Significant steps have been taken to embrace smoke-free alternatives to cigarettes. Milestone moments, such as the Food and Drug Administration’s marketing authorization of nicotine pouch products, have been celebrated as public health achievements that will help legal-age adult nicotine consumers make the switch from cigarettes.
Unfortunately, there has been much misinformation about nicotine pouches and heated tobacco products that, although addictive and not risk-free, are two of the most promising paths for eliminating cigarettes in America. This does a disservice to the 28 million legal-age Americans who want a better choice than sticking with cigarettes.
As a former secretary of Health and Human Services, I find it troubling from a policy perspective. However, as a physician, it’s borderline tragic. Let’s be crystal clear that smoking is the most dangerous way of consuming nicotine. Smokers need to know there are better, smoke-free options available that they can switch to if they choose.
It is essential to begin with the facts, specifically those offered by the U.S. government, from Republican and Democratic administrations, acknowledging the benefits of smoke-free products compared to traditional cigarettes.
Let’s start with ZYN, a well-known nicotine pouch brand and the only one that has cleared the FDA’s years-long premarket tobacco product application process. Consumers must know that, among other things, the FDA concluded that “these products offer greater benefits” to the population’s health than risks, benefiting adults who use cigarettes and/or smokeless tobacco products and completely switch to ZYN.
Understandably, no one wants to increase youth smoking or nicotine use. However, the Centers for Disease Control and Prevention’s 2024 National Youth Tobacco Survey found that “youth nicotine pouch use did not show a statistically significant change from 2023,” remaining lower than 2 percent. In other words, nicotine pouches are not being used by minors to any degree close to what the critics would have Americans believe.
It’s baffling to me that some nicotine prohibitionists demand government action but go out of their way to dismiss such action when it doesn’t suit their desire to rob American adults of better alternatives.
It is unfortunate that a second form of innovative smoke-free product, heated tobacco products, has been inaccurately maligned. While critics have questioned whether heated tobacco products provide health benefits compared to cigarettes, the FDA has already authorized two versions as modified risk tobacco products. Specifically, after reviewing the available scientific evidence, public comments and recommendations, the agency stated that scientific studies have shown that switching completely from conventional cigarettes significantly reduces a smoker’s exposure to harmful or potentially harmful chemicals.
HHS Secretary Robert F. Kennedy Jr. and FDA Commissioner Marty Makary have said their priority is to “Make America Healthy Again.” I hope their commitment to that goal can help build a healthier country. We must begin by using facts, including a concerted effort to educate American consumers on the benefits of these smoke-free products compared to continued smoking, rather than allowing the spread of misinformation that muddies the waters and serves only to keep Americans smoking.
