This scoping review examines the potential public health impact of oral nicotine pouches (ONPs), a new class of nicotine products. The review includes 62 studies, with 17 industry-funded, and focuses on product characteristics, use patterns, beliefs and perceptions, toxicity, and marketing and sales. Key findings include: - **Use Patterns**: Current youth use is estimated at 1.5% and lifetime use at 2.5% in the U.S., while adult use is limited to those with a history of tobacco use. - **Beliefs and Perceptions**: High awareness and susceptibility to try ONPs among youth and young adults, with marketing emphasizing "tobacco-free" and "flavor-ban approved." - **Product Characteristics**: ONPs deliver comparable or higher nicotine levels than conventional smokeless tobacco (SLT) products, with slower nicotine release. - **Toxicity**: Industry-funded studies suggest ONPs are less cytotoxic than cigarettes, but non-industry-funded studies find some harmful compounds, including formaldehyde. - **Marketing and Sales**: Industry advertising expenditures for ONPs have increased, and they are widely available in convenience stores. The review highlights the need for independent research to confirm the findings and determine the net public health impact of ONPs, particularly regarding youth uptake and dual-use. Regulatory bodies should address the lack of authorization and regulation for ONPs, ensuring standards for content and marketing practices.This scoping review examines the potential public health impact of oral nicotine pouches (ONPs), a new class of nicotine products. The review includes 62 studies, with 17 industry-funded, and focuses on product characteristics, use patterns, beliefs and perceptions, toxicity, and marketing and sales. Key findings include: - **Use Patterns**: Current youth use is estimated at 1.5% and lifetime use at 2.5% in the U.S., while adult use is limited to those with a history of tobacco use. - **Beliefs and Perceptions**: High awareness and susceptibility to try ONPs among youth and young adults, with marketing emphasizing "tobacco-free" and "flavor-ban approved." - **Product Characteristics**: ONPs deliver comparable or higher nicotine levels than conventional smokeless tobacco (SLT) products, with slower nicotine release. - **Toxicity**: Industry-funded studies suggest ONPs are less cytotoxic than cigarettes, but non-industry-funded studies find some harmful compounds, including formaldehyde. - **Marketing and Sales**: Industry advertising expenditures for ONPs have increased, and they are widely available in convenience stores. The review highlights the need for independent research to confirm the findings and determine the net public health impact of ONPs, particularly regarding youth uptake and dual-use. Regulatory bodies should address the lack of authorization and regulation for ONPs, ensuring standards for content and marketing practices.