North Dakota Teen Smokeless Tobacco Use Doubled
High school students report increased use of nicotine pouches despite a drop in e-cigarette vaping.
Updated on Oct. 2, 2026 in Substance Abuse
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Data from the 2025 Youth Risk Behavior Survey shows that smokeless tobacco use among North Dakota high schoolers reached 7%, up from 3% in 2023. While teen e-cigarette vaping is trending down, health officials note a concerning rise in the popularity of nicotine pouches.
Why it matters
The shift toward smokeless tobacco highlights the appeal of nicotine pouches, which are often marketed as tobacco-free and may lead young people to underestimate their safety profile. This trend has prompted a shift in focus as officials work to address the rising health risks associated with these products.
The 2025 Youth Risk Behavior Survey, which tracks substance use every two years, recorded a 7% usage rate of smokeless tobacco among high schoolers compared to 3% in 2023. Researchers continue to analyze how these trends correlate with the marketing of nicotine-containing products.
The players
State Board of Health
The North Dakota regulatory body responsible for overseeing public health initiatives and reviewing state-wide youth risk survey findings.
Fargo Cass Public Health
A local health department that conducts the biennial Youth Risk Behavior Survey to monitor regional health trends.
FDA
The federal agency that regulates tobacco and nicotine products and issued recent safety recommendations for child-resistant packaging.
The details
Nicotine pouches are increasingly marketed with tobacco-free labeling, which may inadvertently signal to adolescents that these products are a safer alternative to traditional tobacco or vapes. Before the FDA intervened to recommend child-resistant packaging in 2025, there was also a notable increase in nicotine-related poisonings among children age 5 and younger, emphasizing the inherent danger of these concentrated nicotine delivery systems.
Timeline
2023: High school smokeless tobacco use measured at 3%.
2025: High school smokeless tobacco use measured at 7%.
2025: FDA recommended child-resistant packaging for nicotine pouches.
October 2, 2026: Survey results presented to State Board of Health.
2027: Next youth health survey expected.
Health Landscape
This development follows the 2025 FDA recommendation for child-resistant packaging for nicotine pouches to mitigate accidental poisoning risks. It reflects a broader shift in the nicotine landscape where regulatory agencies are scrambling to keep pace with the market expansion of novel, non-combustible products.
Parents and guardians should be aware that products labeled as tobacco-free can still contain high levels of addictive nicotine. If you have concerns about a young person's exposure to these products, it is worth discussing the risks and warning signs of nicotine use with a pediatrician.
The takeaway
While vaping rates among North Dakota teens are trending down, the rise in nicotine pouch use indicates a shift toward different, equally addictive products. It is important to treat all nicotine-containing items with caution and keep them secured, especially if there are children in the home.
What happens next
The next round of the Youth Risk Behavior Survey is scheduled to take place in 2027.
Further reading
For more on the current research surrounding adolescent product use, visit the Substance Abuse section.
Source note: This article includes information reported by INFORUM.
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