This study was exempt from ethics review board approval because it involved the analysis of publicly available, anonymized data that did not include any identifiable private or sensitive personal information [23], consistent with previous tobacco-related social media research that has also been exempted from ethics approval for using public data [24,25].

A systematic search was conducted on Instagram in September 2024 using the hashtags #oralnicotinepouch, #zyn, #on, #velo, and #nicotinepouch. We selected Instagram because it is one of the most commonly used social media platforms by young people, and memes are a prominent and widely shared content type on Instagram [22,26]. All data included were publicly accessible through Instagram’s web interface. No private accounts or nonpublic posts were collected, ensuring compliance with Instagram’s user agreement. Data were extracted manually through systematic searches on the Instagram platform; no application programming interface was used. Each post was documented and stored in a secure database with screenshots and URLs to ensure reproducibility.

Approximately 1800 posts across 8 Instagram accounts associated with #oralnicotinepouch, #zyn, #on, #velo, and #nicotinepouch were screened by the second and third authors. The inclusion criteria required the memes to be photo based and text based and originate from specific Instagram accounts associated with ONP-related hashtags. Posts were reviewed independently by the 2 coauthors to identify the eligible memes. Duplicate posts (n=47), videos (n=1086), posts from deleted accounts (n=396), or posts from accounts without meme content (n=27) were excluded. A total of 244 photo- and text-based memes met the inclusion criteria and were incorporated into the final database for analysis. We selected both photo- and text-based memes for analysis because doing so would enable us to examine both visual and textual elements, which was expected to provide a comprehensive understanding of how the message was communicated in terms of language, tone, and impact.

The coding team consisted of 3 coauthors (YW, SB, and SA). Before coding commenced, the research team developed a detailed codebook. The team conducted a preparatory review of 10 randomly selected memes to familiarize themselves with the dataset and identify preliminary themes, visual styles, and recurring elements. The coding team collaborated using a structured approach to ensure consistency and accuracy in the analysis process.

For the development of the coding framework, the research team assigned each of the 3 coders (YW, SB, and SA) a subset of 30 randomly selected memes from the dataset. Each coder independently generated codes based on the primary themes and messages conveyed in the memes. Following this individual coding process, the team convened for a series of collaborative meetings to identify the most salient codes that aligned with the research objectives and grouped them into broader categories. Minor refinements were made to expand and remove a few codes based on team consensus, and all revisions were documented in an updated codebook to ensure transparency and auditability. The final codebook was organized into 3 major themes (Zyn community, marketing and branding, and perceived consequences of use), along with several additional but less prominent themes. A coding tree accompanied the codebook to ensure consistent application across the dataset. The codebook was developed primarily using an inductive approach; based on a careful review of a sample of memes, no deductive coding based on existing frameworks was applied [27,28]. The unit of analysis was each individual Instagram post containing memes. For carousel posts, the entire carousel was treated as 1 post, and only the first meme image was coded, as it is the primary visual content displayed to users. The complete codebook with operational definitions for each code is provided as Multimedia Appendix 1.

The team used qualitative analysis software (NVivo; Lumivero) to code the memes systematically, with 2 team members (YW and SB) independently coding each meme. Team meetings were conducted regularly, both virtually and in person, to discuss progress and refine the codebook. Shared resources, including the dataset and coding materials, were organized and stored on Google Drive for seamless access and collaboration. Discrepancies were addressed through group discussions. Once consensus was reached, the codes were finalized and stored in a centralized repository for review and further analysis. The final codebook was used to systematically code the 244 memes.

To ensure reliability, intercoder agreement using Cohen κ was periodically assessed throughout the coding process [29]. During pilot coding, Cohen κ ranged from 0.82 to 0.88 across all individual codes, and the mean κ of 0.85 (SD 0.02) was calculated for overall coding agreement, which demonstrated a high level of consistency and reproducibility in data categorization among all coders.

To maintain high construct validity, we ensured that the codes and categories accurately reflected the underlying concepts of health messaging, product promotion, and nicotine pouch use. This was done by obtaining continuous feedback from the research team and refining the codes based on the feedback [30].

Engagement metrics were extracted for the 3 most prominent themes (Zyn community, marketing and branding, and perceived consequences of use) by collecting the total number of likes, comments, and shares associated with posts in each theme. Cumulative engagement values were calculated to quantify overall user interaction across themes.

The engagement metrics revealed that the top 3 themes driving interaction were Zyn community, marketing and branding, and perceived consequences of use. The Zyn community category garnered significant interaction, with 650,000 likes, 1600 comments, and 696,000 shares. Similarly, the marketing and branding category achieved 585,000 likes, 738 comments, and 497,000 shares. In comparison, the perceived consequences of use category recorded 215,000 likes, 224,000 comments, and 422 shares.

The most common meme category was Zyn community (87/244, 35.6%), followed by marketing and branding (68/244, 27.8%) and perceived consequences of use (34/244, 13.9%). Figure 1 shows a sample of memes that reflected these top 3 themes.

Other themes identified in the analysis included nicotine strength, flavor varieties, first-time user experiences, and comparisons between Zyn and other tobacco product. When combined, these themes represent a minor portion of the overall dataset, contributing approximately 22.5% (55/244) of the total samples. Figure 2 shows a sample of memes that reflected these additional themes. Engagement metrics for other themes were not reported due to lower levels of interaction.

This study explored ONP-related memes on the social media platform Instagram. The analysis revealed 3 prominent themes across the memes: Zyn community, marketing and branding, and perceived consequences of use. Memes in the Zyn community theme highlighted social bonding and shared experiences among users, while marketing and branding evaluated the potential appeal of ONPs. The perceived consequences of use theme captured the mixed perceptions of potential consequences of ONP use, such as stress or affect regulation and dependence. Additional themes, including nicotine strength, flavor varieties, first-time user experiences, and comparisons between Zyn and other tobacco products, were less prevalent.

Emerging tobacco products such as e-cigarettes are increasingly shaped by digital culture, where social media communities play a critical role in influencing how these products are perceived, shared, and normalized. Prior research on vaping and ONP-related social media content closely aligns with the Zyn community theme in this study, demonstrating how humor, shared narratives, and visually engaging posts foster a sense of belonging and normalize product use. Humor-driven content has been shown to strengthen community connections [39], while in-group communication and youth-friendly imagery help promote shared identity and normalize vaping behaviors [40]. Similarly, visually appealing posts such as selfies and product photos reinforce community bonds [41]. This pattern extends to ONPs, with Reddit discussions framing ONPs as lifestyle enhancers and TikTok content portraying them as trendy and youth-oriented through humorous, relatable narratives [9-11]. Our findings show that Instagram memes replicate these mechanisms, positioning ONPs as products that facilitate social connection and identity formation.

Advertisement, brand promotion, and marketing of e-cigarettes on social media have become prevalent practices [42-44]. Emerging evidence shows that ONPs are promoted on social media in ways similar to other tobacco products, such as e-cigarettes, with content framing them as socially acceptable, lifestyle-oriented, and often humorous, appealing to younger audiences [9-11]. Studies have shown that images depicting vaping activities tend to generate high engagement and that platforms such as Instagram and Pinterest are effective channels for e-cigarette product displays [11,42]. These findings align with our study’s marketing and branding theme, which highlights Zyn’s marketing strategies, particularly through memes that humorously position the brand as aspirational and ubiquitous, while also suggesting that Zyn use is a grown-up behavior. Research studies also indicate that ONPs are marketed for noncessation purposes and commonly use youth-targeted cues, lifestyle imagery, and implicit health messaging [12,17]. Collectively, these findings reinforce that ONP marketing on social media, much like e-cigarette marketing, leverages visual storytelling, humor, and lifestyle branding to broaden appeal, particularly among younger and digitally engaged audiences.

The perceived consequences of use theme reflects the mixed beliefs surrounding ONP use. Consistent with recent TikTok and Reddit studies, our findings show that users often frame ONPs as tools for stress relief or affect regulation, despite contradictory evidence [9,10]. Memes in this category frequently portray Zyn as a coping mechanism for stress, affect, or poor mental health symptoms (eg, anxiety and depression) [11] or a humorous dependency (eg, the “mini heart attack” when a pouch is missing). These portrayals align with findings from nicotine research indicating that users often perceive nicotine as stress reducing, although nicotine can exacerbate stress and withdrawal symptoms [45]. The humorous framing in memes may obscure these harms, reinforcing the normalization and trivialization of dependence.

The findings from this study highlight significant implications for public health strategies targeting ONP use. First, given the widespread use of humor and relatability in memes, public health campaigns could consider adopting similar strategies to effectively communicate the health risks associated with ONPs. By leveraging humor, these campaigns may better engage younger and more digitally connected audiences, potentially reshaping the cultural narratives surrounding nicotine use. Second, the study emphasizes the need for policies that address the normalization of these products in online spaces. Regulatory agencies should recognize memes and other user-generated content as influential promotional tools and consider monitoring these platforms, as understanding how memes reinforce marketing tactics and community identities can inform regulatory frameworks aimed at controlling the promotion and accessibility of these products, particularly on youth-oriented digital platforms. At the same time, public health professionals have an opportunity to engage with active communities, such as the online Zyn community on Instagram, using their language and humor to provide accurate, balanced, and reliable information about nicotine, including both addiction risks and potential harm-reduction aspects of noncombustible products. Third, policies should also target indirect marketing practices, including influencer partnerships, trend-based content, and meme-driven brand symbolism, which often escape traditional advertising oversight. By combining engaging public health messaging with updated regulatory measures, it may be possible to reduce the appeal of ONPs among adolescents and young adults.

This study has several strengths that enhance its relevance to tobacco research. First, it investigates the growing online community of ONP users, using memes that capture the social dynamics and cultural narratives surrounding these products. The analysis also examines how memes blend humor and social commentary, offering insights into user perceptions and behaviors. This is particularly relevant to young people—a group especially vulnerable to nicotine initiation and addiction—as such content may reinforce interest in and normalize nicotine pouch use. By focusing on the popular social media platform Instagram, this study highlights the need for innovative public health interventions that resonate with digital communities. Furthermore, the research sheds light on the influence of user-generated content in shaping product perceptions and cultural identities, contributing to the broader conversation about how digital platforms impact health behaviors.

While our study offers valuable insights into the social and cultural dimensions of ONP use, there are several limitations to consider. The analysis was limited to Instagram, which was selected due to its popularity among young adults and its prominence in visual meme-based content. However, nicotine-related messaging also appears on platforms such as TikTok, X (formerly Twitter), and Reddit, which were not examined here. The reliance on memes as a primary data source may also have introduced skewed perceptions, as memes often exaggerate or trivialize experiences for comedic effect and may not fully capture the complexities of user experiences or broader attitudes. The hashtag-based sampling strategy may have excluded relevant content outside those parameters and increased the likelihood of including posts from nonhuman accounts, such as automated promotional profiles. Additionally, posts were manually screened, and lower-engagement content was removed, which limits reproducibility and generalizability and may have omitted important perspectives. Finally, the engagement matrix was reported as cumulative totals per theme, which may limit variation at the individual post level.

Future research should explore cross-platform differences in nicotine-related discourse to develop a more comprehensive understanding of how ONPs are represented and circulated online. Combining meme analysis with traditional qualitative methods, such as focus groups or in-depth interviews with members of digital communities, could provide a more nuanced understanding of how ONP use is perceived across different demographic groups. Incorporating bot detection tools and broader sampling strategies could help improve the rigor of future analyses. Studies using post-level engagement data and applying descriptive or inferential statistical techniques may more accurately characterize patterns of user interaction. Additionally, longitudinal designs could help track evolving cultural perceptions of nicotine products as they become more mainstream, and future work may also examine how memes contribute to the adoption of other emerging nicotine products, such as smokeless and heated tobacco products.

Our study illustrates how memes reflect the perceptions of ONPs, emphasizing key themes of community, marketing, and consequences of use. The findings highlight the importance of understanding the digital culture surrounding these products, particularly as they gain popularity among younger, more digitally connected populations. By recognizing the role of humor, relatability, and branding in influencing attitudes, public health campaigns can be better tailored to address the cultural appeal of ONPs and mitigate their potential harm and understand their potential as substitutes for cigarettes. The study lays the groundwork for future research that can explore the intersection of digital culture, substance use, and public health, offering valuable insights for designing more effective, culturally relevant health interventions and providing reliable, balanced, and evidence-based information on nicotine and tobacco products.