Modified risk tobacco product (MRTP) claim, nicotine strength and nicotine label on ZYN perceptions and use intentions among adults who are currently smoking cigarettes

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Abstract
Background: On 17 June 2025, the U.S. Food and Drug Administration (FDA) filed a scientific review for modified risk tobacco product (MRTP) applications from Swedish Match USA for 20 ZYN oral nicotine pouches. This study aims to provide a timely test of the MRTP claim to inform the FDA’s decision-making, by examining the effects of the claim on risk and benefit perceptions, intentions to use ZYN to cut down on cigarettes and intentions to switch completely from cigarettes to ZYN among adults who are currently smoking cigarettes. The study also examined how nicotine strength and label impact ZYN perceptions and intentions. Methods: We recruited 485 adults who were currently smoking cigarettes and conducted a 2 (MRTP claim: present, absent) by 2 (nicotine strength: 3 mg, 6 mg) by 2 (nicotine label: ‘tobacco-free nicotine’, ‘nicotine’) between-subjects experiment with a control condition. Multivariate analyses and logistic regressions examined the impact of the MRTP claim on risk and benefit perceptions, relative risk perceptions and use and complete switch intentions of ZYN, as well as the impact of nicotine strength and nicotine label on perceptions and intentions. Results: MRTP claim led to higher benefit perceptions of ZYN and greater odds of perceiving ZYN as less harmful than cigarettes. ZYN with 3 mg nicotine and the ‘tobacco-free nicotine’ label were associated with greater odds of perceiving ZYN as less harmful. Ethnicity and ZYN use status moderated the impact of message features. The impact of each message feature on use and complete switch intentions was non-significant. Conclusions: The proposed MRTP claim may have limited effectiveness in nudging switching from cigarettes to ZYN among adults who currently smoke. More education is needed to better inform people of ZYN health harm and nicotine risks.

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