Smoking and Nicotine Use Are Two Different Issues

In the United States, it is estimated that approximately 500,000 Americans die of smoking-related diseases each year, a number that hasn’t wavered much over the last decade, even though smoking rates have consistently dropped year over year. During the same period, a wide array of new products that deliver nicotine without combustion (smoke) entered the marketplace. The presence of these products has been the source of much debate in terms of impact on public health, potential unforeseen health risks that might arise from long-term use of these products, and their role in reducing the health burden associated with smoking cigarettes.

One clear aspect of these novel products is that they deliver nicotine in a manner that carries less risk compared to smoking cigarettes. Whether in the form of electronic cigarettes (ENDS, also referred to as vapes or e-cigarettes), heated tobacco products, or oral nicotine (either tobacco or tobacco-free nicotine pouches), the harm associated with new nicotine delivery systems is much lower than combustible cigarettes. Unfortunately, there have been some conversations about the risks associated with these delivery systems, which have clouded the public’s perception of the wide-ranging benefits of using these products instead of smoking.

One major issue is how the potential health benefits of switching from cigarettes to these novel products are obscured, with messaging from major health organizations often equating the risks of nicotine use to those of smoking. This inaccuracy has confused both consumers and medical professionals, since migrating from cigarettes to reduced-risk nicotine products is the single most effective pathway to better health for smokers who choose to continue to use nicotine products or have been unable to quit smoking using traditional approaches.


No one entity is solely responsible for protecting consumers from the harms of combustible products. To further reduce mortality and disease, public health advocacy groups, tobacco/nicotine product manufacturers, and regulatory bodies must work together.