The purpose of this 3-minute screening survey is to see if you meet the criteria for taking part in a research study to learn more about the effects of different doses of an oral nicotine pouch. We will ask you to complete questions about yourself, your tobacco use, and medical history. While there is always risk involved in providing personal data, all information that you give during this survey will be kept as confidential as possible by storing it in a secure database indefinitely, however absolute confidentiality cannot be guaranteed. There are no benefits to you for taking part in this survey. If you feel uncomfortable at any time you may choose to refuse to participate, stop the survey, or skip any questions without penalty. Your participation is completely voluntary.

If you have any questions, concerns, or complaints about this survey, please contact Dr. Alison Breland at or 804-827-3562. For questions, concerns, or complaints about your rights as a research volunteer, you may contact Virginia Commonwealth University Office of Research at 804-827-2175.
Do you consent to participate in the screening survey and agree that information that identifies you may be used and disclosed for this research?