findings from previous nicotine product research suggest that products perceived as less harmful can have high user appeal and influence perceptions of safety and use, particularly when cooling agents such as WS-23 enhance sensory appeal.^{[19, 20]}

Although the FDA marketing authorization permits legal sale, Zyn pouches present risks for nicotine addiction and adverse health effects.^[21] Some users may maintain dual use with combustible tobacco, sustaining nicotine dependence and exposure to smoking-related harms.^[22] Prolonged use has been associated with increased adverse cardiovascular risk, gum disease, oral lesions, sore throat, and nausea.^[23-25] The discreet design of Zyn pouches has also raised concerns about youth appeal and concealability.^[26]

These risks may be misunderstood or minimized following federal marketing authorization, making public interpretation of the FDA’s Zyn authorization especially important given the growing popularity of Zyn and the limited independent research on its long-term health effects. Social media platforms capture real-time, unfiltered public discourse in response to major FDA decisions.^[27] Social media has amplified Zyn’s visibility through influencer-style content and hashtag-based promotion on TikTok and X.^{[28, 29]}

X has been widely used in public health and tobacco control research to examine real-time dissemination of opinions, information, and policy-related discourse.^{[30, 31]} X’s open structure and rapid information flow enable observation of emerging narratives, sentiment shifts, and engagement patterns, while its role as a hub for health communication and policy discussion allows FDA announcements to be amplified, debated, or reframed in ways that provide insight beyond surveys or controlled studies.^[32-34]

This study analyzed publicly available discourse on X following the FDA’s authorization of Zyn nicotine pouch products to characterize dominant themes, sentiment, and patterns of engagement surrounding the announcement.

METHODS

Data Collection and Procedures

Posts containing “Zyn” or “#Zyn” were collected from X from January 16 to January 23, 2025 using the social media listening platform Meltwater. Preliminary monitoring indicated that most discussion occurred in the first week after the January 16 announcement, with post volume concentrated in the first two days and declining sharply thereafter; therefore, the dataset was limited to this period (Supplementary Figure 1). The initial search yielded 7,311 posts. Consistent with prior X-based content analyses, reposts and quote posts were excluded because the unit of analysis was each original post’s standalone text; this reduced duplication and maintained consistency in text-based thematic coding.^[35] After removing reposts and quote posts, 2,846 unique posts remained. Posts unrelated to the FDA announcement (i.e., general conversations about Zyn or other ONP manufacturers) were then excluded, resulting in 630 posts. Removing non-English content left a final analytic sample of n=549 posts. Metadata (e.g., number of views, likes, replies, reposts, and quotes) were downloaded for each post to facilitate engagement analyses.

The first author and three additional trained coders conducted an initial review before developing a codebook and coded posts into themes using an inductive approach.^{[30, 35, 36]} The text of each post constituted the unit of analysis. Images were excluded to maintain consistency in text-based thematic coding. Only information explicitly stated within the post text was coded; content accessible via embedded or external links was not analyzed. Systematic cleaning and standardization produced a finalized dataset. Thematic analysis reached analytic saturation once no new codes or patterns emerged, resulting in ten themes derived inductively from the data to ensure findings remained grounded in the content rather than influenced by preconceived categories.^[37]

The codebook comprised ten themes derived inductively through qualitative content analysis; operational definitions and exemplary posts are provided in Table 1. The themes included “News,” “Public Health Benefits,” “Potential Harms” including the subtheme “Harms to Youth,” “Flavor Discussion,” “Government Distrust,” “Policy Inconsistencies,” “Misinformation,” “Personal Experience,” “Information Seeking,” and “Jokes/Humor.” Themes were applied at the post level, and posts could be assigned to multiple themes. Sentiment was coded independently of thematic categories as supportive of, opposed to, or neutral toward the FDA marketing authorization.^{[30, 35]}

Table 1.

Codebook

Theme	N (%)	Definition	Paraphrased Post
News	377 (68.7%)	Post includes news articles, announcements, and/or states or summarizes information and facts about FDA’s marketing authorization.	FDA officials say that Zyn has fewer harmful ingredients than cigarettes and other kinds of chewing tobacco (link)
Public Health Benefits	225 (41.0%)	Post highlights expected public health benefits (or individual benefits) of Zyn authorization, such as lower smoking rates, lives saved, and/or a reduced burden of tobacco-related diseases.	Bans just don’t work. Nicotine pouches give smokers safer alternatives to cigarettes. Harm reduction is always better than prohibition.
Potential Harms	61 (11.1%)	Post discusses the harms of the FDA’s authorization (e.g., teens becoming addicted to nicotine, Zyn isn’t effective at helping people quit smoking and will just get more people addicted to nicotine).	The FDA gave marketing authorization to Zyn nicotine pouches. That doesn't mean they're safe to use, especially for youth. Experts say there's little evidence that they help adults quit smoking.
Harms to Youth	35 (6.4%)	While discussing the potential harms of Zyn, the post refers to dangers posed to youth (adolescents/teens).	FDA has authorized Zyn nicotine pouches, citing health benefits for adult smokers, despite some concerns over flavored products' appeal to teens. (link)
Flavor Discussion	52 (9.5%)	Post discusses Zyn flavors (either in general or specific flavors) while also referencing the FDA’s approval of Zyn marketing.	This announcement happened just one month after the Denver City Council voted to ban flavored nicotine products (like Zyn), while leaving traditional cigarettes and smokeless tobacco alone, all in the name of helping protect the youth.
Government Distrust	88 (16.0%)	Post expresses (prior or current) distrust in or disagreement with the government, health organizations, or media organizations; may include accusations related to the FDA’s authorization.	The FDA officially authorized Zyn nicotine pouches for sale. In the US, poisoning teens is fine just as long as supporter companies are the ones supplying the poison.
Policy Inconsistencies	32 (5.8%)	Mentions of accusations regarding the FDA’s authorization. Post may make comparisons between Zyn and other substances that are currently banned or not banned.	Just when Biden basically bans cigarettes, Philip Morris scores an endorsement this way, through Zyn. Funny how coincidental timing works.
Misinformation	19 (3.5%)	Post mentions that Zyn/nicotine has health benefits. False claims surrounding Zyn, the FDA, government, and related topics.	Zyn is healthy! I want to get them with my HSA. Under the “harm reduction” rules my state applies to other drugs, this means taxpayers are now required to set up Zyn clinics to prevent cigarette use.
Personal Experience	23 (4.2%)	Post refers to the user’s personal experience using Zyn. User may discuss sensations caused by using Zyn, side effects, how much they like/disliked using it, etc.	I quit using Zyn. I had night terrors for weeks. Quitting definitely led to higher levels of anxiety / energy fluctuations (link)
Information Seeking	20 (3.6%)	Post is either requesting information from other users about, or asking an open-ended question regarding, the FDA’s Zyn authorization. May or may not be a response to another post.	What exactly does it mean that Zyn is FDA approved? They've already been sold for a long time. Was Zyn in a go-to-market temporary review status?
Jokes / Humor	43 (7.8%)	Sarcasm/satirical posts about the FDA’s Zyn authorization.	Uff, I thought I read that they were authorizing a BAN of zyn! I was ready to storm the capitol like during Jan 6.
Sentiment	N (%)	Definition	Paraphrased Post
Pro-Authorization	157 (28.6%)	Posts that express a positive opinion or attitude towards the FDA’s authorization.	This is a good step forward but it makes me wonder if Zyn was authorized just because they’re owned by big tobacco.
Anti-Authorization	73 (13.3%)	Posts that express a negative opinion or attitude towards the FDA’s authorization.	This means Zyn will soon be chock-full of cancer-causing agents and food coloring.
Neutral	319 (58.1%)	Posts that expressed neither pro-authorization nor anti-authorization sentiments.	The FDA has authorized the marketing of 20 Zyn products through the premarket tobacco product application pathway following an extensive scientific review.

Note. Themes were coded at the post level and are not mutually exclusive. Percentages are calculated from the total analytic sample (N = 549).

Four independent coders analyzed the X posts using a binary (yes/no) coding system for each theme. Interrater reliability was assessed by having two coders independently code all posts before reconciliation, and coding definitions were refined accordingly. Coders then applied the revised codebook to resolve inconsistencies until interrater agreement reached at least 90% with a Cohen’s kappa greater than 0.80. The first author served as the final arbiter for any remaining discrepancies.

Data Analysis

Descriptive statistics were calculated to summarize the prevalence of each theme and sentiment category. Pairwise theme co-occurrence analyses were conducted to assess how frequently themes appeared together within posts. This approach examines relationships among coded themes by identifying patterns in how themes co-occur within the same unit of analysis, which can reveal higher-order thematic relationships not apparent from theme frequencies alone.^[38] Engagement metrics (views, likes, replies, reposts, and quotes) were summarized by theme.

Associations between thematic content and engagement were examined using separate negative binomial regression models for each engagement metric. Themes were operationalized as binary indicators (coded 1 if present and 0 if absent) and entered simultaneously in each model to account for co-occurrence within posts. Follower count was included as a covariate to adjust for variation in potential audience size across accounts. Negative binomial models were selected due to overdispersion in engagement counts. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were reported, with statistical significance set at p < 0.05.

A small proportion of posts (n = 19; 3.5%) had missing values for follower count and corresponding engagement metrics; therefore, regression analyses were conducted using complete-case observations for each outcome. All analyses were performed using Stata version 19.^[39]

RESULTS

Descriptive Characteristics

The codebook and example paraphrased posts are reported in Table 1. Posting activity increased sharply on the day of the FDA announcement (January 16; n=276) and remained high the following day (January 17; n=199). Thereafter, daily post volume declined markedly, falling to 27 posts on January 18 and 22 on January 19, and dropping to single digits by January 20 (n=7). Only one post was observed on January 23 (Supplementary Figure 1). Overall, the most prevalent themes were News (n=377, 68.7%) and Public Health Benefits (n=225, 41.0%). Government Distrust (n=88, 16.0%), Potential Harms (n=61, 11.1%; Harms to Youth n=35, 6.4%), and Flavor Discussion (n=52, 9.5%) were less prevalent. Other themes had relatively low prevalence in the sample: Jokes/Humor (n=43, 7.8%), Policy Inconsistencies (n=32, 5.8%), Personal Experience (n=23, 4.2%), and Information Seeking (n=20, 3.6%).

Post Engagement

Posts referencing the FDA authorization within the week after the announcement generated 7,406,013 views, 2,400 likes, 1,789 replies, 41,138 reposts, and 1,226 quotes (Table 2). Although Flavor Discussion appeared in only 52 posts (9.5%), posts coded for this theme generated 4,049,862 views, representing 54.7% of all views in the analytic sample. These posts also generated 25,100 reposts, representing 61.0% of all reposts. Because themes were not mutually exclusive, these totals reflect engagement with posts coded for Flavor Discussion rather than engagement attributable exclusively to this theme. IRRs greater than 1 indicate higher engagement relative to posts not coded for the specified theme, whereas IRRs less than 1 indicate lower engagement. Posts categorized as Flavor Discussion were associated with higher engagement across multiple metrics compared to posts without this theme, including views (IRR = 16.20, 95% CI: 8.56–30.64, p < 0.001), likes (IRR = 14.65, 95% CI: 5.72–37.52, p < 0.001), replies (IRR = 4.08, 95% CI: 1.48–11.20, p = 0.006), reposts (IRR = 12.37, 95% CI: 3.97–38.58, p < 0.001), and quotes (IRR = 11.27, 95% CI: 2.37–53.62, p = 0.002) (Table 3).

Table 2.

Total engagement counts by theme and sentiment in posts discussing the FDA’s Zyn authorization on X (N = 549).

Theme	Views	Likes	Replies	Reposts	Quotes
News	7,079,444	2,278	1,614	39,813	1,210
Public Health Benefits	2,184,647	825	877	9,601	394
Potential Harms	165,547	75	92	370	20
Harms to Youth	115,760	59	71	279	18
Flavor Discussion	4,049,862	1,187	412	25,100	624
Government Distrust	166,218	95	97	854	18
Policy Inconsistencies	7,371	11	15	69	1
Misinformation	21,001	50	17	275	5
Personal Experience	125,020	27	30	192	1
Information Seeking	32,859	9	19	311	4
Jokes/Humor	13,545	5	6	68	3
Pro-Authorization	1,268,720	475	466	7,670	225
Anti-Authorization	138,936	61	92	530	10
Neutral	5,998,357	1,864	1,231	32,938	991
Total	7,406,013	2,400	1,789	41,138	1,226

Note. Values represent total engagement counts across posts coded for each theme or sentiment category. Themes are not mutually exclusive.

Table 3.

Associations between themes and engagement metrics in posts discussing the FDA’s Zyn authorization on X (n = 530).

Views
Theme	IRR	95% CI	p-value
News	2.21	1.10–4.41	0.025
Public Health Benefits	1.02	0.67–1.54	0.937
Potential Harms	0.19	0.08–0.43	<0.001
Harms to Youth	2.43	0.85–7.01	0.099
Flavor Discussion	16.20	8.56–30.64	<0.001
Government Distrust	1.16	0.57–2.34	0.680
Policy Inconsistencies	0.13	0.06–0.31	<0.001
Misinformation	0.97	0.28–3.34	0.964
Personal Experience	0.37	0.12–1.17	0.090
Information Seeking	3.47	1.15–10.48	0.028
Jokes/Humor	0.27	0.12–0.58	0.001
Likes
Theme	IRR	95% CI	p-value
News	2.86	0.96–8.53	0.060
Public Health Benefits	0.82	0.43–1.57	0.554
Potential Harms	0.14	0.03–0.58	0.007
Harms to Youth	1.83	0.32–10.59	0.498
Flavor Discussion	14.65	5.72–37.52	<0.001
Government Distrust	1.03	0.34–3.14	0.955
Policy Inconsistencies	0.21	0.05–0.89	0.035
Misinformation	1.03	0.19–5.69	0.974
Personal Experience	0.16	0.03–0.96	0.046
Information Seeking	0.84	0.14–4.90	0.842
Jokes/Humor	0.71	0.17–2.96	0.641
Replies
Theme	IRR	95% CI	p-value
News	0.95	0.29–3.06	0.929
Public Health Benefits	0.72	0.37–1.44	0.357
Potential Harms	0.34	0.08–1.51	0.154
Harms to Youth	2.63	0.40–17.12	0.312
Flavor Discussion	4.08	1.48–11.20	0.006
Government Distrust	0.82	0.25–2.66	0.737
Policy Inconsistencies	0.25	0.05–1.16	0.077
Misinformation	0.64	0.09–4.47	0.648
Personal Experience	0.23	0.03–1.73	0.152
Information Seeking	0.68	0.11–4.42	0.690
Jokes/Humor	0.32	0.07–1.40	0.129
Reposts
Theme	IRR	95% CI	p-value
News	1.64	0.55–4.94	0.376
Public Health Benefits	0.83	0.39–1.76	0.626
Potential Harms	0.26	0.05–1.35	0.108
Harms to Youth	6.15	0.55–69.32	0.142
Flavor Discussion	12.37	3.97–38.58	<0.001
Government Distrust	0.83	0.26–2.67	0.752
Policy Inconsistencies	0.09	0.01–0.86	0.036
Misinformation	0.32	0.04–2.67	0.290
Personal Experience	0.04	0.01–0.71	0.029
Information Seeking	0.55	0.07–4.22	0.564
Jokes/Humor	0.16	0.04–0.75	0.020
Quotes
Theme	IRR	95% CI	p-value
News	6.19	1.00–38.33	0.050
Public Health Benefits	0.47	0.14–1.56	0.219
Potential Harms	0.12	0.01–2.67	0.178
Harms to Youth	3.14	0.07–136.07	0.552
Flavor Discussion	11.27	2.37–53.62	0.002
Government Distrust	1.16	0.14–9.48	0.888
Policy Inconsistencies	0.23	0.01–6.72	0.393
Misinformation	1.89	0.04–88.26	0.747
Personal Experience	0.57	0.01–26.97	0.776
Information Seeking	0.05	0.01–2.59	0.139
Jokes/Humor	0.30	0.03–3.24	0.321

Note. IRR = incidence rate ratio; CI = confidence interval. Models estimated using negative binomial regression. IRRs > 1 indicate greater engagement; IRRs < 1 indicate lower engagement relative to posts not coded for the specified theme. Statistical significance assessed at p < 0.05.

Posts containing News were associated with greater views (IRR = 2.21, 95% CI: 1.10–4.41, p = 0.025) compared to posts without this theme. Information seeking posts generated more views (IRR = 3.47, 95% CI: 1.15–10.48, p = 0.028) compared to posts without this theme. In contrast, posts discussing Potential Harms were associated with fewer views (IRR = 0.19, 95% CI: 0.08–0.43, p < 0.001) and fewer likes (IRR = 0.14, 95% CI: 0.03–0.58, p = 0.007) compared to posts that did not.

Themes associated with lower engagement included Policy Inconsistencies, which generated fewer views (IRR = 0.13, 95% CI: 0.06–0.31, p < 0.001), fewer likes (IRR = 0.21, 95% CI: 0.05–0.89, p = 0.035), and fewer reposts (IRR = 0.09, 95% CI: 0.01–0.86, p = 0.036) compared to posts without this theme. Posts reflecting Personal Experience were associated with fewer likes (IRR = 0.16, 95% CI: 0.03–0.96, p = 0.046) and fewer reposts (IRR = 0.04, 95% CI: 0.01–0.71, p = 0.029) compared to posts that did not. Posts categorized as Jokes/Humor generated fewer reposts (IRR = 0.16, 95% CI: 0.04–0.75, p = 0.020) compared to posts that were not.

Sentiment

Neutral sentiment (n=319, 58.1%) was observed most frequently, followed by pro-authorization posts (n=157, 28.6%), and anti-authorization posts (n=73, 13.3%). Among posts with neutral sentiment, 78.1% discussed News and 31.7% addressed Public Health Benefits (Table 4). Posts with pro-authorization sentiment also predominantly focused on News (63.7%) and Public Health Benefits (70.1%), indicating that supportive posts often framed the FDA’s decision as a step toward harm reduction, smoking cessation, and the development of less harmful nicotine alternatives. In contrast, anti-authorization posts most frequently discussed Government Distrust (61.6%) and Potential Harms (52.1%), suggesting skepticism toward regulators, concerns about industry influence, and perceptions that the FDA’s decision favored corporate interests over public health.

Table 4.

Prevalence of themes by sentiment toward FDA authorization of Zyn flavored nicotine pouches (N = 549).

Theme	Pro-Authorization 157 (28.6%)	Neutral 319 (58.1%)	Anti-Authorization 73 (13.3%)
News	100 (63.7%)	249 (78.1%)	28 (38.4%)
Public Health Benefits	110 (70.1%)	101 (31.7%)	14 (19.2%)
Potential Harms	6 (3.8%)	17 (5.3%)	38 (52.1%)
Harms to Youth	5 (3.2%)	14 (4.4%)	16 (21.9%)
Flavor Discussion	16 (10.2%)	26 (8.2%)	10 (13.7%)
Government Distrust	10 (6.4%)	33 (10.3%)	45 (61.6%)
Policy Inconsistencies	4 (2.5%)	17 (5.3%)	11 (15.1%)
Misinformation	13 (8.3%)	1 (0.3%)	5 (6.8%)
Personal Experience	13 (8.3%)	5 (1.6%)	5 (6.8%)
Information Seeking	4 (2.5%)	16 (5.0%)	0 (0.0%)
Jokes/Humor	17 (10.8%)	18 (5.6%)	8 (11.0%)

Note. Percentages are calculated within sentiment category. Themes are not mutually exclusive.

Theme Co-occurrence

Figure 1 presents the pairwise theme co-occurrences, with corresponding frequencies and percentages in Supplementary Table 1; only theme pairs co-occurring in at least 10 posts are displayed. The co-occurrence network showed that News frequently appeared alongside Public Health Benefits (n = 190, 34.6%), indicating that many posts shared information about the FDA authorization while also referencing harm reduction or other potential benefits (Supplementary Table 1).

Figure 1.

Pairwise theme co-occurrences in posts discussing FDA authorization of Zyn nicotine pouches (N = 549). Node size represents theme prevalence. Edge thickness represents the frequency of pairwise co-occurrences within the same post. Only theme pairs co-occurring in ≥10 posts are displayed for visual clarity. Node colors indicate thematic groupings based on the study codebook: authorization stance (red), health framing (orange), policy framing (green), and communication type (blue).

Additional notable co-occurrences included News with Potential Harms (n = 38, 6.9%) and Flavor Discussion (n = 35, 6.4%), as well as Potential Harms with Harms to Youth (n = 34, 6.2%). Public Health Benefits also co-occurred with Potential Harms (n = 23, 4.2%), indicating that some posts referenced both positive and negative health considerations within the same message.

In the co-occurrence network, health-related themes clustered with authorization stance themes, reflecting frequent overlap between health framing and attitudes toward the FDA’s decision. Communication-oriented themes, such as Information Seeking, Personal Experience, Jokes/Humor, and Misinformation, exhibited fewer high-frequency co-occurrences and were comparatively peripheral within the network.

DISCUSSION

This study examined public discourse on X following the FDA’s January 2025 authorization of 20 Zyn nicotine pouch products, the first authorization of an oral nicotine pouch in the United States. In the week after the announcement, most included posts were neutral and focused on sharing or commenting on news coverage, while a smaller proportion of X posts expressed strong approval or disapproval of the FDA’s decision. The most common themes, News, Public Health Benefits, Government Distrust, and Potential Harms, suggest that discourse on X centered on both the health implications of Zyn and the motivations behind its authorization.

Posts expressing support for the FDA’s decision frequently discussed News and Public Health Benefits, framing authorization as a step toward harm reduction and a recognition of smoke-free alternatives to traditional tobacco products. In some posts, this framing presented the authorization as an indication of relative safety. These views echo industry narratives that promote oral nicotine pouches as tools for cessation or reduced exposure.^[40] However, such interpretations risk reinforcing misconceptions that marketing authorization equates to product approval or safety. These findings suggest the importance of clear communication from the FDA and public health agencies to clarify that marketing authorization permits legal sale but does not mean that these products are safe, FDA approved, or without risk.

In contrast, posts opposing the FDA’s decision often reflected Government Distrust and Potential Harms. These discussions questioned whether the agency’s decision favored corporate interests over public health priorities. Expressions of mistrust toward regulatory bodies are consistent with previous findings on tobacco-related discourse, where perceived inconsistencies in enforcement and policymaking amplify skepticism.^[41] This suggests that interpretation gaps persist around the FDA’s regulatory framework and the scientific criteria guiding such decisions.

Engagement patterns were not solely explained by theme prevalence. Although News was the most common theme and was associated with higher view counts, Public Health Benefits was also common but was not independently associated with higher engagement after adjustment for co-occurring themes and follower count. By contrast, Flavor Discussion appeared in a relatively small proportion of posts but was consistently associated with higher engagement across all outcomes, including views, likes, replies, reposts, and quotes. These findings suggest that flavor-related messages were particularly prominent within X discourse surrounding the FDA authorization. Because flavored nicotine products may be misinterpreted as lower risk or implicitly endorsed when authorized for marketing, regulatory and public health messaging should clearly distinguish FDA marketing authorization from product approval, safety, or absence of harm. Messaging should also clarify that authorization of flavored nicotine pouch products does not mean that flavors are harmless, that flavored products are appropriate for youth or people who do not use nicotine, or that flavor-related appeal was resolved as a public health concern. Prior analyses of nicotine-related content on social media platforms have shown that peer-to-peer promotion and influencer-style marketing amplify product visibility, normalize use behaviors, and reinforce positive product perceptions, particularly for emerging nicotine products such as e-cigarettes.^{[42, 43]}

The subsequent FDA issuance of MRTP orders for 20 ZYN products further underscores the importance of precise risk communication. Although MRTP authorization allows these products to be marketed with a specific reduced-risk claim for adults who switch completely from cigarettes to ZYN, the public discourse observed in this study suggests that FDA regulatory actions can be rapidly reframed online as broader endorsements of product safety. This distinction is especially important for flavored nicotine pouch products, given the high engagement observed for Flavor Discussion posts. Public health messaging should therefore clarify not only the difference between PMTA marketing authorization and FDA approval, but also the difference between a product-specific MRTP claim for adults who smoke and broader claims that ZYN is safe, risk-free, or appropriate for youth or nicotine-naïve individuals.^[12]

Overall, the prominence of News, Public Health Benefits, and Government Distrust posts underscores social media’s dual role as an information source and a conduit for misinterpretation or misinformation. This pattern is widely documented in tobacco control research, where user-generated content simultaneously disseminates health information and circulates misleading or inaccurate claims about product safety, regulatory decisions, and industry practices.^{[44, 45]} The observed tendency in posts to conflate FDA authorization with safety approval reveals a need for targeted communication. Regulators and health organizations should consider proactive outreach to clarify what marketing authorization entails and to dispel misconceptions about product safety. Continued social media monitoring can identify emerging narratives and inform timely, evidence-based messaging. Social media surveillance has increasingly been recognized as a valuable component of tobacco regulatory science, enabling researchers and public health agencies to detect emerging narratives, track shifts in sentiment, and respond rapidly to misinformation or evolving marketing strategies.^{[46, 47]}

LIMITATIONS

Several limitations should be considered. The analysis was limited to publicly available posts on X and does not capture conversations on other platforms or within private accounts; however, the study’s focus on public-facing discourse makes X an appropriate platform for examining discourse surrounding a major regulatory decision. Data were collected in the first week after the FDA announcement and do not reflect longer-term shifts in sentiment or engagement. Although this window captured peak posting activity (Supplementary Figure 1), it may overrepresent news-following, politically engaged, or health-engaged X users. Public discourse may have differed as information spread through other channels and reached less immediately engaged audiences. Because the announcement occurred four days before the January 20, 2025 presidential inauguration, some Government Distrust posts may have reflected broader political or anti-regulatory sentiment during this period rather than concerns specific to Zyn or the FDA authorization. In addition, prior political discourse surrounding Zyn, including U.S. Senator Chuck Schumer’s calls for regulators to examine youth appeal and social media-driven marketing, may have shaped how users framed the authorization in relation to regulatory trust, industry influence, and youth uptake.^[14]

Keyword-based data collection may have missed indirect references to Zyn. Because posts were collected through Meltwater, we could not independently verify whether X platform-level restrictions, rate limits, vendor-specific access constraints, or other sampling processes affected capture of all eligible public posts matching the search terms.

Reposts and quote posts were excluded to reduce duplication and maintain consistent text-based coding; however, quote posts may include substantive commentary and high-engagement reactions. Their exclusion may have reduced representation of reactive or polarized discourse.

Social media users are not representative of the general population and may skew toward younger, more digitally active individuals.^[48] Nicotine pouch use has been reported among youths and adults who use cigarettes, e-cigarettes, and smokeless tobacco, making X relevant for examining discourse around these products.^[49]

Posts were analyzed at the post level, and although repeat posting was limited, a small number of accounts contributed more than one post. We did not classify posts by account type, such as news organizations, journalists, policymakers, researchers, advocacy groups, industry-affiliated accounts, or individual consumers. Because X includes institutional and individual users, the high prevalence of News, Public Health Benefits, and Neutral posts may partly reflect dissemination by news outlets and professional accounts.

We did not conduct formal bot detection, coordinated-activity analysis, or assessment of industry-affiliated amplification. Although no obvious coordinated activity was identified during coding, engagement metrics, particularly for Flavor Discussion posts, may have been influenced by automated accounts, coordinated posting, algorithmic amplification, or industry-adjacent promotion.

Finally, this study analyzed public discourse rather than user characteristics or behaviors and therefore cannot determine who is engaging with these products. Future profile analyses may examine user-level characteristics, network structures, and posting histories to identify which populations are driving and amplifying these conversations.

CONCLUSION

Public discourse following the FDA’s authorization of Zyn nicotine pouches reflected both enthusiasm for its potential public health benefits and skepticism regarding regulatory motives. Posts emphasizing Public Health Benefits and Government Distrust illustrated competing narratives about nicotine innovation, safety, and oversight. The prominence of flavor-related engagement suggests that flavor framing was an important feature of online discourse surrounding the FDA authorization. Together, these findings show how FDA marketing authorization can be rapidly reframed on social media through harm-reduction narratives, regulatory skepticism, and flavor-related narratives.

These findings underscore the importance of clear communication about what FDA marketing authorization signifies and what it does not, particularly for flavored nicotine products. Integrating social media monitoring into tobacco regulatory science may help identify emerging misperceptions, track evolving narratives, and support more responsive, evidence-based public health communication strategies.^{[46, 47]}

Supplementary Material

Supp1

Supplementary Figure 1. Distribution of posts discussing FDA authorization of Zyn nicotine pouches by date (N = 549). Bars represent the number of posts collected on each date from January 16 to January 23, 2025. Post volume was highest on January 16, the date of the FDA authorization announcement, and declined sharply over the subsequent week.

What is already known on this topic

• FDA marketing authorization for tobacco products is often mistaken for FDA approval or evidence that products are safe.

• Nicotine pouches are a growing smoke-free nicotine product category, with concerns about youth appeal, addiction, and long-term health effects.

• Social media can rapidly shape public interpretation of tobacco regulation, harm reduction, and product safety claims.

What this study adds

• This study analyzed 549 X posts after FDA authorization of Zyn nicotine pouches to characterize themes, sentiment, and engagement.

• X discourse was dominated by news sharing and harm-reduction framing, alongside regulatory distrust and concerns about addiction and youth uptake.

• Flavor-related posts were uncommon but generated substantially higher engagement across views, likes, replies, reposts, and quotes.

How this study might affect research, practice or policy

• FDA and public health agencies should clearly distinguish marketing authorization from product approval, safety, or absence of risk.

• Risk communication should address flavored nicotine pouch authorization, especially because flavor-related content attracted high engagement online.

• Ongoing social media surveillance can help identify misinterpretations of tobacco regulatory decisions and support timely corrective messaging.

Data availability statement:

The data analyzed in this study consist of publicly available posts from X collected during the specified study period. In accordance with platform terms of service governing redistribution of user-generated content, the raw post content cannot be publicly shared. Post identifiers and analytic code may be made available from the authors upon reasonable request.