Predicting Tobacco-Free Nicotine Pouch Intention Among Swedish Young Adults: Gender and the Proximal Predictors of the Theory of Triadic Influence

Sammanfattning: Nicotine pouches are popular products marketed in Sweden as tobacco-free alternatives to tobacco-containing snus. The purpose of the present study was to investigate the underlying factors influencing use of nicotine pouches among Swedish young adults using the theory of triadic influence (TTI; Flay et al., 1995), a model used to predict health-related behaviors. A questionnaire measuring self-efficacy/perceived behavioral control, social normative beliefs, and affective attitudes toward nicotine pouches and snus was administered to nicotine-using and non-using Swedish adults ages 18-29 (N = 493). Ordinal logistic regressions were conducted to assess the predictive power of the three TTI predictors and gender on nicotine pouch use intention with nicotine-use status and age as controls. Additional tests were conducted to measure between-gender differences in intention and within-subject differences in nicotine pouch and snus affective attitudes. Participants with higher self-efficacy/perceived behavioral control had .460, 95% CI [.389, .544] the odds of expressing higher intention, and participants with more positive affective attitudes toward nicotine pouches had 1.144, 95% CI [1.054, 1.243] the odds of expressing higher intention than those that scored lower. No significant differences were found in intention between genders, U = 25746, z = -1.386, p = .166. Nicotine pouches elicited a mean increase in affective attitudes when compared to snus, t(476) = 14.474, p < .001, d = .66. Results indicated that self-efficacy/perceived behavioral control and affective attitudes toward nicotine pouches were significant predictors for nicotine pouch use intention, and participants held more positive affective attitudes toward nicotine pouches than snus.