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Oral nicotine pouches can contain high levels of nicotine, and a study from 2022 found that sales of oral nicotine pouches containing the highest nicotine concentration (8 mg) increased faster than sales of pouches with a lower nicotine concentration (6, 4, or 3 mg), raising concerns about the addictiveness of these products

A study by the University of California at San Diego and Truth Initiative found that the brand may have been effective in encouraging young girls to start smoking, with teen girls citing it as a favorite cigarette campaign

Some users prefer to keep them in longer, but effectiveness diminishes over time

Experience the pure essence of tobacco with the distinct quality of American Spirit