🩺 A Public Health Physician’s Perspective on Nicotine Options

Dr. Edward Anselm, the physician behind this site, has spent decades in public health and tobacco cessation. While this site encourages each person to explore their own goals and preferences, Dr. Anselm shares a few reflections from his experience—offered as one perspective among many:

Nicotine harm reduction works best when people have access to clear, judgment-free information and realistic options. Over the years, I’ve seen what tends to help—and what doesn’t. These reflections are based on that experience.

• Consider your goals. Whether you want to quit, cut back, or reduce harm, the first step is clarity about what you're trying to achieve. There's no one-size-fits-all plan.

• Understand your use. Are you using nicotine to cope with stress, focus better, or avoid withdrawal? Recognizing why you use it can help you find substitutes or support systems that address the same needs more safely.

• Look at the continuum of risk. Cigarettes are the most dangerous way to use nicotine. Patches, gums, lozenges, and some forms of vaping are significantly lower risk. FDA-authorized products may offer more consistent quality and support.

• Get support if you want it. A conversation with your doctor can open the door to low-cost or covered resources like medication or counseling. And you don’t need to be ready to quit completely—just to talk about what might help.

Of course, the least harmful option is not using nicotine at all. But for many people, reducing harm is a more realistic starting point—and often a more sustainable one. In my experience, combining counseling with medication leads to the best outcomes. One medication in particular, varenicline (formerly sold as Chantix), has helped many people shift their entire outlook on quitting. Even if you’ve tried before, giving it a real trial—especially alongside counseling—can make all the difference.