Current Professional Society Recommendations
The role of vaping tobacco treatment:
England’s NHS public guidance on quitting smoking states that “nicotine vaping is less harmful than smoking and is one of the effective tools to help people stop smoking, though it is not risk-free”. It also notes that combining vaping with behavioral support increases quit success.
In the United States, no professional society has endorsed the use of vaping for smoking cessation.
Understanding the risks of FDA authorized tobacco products:
The Food and Drug Administration has accelerated review of nicotine pouches and maintains a website:
The Relative Risks of Tobacco Products.
Expert Opinions
Nancy Rigotti, M.D., NEJM 2/14/24 Electronic Cigarettes for Smoking Cessation — Have We Reached a Tipping Point?
Debates on harm reduction and safety
There are strong differences of opinion among national and international sources and I provide links to multiple perspectives. The perspectives of the authors are anchored on a few key concepts:
Nicotine, in any form, is harmful and thus access to all forms of nicotine should be limited, with particular concern for young people. Truth Initiative, Tobacco Free Kids on Flavor, Impact of Smokeless Oral Nicotine Products on Cardiovascular Disease: Implications for Policy, Prevention, and Treatment: A Policy Statement From the American Heart Association, Stan Glantz, the most forceful advocate for this point of view writes E-cigarettes are nearly as risky as cigarettes; dual use is worse: The evidence continues to pile up
OR
Given the challenges that some people have in quitting tobacco, harm reduction is a reasonable approach for adults.
My opinion? We should improve our performance in tobacco treatment and for the small number of people who still are not able to abstain, harm reduction may be a reasonable strategy.
There are other perspectives. The best advocate for honest communication about nicotine products is Kim “Skip” Murray who maintains an independent website.