Lay summary
Despite the decline in smoking prevalence in Aotearoa New Zealand (NZ), smoking rates remain high in certain subgroups of the population. Furthermore, smoking is a leading cause of death and disability in NZ. A number of reduced harm nicotine products (e.g. nicotine patches, gum, lozenges, and e-cigarettes) are endorsed by the NZ government to help people quit smoking, based on high-quality trial evidence. The current government has signalled they intend to further support smoking cessation by permitting more reduced harm nicotine products to be sold in NZ, including oral nicotine pouches. However, there are no published trials on the effectiveness of nicotine pouches for smoking cessation. A pragmatic, community-based three-arm trial is therefore proposed looking at the effectiveness, safety and acceptability of nicotine pouches for smoking cessation. Stopping smoking leads to immediate, mid- and long-term health benefits for individuals, their whānau (family) and the community, and is extremely cost-effective.