Help to stop smoking

Category: Products

  • Nicotine pouches

    Nicotine pouches

    In the evolving landscape of nicotine products, a new contender has emerged: the nicotine pouch. These small, often mint-flavored sachets offer a smoke-free, vapor-free nicotine experience. But what exactly are these pouches, and do they represent a genuine step forward in public health?

    What is a nicotine pouch?

    Nicotine pouches are designed for oral use, placed between the gum and lip where nicotine is absorbed through the lining of the mouth. Unlike traditional chewing tobacco or snus, they are tobacco-free. Instead, they contain a pharmaceutical-grade nicotine salt, typically derived from the tobacco plant but purified. This nicotine is then mixed with food-grade fillers, flavorings – ranging from refreshing mint to exotic fruits – and sweeteners and pH regulators, all enclosed within a small, permeable cellulose pouch. The absence of tobacco leaf itself is a key selling point, distinguishing them from their predecessors and positioning them as a potentially cleaner alternative. Because nothing is burned or heated, users are not exposed to tar or carbon monoxide, two of the most dangerous byproducts of smoking.

    Who should use them and who should not

    Public health authorities broadly agree on one point: people who do not already use nicotine should not start. That includes children, teenagers and adults with no history of smoking or nicotine dependence. For these groups, nicotine offers no health benefit. The very nature of nicotine – an addictive substance – means that these pouches should not be used by never-smokers.

    The target consumers of nicotine pouches are adult smokers seeking an alternative to cigarettes, and a convenient way to get nicotine in situations where smoking or vaping is not permitted or desired. For individuals already addicted to nicotine through other means, switching to a tobacco-free product is a logical step toward reducing exposure to harmful combustion chemicals.

    Nicotine pouches are comparable to nicotine gum or lozenges, though they are sold as consumer products rather than medical therapies. This difference matters, because nicotine replacement therapies are regulated, dosed, and usually accompanied by guidance on quitting, while pouches are marketed for ongoing use.

    Toxicity and Side Effects

    The toxicity and side effects of nicotine pouches, while less severe than those associated with smoked tobacco, are not negligible. Nicotine itself is a potent chemical, and its rapid absorption can lead to addiction and to symptoms like nausea, hiccups, and gum irritation. There is also the potential for accidental ingestion by children, which can lead to nicotine poisoning requiring urgent medical attention.

    Are nicotine pouches effective for smoking cessation?

    As for their effectiveness in helping people quit smoking, the evidence remains limited. Unlike nicotine patches or prescription medications, nicotine pouches have not been widely studied in randomized clinical trials for smoking cessation. While some users report successfully transitioning from cigarettes to pouches, and even subsequently reducing their overall nicotine intake, these products are not officially recognized as smoking cessation aids by major health authorities like the FDA or the NHS. They are primarily nicotine delivery systems, and while they might reduce exposure to other harmful chemicals in tobacco smoke, they perpetuate nicotine dependence. Nevertheless, they are very similar in their usage and nicotine delivery to nicotine gums, which are effective smoking cessation aids and have few side effects.

    The Harm Reduction Controversy

    On a population level, the rise of nicotine pouches presents a familiar dilemma for public health officials. If large numbers of smokers fully switch from cigarettes to pouches, overall disease and death from smoking-related illnesses could decline. Sweden is often cited in this context, as it has one of the lowest smoking rates and lung cancer rates in Europe, alongside widespread use of oral nicotine products. Whether that experience can be replicated elsewhere remains an open question.

    This brings us to the heart of the controversy: their public health impact and the concept of “harm reduction.” Proponents argue that by offering a less harmful alternative to combustible tobacco, nicotine pouches can play a role in reducing the immense burden of smoking-related diseases. They suggest that giving smokers a safer way to consume nicotine is better than smoking. Critics, however, fear that these products could undermine public health efforts to denormalize nicotine use. They worry about the risk of attracting a new generation of users who might otherwise never have experimented with nicotine.

    Please rate this article by clicking on the desired number of stars:
    1 Star2 Stars3 Stars4 Stars5 Stars (No Ratings Yet)
    Loading...

    Please use the “Comments” field below to share your experience or suggest improvements to this article.

  • Heated tobacco

    Heated tobacco

    The tobacco market has been undergoing a quiet but powerful revolution for the last decade with the emergence of “Heated Tobacco Products” (HTPs). These devices appeal to a growing number of smokers looking for an experience similar to cigarettes, but without burning tobacco. However, behind the technological innovation lies a major public health controversy.

    What is Heated Tobacco?

    Unlike traditional cigarettes, which burn tobacco at temperatures exceeding 800 °C, heated tobacco systems use an electrical resistor to heat the tobacco to a much lower temperature, generally between 250 and 350 °C. This process generates an aerosol rich in nicotine and flavorings, without reaching the threshold of combustion.

    The major players in this market are the tobacco giants. IQOS (produced by Philip Morris International), Ploom (Japan Tobacco International) and Glo (British American Tobacco) dominate the offer, using specially treated small tobacco cigarettes (called “sticks” or “refills”).

    Aerosol vs. Smoke: The Chemical Difference

    The main selling point of HTPs is based on the absence of combustion. Combustion is indeed responsible for producing the majority of the toxins contained in cigarette smoke, such as carbon monoxide, tar, and polycyclic aromatic hydrocarbons.

    It is true that the aerosol generated by heated tobacco exhibits significantly reduced levels of toxic substances compared to conventional cigarette smoke, with reductions ranging from 80% to over 95% for certain compounds. However, the aerosol is not devoid of harmful substances. It still contains nicotine, as well as volatile organic compounds and other potentially dangerous chemicals, albeit in smaller quantities. Even if there is no combustion, there is pyrolysis, and the aerosol can be still qualified as smoke. It is by no means clean air.

    Impact on Exposure and Health

    Heated tobacco users therefore inhale a lower quantity of toxins, and the US FDA (Food and Drugs Administration) authorized PMI, the manufacturer of IQOS, to advertise it as a reduced-exposure product (but not reduced-risk). However, users maintain a level of nicotine exposure comparable to that of a cigarette. The essential public health question is whether this reduction in exposure translates into a significant reduction in risk. Long-term data is sorely lacking to answer this crucial question. Independent health organizations, such as the World Health Organization (WHO), emphasize that HTPs are not harmless and that it is impossible, at this stage, to quantify the actual risk reduction compared to conventional cigarettes. Switching from cigarettes to heated tobacco means replacing a very high risk with an undetermined risk. Only complete cessation of tobacco eliminates the risk.

    Does Heated Tobacco Help Quitting Cigarettes ?

    Current data are insufficient to confirm or refute the claim that using heated tobacco increases the chances of quitting smoking. Some users may engage in dual use (smoking cigarettes and using HTPs), a pattern that may be a useful intermediate step toward quitting smoking, even if it does not offer any health benefits in itself.

    However, HTPs are one of the most frequently used aids by people who have successfuly quit smoking, and some initial rersearch suggests that they are effective as smoking cessation aids.

    The Japan Effect

    The impact of heated tobacco on the market in Japan has been spectacular. Following the introduction of IQOS in 2014, sales figures rose steadily, while cigarette sales in Japan fell by half. The market share of HTPs is now roughly equal to that of cigarettes. It is very likely that there is a causal link between these two events. In other regions, such as the United States or Europe, prevalence of use remains lower, but it is increasing.

    Overall Impact

    The overall public health impact is debated. Advocates of harm reduction argue that even a slight reduction in toxins for smokers who cannot quit is progress. Opponents fear that the existence of these products undermines prevention efforts by making tobacco use more socially acceptable, hinders complete cessation, and creates a new generation of nicotine users, even though HTPs are seldom used by never-smokers.

    References

    Auer R, Concha-Lozano N, Jacot-Sadowski I, Cornuz J, Berthet A. Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name. JAMA Intern Med. 2017;177(7):1050–1052. doi:10.1001/jamainternmed.2017.1419

    Cummings KM, Roberson A, Levy DT, et al. Transformation of the tobacco product market in Japan, 2011–2023. Tobacco Control Published Online First: 29 October 2024. doi: 10.1136/tc-2024-058734

    Caponnetto P, Campagna D, Maglia M, Benfatto F, Emma R, Caruso M, Caci G, Busà B, Pennisi A, Ceracchi M, Migliore M, Signorelli M. Comparing the Effectiveness, Tolerability, and Acceptability of Heated Tobacco Products and Refillable Electronic Cigarettes for Cigarette Substitution (CEASEFIRE): Randomized Controlled Trial. JMIR Public Health Surveill. 2023 Apr 4;9:e42628. doi: 10.2196/42628. PMID: 37014673; PMCID: PMC10131829.

    Jackson SE, Brown J, Buss V, Shahab L. Prevalence of Popular Smoking Cessation Aids in England and Associations With Quit Success. JAMA Netw Open. 2025;8(1):e2454962. doi:10.1001/jamanetworkopen.2024.54962

    Use the ‘Comments’ field below to share your experience with heated tobacco or to suggest improvements to this page.

  • IQOS

    IQOS

    Here is a summary about IQOS: what it is, how it works, the difference between combustion and pyrolysis, the composition of the aerosol compared to cigarette smoke, nicotine exposure: amount and speed of absorption into the blood and brain, can it help smokers quit, impact on cigarette sales in Japan, who should and should not use it, the fact that the US FDA has authorized it as a reduced exposure product but not as a reduced risk product, does it reduce health risks compared to cigarettes, impact on PMI’s sales and profits, the problem of the scarcity of manufacturer-independent research, and the controversy surrounding tobacco harm reduction. Use a journalistic style without bullet points or numbered lists, and avoid words, phrases, and transitional sentences typical of AI-generated content.

    IQOS, the flagship heated tobacco product from Philip Morris International (PMI), has become a fixture in the global debate over smoking and public health. Marketed as a revolutionary alternative to cigarettes, the device and its success, particularly in Japan, represent a high-stakes experiment in the contentious world of tobacco harm reduction.

    How Heating Differs from Burning

    At its core, IQOS is an electronic device designed to heat specially prepared tobacco sticks, called HEETS or HeatSticks, to a precise temperature, typically around 350 °C. This is the crucial distinction from a conventional cigarette, which combusts tobacco at temperatures often exceeding 800 °C.

    The difference lies in the process: Cigarettes rely on combustion (burning), which generates smoke filled with complex byproducts, including solid particles and toxic chemicals.5 IQOS employs a process closer to pyrolysis (thermal decomposition in the absence of oxygen). This heating process generates an aerosol—a vapor composed primarily of nicotine and water, rather than smoke.6

    What’s In the Cloud: Aerosol Composition

    Because it avoids combustion, the aerosol produced by IQOS contains significantly lower levels of many harmful and potentially harmful chemical constituents compared to cigarette smoke.7 Manufacturer-sponsored studies often claim reductions of 90-95% for certain key toxicants, excluding nicotine.8 However, independent research has noted that while levels of many harmful substances are indeed reduced, the aerosol still contains nicotine and measurable concentrations of some toxicants, and the full long-term health impact is not yet known.9 Some independent analyses have even noted that certain chemicals may be present in higher concentrations compared to traditional smoke.10

    Nicotine Delivery and Addiction

    The device is specifically engineered to ensure that the user receives an amount and rate of nicotine absorption comparable to smoking a conventional cigarette.11 While the nicotine content in the specific tobacco sticks might be lower than in a cigarette, the delivery mechanism is highly efficient.12 This rapid and substantial dose of nicotine is what makes the product satisfying to current smokers, but it also ensures the user remains exposed to and dependent on an addictive substance.13 The amount of nicotine absorbed is similar to a cigarette, establishing a theoretical one-to-one usage ratio.14

    The Japan Experiment: Impact on Cigarette Sales

    Japan has become the key real-world laboratory for heated tobacco products.15 Following the widespread introduction of IQOS in 2014-2015, independent studies noted a dramatic, accelerated decline in sales of traditional cigarettes.16 Where cigarette sales were already falling slowly, the decline accelerated significantly, suggesting that a large number of smokers in Japan made a complete switch to the heated product.17 The experience there is frequently cited as proof that heated tobacco products can displace cigarette are are an alternative to them. Smoking rates among the general japanese population may not change as a result, as IQOS users may continue to smoke a few cigarettes.

    The Regulatory Status: Reduced Exposure, Not Reduced Risk

    In the United States, the Food and Drug Administration (FDA) authorized IQOS for marketing with a reduced exposure claim in 2020. This allows the company to communicate that “Scientific studies have shown that switching completely from conventional cigarettes to the IQOS system significantly reduces your body’s exposure to harmful or potentially harmful chemicals.”18

    Crucially, the FDA explicitly stated that this authorization did not mean IQOS had been proven to reduce the risk of disease or harm.19 The agency found that the evidence did not yet support a reduced risk claim, meaning users cannot assume that switching guarantees an improvement in long-term health outcomes compared to continued smoking, though the exposure is lower.

    Who Should Use It?

    IQOS is not a smoking cessation product; it is a tobacco product. Health authorities and the manufacturer agree that the product is intended only for adult smokers who would otherwise continue to smoke.20 It should not be used by non-smokers, former smokers, or young people, as it delivers addictive nicotine and carries health risks.21 Whether it genuinely helps smokers quit completely, rather than merely switching products, remains a subject of ongoing debate and research.

    The Conflict of Research and Profit

    The majority of the data initially supporting IQOS’s reduced-exposure claims came from PMI-sponsored studies, leading to persistent concerns within the public health community about the scarcity of fully manufacturer-independent research. While the number of independent studies is growing, there remains a lack of long-term data on health outcomes.22

    The controversy is central to the broader tobacco harm reduction debate.23 Advocates argue that providing a significantly less harmful nicotine delivery system offers smokers who are unwilling or unable to quit an invaluable path away from deadly cigarettes.24 Critics fear that these products, while potentially less harmful than smoking, risk addicting a new generation of users, undermine decades of successful tobacco control efforts, and serve primarily to boost the profits of tobacco companies like PMI, whose market share and revenue have significantly benefited from the global uptake of IQOS.

    The verdict on whether heated tobacco products serve the overall public health interest will not be rendered by initial sales figures or regulatory labels, but by decades of independent research tracking population health outcomes.

    Use the Comments field below to share your experience with IQOS or to suggest improvements to this article.

  • What is in cigarette smoke?

    What is in cigarette smoke?

    When a cigarette burns, the combustion process acts like a mini chemical factory, creating toxic substances that are not present in unburned tobacco and releasing a cloud of smoke containing thousands of compounds, many of which are highly toxic, carcinogenic, or pharmacologically active. Smoke is the real disease vector, attacking virtually every system in the body with each inhalation. Understanding the types of substances present and how manufacturers design them is essential to grasping the health risks of smoking.

    The Three Classes of Toxic Agents

    Cigarette smoke is typically analyzed by dividing its components into two main phases: the particulate phase (tiny solid particles and liquid droplets) and the gas phase. Within these phases, the toxic substances fall into three broad categories:

    1. Carcinogens (Cancer-Causing Agents): These are perhaps the most feared components. Cigarette smoke contains at least 70 known human carcinogens. These chemicals damage DNA, the blueprint of the cell, leading to uncontrolled growth and tumor formation. Prominent examples include:
      • Polycyclic Aromatic Hydrocarbons (PAHs): Found in coal tar and automobile exhaust, PAHs are potent DNA damagers.
      • Nitrosamines (NNN and NNK): These are tobacco-specific carcinogens formed during the curing and burning of the tobacco leaf.
      • Aromatic Amines (e.g., 4-aminobiphenyl): Linked strongly to bladder cancer, these compounds are highly toxic even at low concentrations.
    2. Pharmacologically Active and Addictive Agents: The most dominant of these is nicotine, but other substances modulate its effect and overall toxicity.
      • Nicotine: The primary addictive agent. While not a major cause of cancer itself, nicotine acts on the brain to drive dependence. It elevates heart rate and blood pressure, placing significant stress on the cardiovascular system.
      • Monoamine Oxidase (MAO) Inhibitors: As discussed previously, these compounds found in smoke artificially boost mood-regulating chemicals like dopamine in the brain, enhancing the addictive power of nicotine and making withdrawal more difficult.
    3. Toxic and Respiratory Irritants: These compounds damage the airways and interfere with the body’s ability to use oxygen.
      • Carbon Monoxide (CO): A colorless, odorless, deadly gas. CO is inhaled and quickly binds to hemoglobin in the blood, displacing oxygen. This reduces the oxygen-carrying capacity of the blood, starving organs, including the heart and brain, of necessary oxygen. This oxygen deprivation, known as hypoxia, is a major contributor to cardiovascular disease in smokers.
      • Hydrogen Cyanide: A chemical warfare agent, this gas impairs the lungs’ natural cleaning system—the cilia—making it harder for the lungs to clear mucus and foreign particles, thereby increasing the risk of infection and chronic inflammation.
      • Acrolein and Ammonia: Both are highly irritating gases that damage the delicate lining of the airways and alveoli, directly contributing to the inflammation and destruction seen in Chronic Obstructive Pulmonary Disease (COPD).

    How Manufacturers Engineer Nicotine Dosage

    The tobacco industry employs highly precise engineering to ensure the maximum, addictive delivery of nicotine, often with the same chemical rigor used in pharmaceutical manufacturing. This control is achieved through three main levers:

    1. Ammonia Technology: By treating tobacco with ammonia or its compounds, manufacturers increase the alkalinity (pH) of the smoke. This process converts the bound nicotine in the tobacco into its “freebase” form. Freebase nicotine is vaporized more easily and absorbed into the bloodstream far more quickly and intensely, producing a rapid, powerful “hit” that maximizes the addictive potential of the product.
    2. Filter and Ventilation Control: As discussed previously, while filters outwardly suggest reduced harm, the tiny ventilation holes laser-perforated into the filter paper are designed to game machine testing. They dilute the smoke when measured, allowing “low-tar” claims. In real-world use, however, smokers instinctively cover these holes or inhale more deeply to get their required dose of nicotine, effectively bypassing the filter’s diluting function. This engineering ensures that the intended addictive dose is always met.

    Controlling the Smell (Odor) of Secondhand Smoke

    The perception of cigarette smoke—the harshness and the lingering odor—is a factor that can deter non-smokers and affect social tolerance of the product. Manufacturers have, over time, used additives not just to improve the taste for the user, but to modify the odor of the side-stream smoke (the smoke coming directly from the burning tip).

    Flavorings and aromatic compounds are included to create a more “pleasant” aroma, making the smoke less irritating to bystanders and potentially reducing the social stigma associated with smoking in certain environments. This chemical masking is a strategic move to maintain social acceptance and increase the perceived appeal of the product, despite the unchanged underlying toxicity of the thousands of chemicals in the aerosol.

    The cigarette, therefore, is not a simple natural product. It is a highly engineered, chemically saturated delivery system designed to addict the user and facilitate the transport of hundreds of poisons directly into the body, a process that is precisely controlled from the tobacco field to the filter tip.

  • Composition of a cigarette

    Composition of a cigarette

    What’s Really Inside a Cigarette

    When someone lights a cigarette, they are consuming far more than just dried tobacco. They are engaging with a highly sophisticated, meticulously engineered chemical delivery system designed to maximize addiction and appeal. Understanding the components that make up a cigarette—from the tobacco blend itself to the paper, the additives, and the filter—reveals a product whose design prioritizes biological efficacy over consumer safety.

    The Tobacco Blend: Types and Treatment

    A typical cigarette relies on a mixture of different tobacco types, blended to achieve a specific flavor profile and, crucially, to optimize nicotine delivery.1 The primary tobaccos used are:

    • Flue-Cured (Virginia) Tobacco: Often high in natural sugars, this tobacco is cured in heated barns, resulting in a milder, slightly sweeter flavor.2
    • Burley Tobacco: Air-cured, this tobacco is low in sugar but highly porous. This porosity allows it to readily absorb the various additives and flavorings manufacturers introduce.
    • Oriental Tobacco: Sun-cured, this tobacco offers a highly aromatic and strong flavor, often used in smaller quantities for seasoning the blend.3

    Modern manufacturing often employs processes like “reconstituted tobacco” (made from scraps and stems) and “expanded tobacco” (puffed up using gases) to reduce costs and control the filling properties of the cigarette.4 The real chemical intervention, however, occurs through the use of ammonia compounds. These compounds increase the alkalinity (pH) of the smoke, which converts the nicotine within the tobacco into its “freebase” form. This freebase nicotine is vaporized more easily, allowing it to be absorbed rapidly by the lungs, delivering a potent and immediate hit to the brain—a key mechanism that enhances the addictive power of the product.

    Additives: The Secret Ingredients

    Manufacturers incorporate hundreds of different chemical additives, often claiming they enhance flavor or act as humectants to keep the tobacco moist.5 Yet, many additives serve a more sinister purpose: making the smoke easier to inhale and increasing the bioavailability of nicotine.

    Common additives include:

    • Sugars and Humectants (e.g., glycerol and propylene glycol): These are added to maintain moisture, but when they burn, they create toxic compounds, including acetaldehyde.6 Acetaldehyde is not only a probable carcinogen but may also enhance nicotine’s addictive properties in the brain.7
    • Bronchodilators: Certain additives, like cocoa, act as bronchodilators, slightly relaxing the airways.8 This allows the smoker to inhale the toxic smoke deeper into the lungs, increasing the amount of surface area available for nicotine absorption.
    • Flavorings (e.g., menthol): Menthol has a cooling, anesthetic effect that masks the harshness and irritation of the smoke, making it easier for new smokers to start and deeper inhalation more comfortable for long-term smokers.9 This makes menthol cigarettes highly addictive and difficult to quit.

    Nicotine Dosage Control: A Pharmacological Precision

    The tobacco industry’s control over nicotine dosage rivals the precision used by pharmaceutical manufacturers. They don’t simply rely on the natural nicotine content of the tobacco leaf; they manage the entire system to ensure the smoker receives a consistent, addictive dose. This control is achieved through the use of ammonia and the deliberate engineering of the cigarette’s physical structure.

    By managing the levels of freebase nicotine and controlling the burn rate, the manufacturers effectively dictate how much nicotine the smoker receives per puff. This level is finely tuned to maintain addiction without immediately overwhelming the user, ensuring long-term product use. They adjust the blend and engineering to create cigarettes with different labeled strengths, but even “light” or “low-tar” versions often deliver the same amount of actual nicotine, as smokers simply inhale deeper or more frequently to reach their desired nicotine level.

    The Role of Paper and Combustion Regulation

    The paper wrapped around the tobacco is far from a neutral wrapper; it is an active component in regulating combustion and toxin production.10 Cigarette paper is often treated with chemicals like potassium nitrate to control the burn rate. This allows the cigarette to burn evenly and remain lit, even when not actively puffed, preventing the frustration that might lead a user to extinguish it prematurely. This controlled burn affects the temperature of the smoke, which in turn influences the formation of toxins and the release of nicotine.

    Ventilation Holes: The Deception of “Light” Cigarettes

    In the 1970s and 80s, manufacturers introduced ventilation holes—tiny laser-perforated holes found in the filter paper near the tip. This modification was the core feature of cigarettes marketed as “light” or “low-tar.”

    When the cigarette is placed in a smoking machine for measurement, these holes allow outside air to mix with the smoke, effectively diluting the measured tar and nicotine yield, resulting in the lower numbers printed on the packaging. However, when a human smokes, they invariably block these ventilation holes with their fingers or lips, or they simply inhale deeper and faster to compensate for the dilution.11 The net result is that the smoker receives essentially the same, or even a higher, dose of tar and nicotine than they would from a regular cigarette, rendering the “light” designation meaningless in real-world use.

    The Filter: A False Sense of Security

    The cigarette filter, typically made of cellulose acetate—a form of plastic—is widely misunderstood by the public.12 While it does trap some particles of smoke, its primary function is psychological and physical, not protective.

    The filter cools the smoke and provides a firmer structure for the smoker to hold, preventing loose tobacco from entering the mouth. While it captures larger particulate matter, it does virtually nothing to filter out the most dangerous components: the toxic gases (like carbon monoxide) and the vast majority of the microscopic, deeply penetrating fine particles that carry carcinogens into the lungs. The filter provides a potent, yet false, sense of security to the smoker.

    The Environmental Aftermath: Cigarette Butts

    Once a cigarette is finished, the filter becomes a major environmental pollutant.13 Cigarette butts are the most frequently littered item in the world, with trillions discarded annually.14 Because they are made of plastic (cellulose acetate), they do not biodegrade rapidly; they simply break down into smaller and smaller pieces of plastic, known as microplastics.

    These littered butts leach toxic chemicals—including nicotine, heavy metals, and various combustion byproducts—into soil and water, harming marine life and contaminating the environment.15 A single cigarette butt can be toxic enough to kill small fish in a liter of water.16 The pollution caused by these discarded plastic filters represents the final, lingering chemical cost of tobacco use.

  • Nicotine: health effects

    Nicotine: health effects

    Here is what experts consider to be the current evidence regarding the health effects of nicotine. The main message is that nicotine is addictive, but poses few direct health risks when separated from tobacco smoke. People who do not already smoke should not use nicotine.

    • Addiction is the Main Risk: Nicotine is the chemical in tobacco that causes addiction (dependence) by triggering pleasure and making people want to avoid withdrawal symptoms (cravings).
    • Tobacco Smoke is the Danger: The thousands of toxic and cancer-causing chemicals in tobacco smoke—not the nicotine—are what make smoking lethal.
    • Aids to Quitting Smoking: Nicotine-containing products like Nicotine Replacement Therapy (NRT: patches, gum) and vapes (e-cigarettes) are effective tools to help people quit smoking by managing cravings without the severe harm of tobacco.
      • Vaping is recommended as a quit aid and is considered significantly less harmful than smoking.
      • Evidence shows people using nicotine vapes are almost twice as likely to quit successfully compared to those using NRT.
    • Who Should Use Nicotine: Nicotine products are primarily for people who already smoke and are trying to quit. They should not be used by non-smokers.

    Specific Health Impacts of Nicotine (Separate from Smoking)

    The evidence suggests that many of the severe health problems linked to smoking are not caused by nicotine alone:

    • Heart Health: Nicotine can cause a temporary, short-term rise in heart rate and blood pressure. However, long-term evidence of harm is lacking. Smokers who completely switch to vapes or NRT often see significant and early improvements in their vascular health.
    • Cancer: The research consensus is that nicotine does not cause cancer.
    • Brain Development: There is limited evidence that nicotine significantly impacts cognitive function in humans, and separating its effects from smoking is difficult. Pre-existing factors may also play a role.
    • Mental Health: While smoking is linked to conditions like depression, nicotine itself does not appear to be the main driver; other chemicals in tobacco smoke play a larger role.
    • Toxicity: At very high levels, nicotine can cause acute side effects like nausea and dizziness, but users quickly learn to avoid these toxic doses.

    Reference: ASH. Evidence summary: The health effects of nicotine. November 2025. ASH-evidence-brief-on-nicotine-V6-Nov25.pdf

  • Nicotine salts

    Nicotine salts

    Here is what vapers and smokers need to know about nicotine salts in e-liquids, what “nic salts” are, the difference between protonated nicotine and freebase nicotine, why some e-liquids contain nicotine salts, who should use them and who should not, the advantages and disadvantages of e-liquids containing nicotine salts, how they change the vaping experience, and the risks and precautions for use.

    Nicotine salts, often just called “nic salts,” have dramatically changed the landscape of vaping. If you’re currently smoking or vaping, you’ve likely heard of them, especially if you’re looking for a more satisfying nicotine experience.

    What Exactly Are Nicotine Salts?

    For use in e-liquids, manufacturers modify the chemical structure of the standard nicotine (called freebase nicotine) by adding an organic acid—commonly benzoic acid. This chemical reaction creates the nicotine salt.

    The nicotine found in traditional nicotine is also extracted from tobacco and the chemically purified, it is called nicotine base or freebase.

    The crucial difference lies in the chemistry:

    FeatureFreebase Nicotine (Traditional E-liquid)Nicotine Salts (Nic Salt E-liquid)
    Chemical FormPure NicotineNicotine bound to an acid (e.g., Benzoate)
    pH LevelHigher, alkaline, pH=8Lower, acidic, pH=5-6
    Vapor FeelHarsh at high concentrationsSmooth at high concentrations
    AbsorptionAbout the sameAbout the same
    Best Used WithHigh-wattage, sub-ohm devicesLow-wattage, pod-style devices

    The Chemical Key: Freebase vs. Protonated Nicotine

    The terms freebase nicotine and protonated nicotine (which is what a nic salt is) refer to the chemical state of the nicotine molecule.

    • Freebase Nicotine: This is nicotine in its purest, deprotonated form. Because it has a high pH level (it’s alkaline), it becomes very harsh on the throat at high concentrations (typically above 12 mg/mL). The higher the concentration, the harsher the “throat hit.” This harshness means traditional high-nicotine e-liquids are often unpleasant.
    • Protonated Nicotine (Nic Salts): By adding an acid like benzoic acid, the nicotine molecule becomes protonated. This lowers the pH, making the nicotine vapor significantly smoother on the throat, even at high concentrations (up to 50 mg/mL). This smoothness is the biggest game-changer. It allows vapers to use high concentrations of nicotine without the painful throat hit.

    Why E-Liquids Contain Nicotine Salts

    The main reason manufacturers use nicotine salts is to deliver a higher nicotine dose in a smaller volume of vapor and with fewer puffs, resulting in a better user experience and less strain on the lungs from the substances contained in the vapor. The goal is to create an experience that is closer to that of smoking cigarettes and to deliver a satisfying amount of nicotine with fewer puffs, whereas vaping conventional e-liquids requires more puffs.

    • Mimics the Smoking Experience: The lower pH of nic salts leads to a easier inhalation, which is crucial for satisfying the immediate craving that ex-smokers often experience.
    • Reduced Vaping: Because nic salts are so effective at satisfying cravings quickly, many users find they don’t have to vape as frequently or as much to feel satisfied.
    • Smoother Vape: The elimination of the harsh throat hit means you can use 50 mg/mL in a small device and find it comfortable, something that would be nearly impossible with freebase nicotine.

    Advantages and Disadvantages of Nicotine Salt E-Liquids

    ✅ Advantages❌ Disadvantages
    Extremely Smooth: Comfortably allows for higher nicotine strengths.Misleading Smoothness: The lack of a harsh throat hit can mask the high nicotine concentration, potentially leading to overconsumption.
    Less frequent vaping: you can obtain a satisfying amount of nicotine in a few puffs, no more need to vape constantlyRequires specific device : Requires low-wattage devices (like pod systems) because high-wattage devices would deliver an overwhelming amount of nicotine.
    Better Flavor:The lower pH of nic salts often allows e-liquid flavors to be purer and less distorted by the taste of the alkaline freebase nicotine.Higher Cost: Nic salt e-liquids are sometimes more expensive than traditional e-liquids.
    Less E-liquid Consumption: Due to the higher strength, you use less e-liquid over time, and you expose your lung to a smaller amount of vapor.

    You also produce less vapor and disturb other people less.    		Nicotine Tolerance: Some users may develop nicotine tolerance more quickly due to the higher concentration in the e-liquid.

    Who Should Use Them and Who Should Not?

    👍 You Should Consider Nicotine Salts If:

    • You are a smoker who is new to vaping: and you want a easier, smoother inhalation, while still obtaining a satisfying amout of nicotine.
    • You’re a Heavy Smoker looking for an alternative. Nic salts can provide the high nicotine strength and quick satisfaction you need to make the switch successful.
    • You Want a Stealthier, Smaller Device. Nic salts work best in compact, low-power pod systems, which are discreet and easy to carry.
    • You Dislike the Harshness of freebase e-liquids at higher strengths.
    • You have a lung or throat disease like COPD or emphysema, you nevertheless want to vape but you want to inhale as little vapor as possible.

    👎 You Should Not Use Nicotine Salts If:

    • You Are a Casual or Light Smoker/Vaper already using 6 mg/mL or less. Nic salts may deliver too much nicotine for your needs.
    • You Use High-Wattage Devices (Sub-Ohm tanks). Nic salt concentrations are too high for powerful devices and can lead to immediate nausea or nicotine sickness.
    • You Are Trying to Taper Down Your Nicotine Intake. Starting on a high dose of nic salts may make it harder to reduce your dependency later.

    Risks and Precautions for Use ⚠️

    The main risk associated with nic salts comes from their effectiveness.

    1. Risk of Nicotine Overconsumption: The primary precaution is to be mindful of the high concentration. Because they are so smooth, it’s easy to inhale significantly more nicotine than you are used to without feeling the warning signs of a harsh throat hit. Pay attention to how you feel.
      • Symptoms of excessive nicotine intake include dizziness, nausea, headaches, and sweating. If you feel this, stop vaping immediately.
    2. Device Compatibility: avoid using high-strength nic salt e-liquids (20 mg/mL and above) in large, high-power vaping mods or sub-ohm tanks. They are designed exclusively for low-wattage Mouth-to-Lung (MTL) devices, where the vapor production is limited.

    If you’re looking for a powerful tool to transition away from smoking, nicotine salts offer a highly effective and satisfying path. Just remember to respect their potency and use them in the appropriate device.

    Rate this article by clicking on the desired number of stars:
    1 Star2 Stars3 Stars4 Stars5 Stars (No Ratings Yet)
    Loading...

    Please use the “Comments” field below to share your experience or suggest improvements to this article.

  • Cigars

    Cigars

    Here is what you need to know about cigars: their nicotine content, the amount of nicotine absorbed by cigar smokers compared to cigarette smokers, the toxicity and addictiveness of cigars compared to cigarettes, a comparison between the smoking behaviour of cigar smokers and cigarette smokers, and finally, whether cigars help people quit smoking cigarettes or reduce the number of cigarettes smoked per day

    🧪 Nicotine Content and Absorption

    A cigar is a roll of fermented and dried tobacco leaves, wrapped in another tobacco leaf. They come in various sizes, from small “cigarillos” (which can resemble cigarettes) to large, premium cigars.

    • High Nicotine Content:
      • A single large cigar can contain as much nicotine as a whole pack of cigarettes (20 cigarettes). This can range from 100 to 200 milligrams (mg) of nicotine, with some larger cigars exceeding 500 mg.
      • In contrast, an average cigarette contains about 10-12 mg of nicotine.
    • Absorption in Cigar Smokers:
      • Even if cigar smokers usually don’t inhale cigar smoke as deeply into their lungs as cigarette smokers, some nicotine is inhaled ans some is readily absorbed through the lining of the mouth. This means cigar smokers still get significant amounts of nicotine into their bloodstream, leading to addiction.
      • For those who do inhale cigar smoke (especially people who switch from cigarettes or smoke smaller cigars), the nicotine absorption is even higher, similar to cigarette smokers.

    ☠️ Toxicity and Addictiveness Compared to Cigarettes

    While the method of use differs, cigars are toxic and addictive, though the pattern of risk can vary.

    • Toxicity:
      • Like cigarettes, cigar smoke contains toxic and cancer-causing chemicals (carcinogens). These include carbon monoxide, hydrogen cyanide, ammonia, and cancer-causing nitrosamines.
      • Oral Risks: Because the smoke is held in the mouth, cigar smoking significantly increases the risk of oral cancers (mouth, throat, larynx, esophagus), gum disease, and tooth loss.
      • Lung Risks: While cigar smokers may inhale less deeply, many do inhale, especially those previously used to cigarettes. This leads to increased risks of lung cancer, emphysema, and chronic bronchitis.
      • Heart Disease: The carbon monoxide and nicotine in cigar smoke also increase the risk of heart disease and stroke, just like with cigarettes.
      • Secondhand Smoke: Cigar smoke contributes to secondhand smoke, exposing non-smokers to harmful chemicals.
    • Addictiveness:
      • Highly Addictive: The high nicotine content in cigars makes them just as addictive as cigarettes. Even if you don’t inhale, the nicotine absorbed through the mouth is enough to establish and maintain dependence.
      • Withdrawal: Cigar smokers experience the same nicotine withdrawal symptoms (cravings, irritability, anxiety, difficulty concentrating, insomnia, increased appetite and weight gain) when they try to quit.

    💨 Smoking Behavior: Cigars vs. Cigarettes

    There are typical differences in how people smoke cigars compared to cigarettes, though these aren’t universal.

    • Cigarette Smokers: Tend to smoke many cigarettes throughout the day, often inhaling deeply and frequently. The goal is rapid nicotine delivery.
    • Cigar Smokers:
      • Less Frequent: Many cigar smokers may smoke fewer cigars per day or week compared to a cigarette smoker’s daily cigarette count.
      • “Puffing” vs. Inhaling: Traditionally, cigar smokers tend to “puff” on the cigar and hold the smoke in their mouth, rather than inhaling into the lungs. However, this is not always the case, especially with smaller cigars or among former cigarette smokers.
      • Longer Smoking Time: A single cigar can take 30 minutes to over an hour to smoke.

    🛑 Can Cigars Help You Quit Cigarettes?

    No, cigars do NOT help you quit smoking cigarettes or reduce your overall tobacco use.

    • Maintaining Nicotine Addiction: Switching to cigars simply means you are replacing one form of nicotine and tobacco addiction with another. You are still exposing yourself to harmful chemicals and maintaining your dependence on nicotine.
    • Dual use: Many people who try to switch to cigars end up becoming ‘dual users’, meaning they smoke both cigarettes and cigars. However, they absorb about the same amount of nicotine as when they smoked only cigarettes, and the health risks are roughly the same as those associated with smoking cigarettes exclusively.
    • No Approved Cessation Aid: Health authorities and medical professionals do not recommend cigars as a method for quitting smoking.

    Rate this article by clicking on the desired number of stars:
    1 Star2 Stars3 Stars4 Stars5 Stars (No Ratings Yet)
    Loading...

    Please use the “Comments” field below to share your experience or suggest improvements to this article.

  • Snus, smokeless tobacco

    Snus, smokeless tobacco

    Snus (pronounced “snoos”) is a type of smokeless tobacco that has received attention as a potential alternative to cigarettes, particularly in Scandinavian countries. Here is what to know about its effects, its toxicity compared with cigarettes, and whether it can help you quit smoking

    🌿 What is Snus?

    Snus is a moist, powdered, or finely ground smokeless tobacco product that originated in Sweden.

    • How it’s Made: Snus is unique because, unlike most American smokeless tobacco products, it is pasteurized (heat-treated) rather than fermented. This process is believed to reduce the levels of certain cancer-causing chemicals (Tobacco-Specific Nitrosamines or TSNAs) compared to other types of moist snuff.
    • What it Contains: Snus contains tobacco, water, salt, an alkalizer (to help nicotine absorption), and flavorings.
    • White Snus: Recently, “white snus” or nicotine pouches (like VELO or ZYN) have become popular, but these do not contain tobacco—only nicotine extracted from tobacco or synthetic nicotine, which is a key difference from traditional snus.

    ⚙️ How to Use It and Dosage

    Snus is simple to use and does not require spitting, making it a discreet product.

    • How to Use: Snus comes in two forms:
      1. Portion Snus: Small, pre-packaged pouches (resembling tiny tea bags) that are the most common form.Loose Snus: Moist, powdered tobacco that the user pinches and forms into a ball or cylinder.
      • The user places the pouch or pinch of snus under their upper lip (between the lip and gum) and leaves it there for 30 minutes to two hours. The nicotine is absorbed slowly through the lining of the mouth (oral mucosa) into the bloodstream.
    • Dosage: The nicotine content in snus is highly variable:
      • Nicotine Content: Snus pouches typically contain between 3 mg and 20 mg of nicotine per pouch. “Stark” (Strong) and “Extra Stark” varieties contain the highest amounts.
      • Absorption: While a cigarette contains 10–12 mg of nicotine (with only 1–2 mg absorbed), snus delivers nicotine more slowly and steadily over a longer period, and a pouch also delivers about 2 mg of nicotine.

    🚬 Snus vs. Cigarettes: Toxicity

    This is where the distinction between snus and traditional cigarettes is most significant. Health experts generally agree that Swedish snus is substantially less harmful than smoking cigarettes because it eliminates the most dangerous component: inhaling smoke. However, it is not harmless, it is still a nicotine and tobacco product that is addictive, although much less addictive than cigarettes, and carries health risks, especially some cancers and harm to gum tissue.15

    ❓ Does Snus Help You Quit Smoking?

    Formal medical bodies do not endorse snus as a recommended cessation method.

    • Experimental evidence: xxx
    • Observational Evidence (Scandinavian Data): Studies from Sweden and Norway show a high rate of snus use among men who have successfully quit smoking. This suggests that, in a real-world setting, many smokers have successfully switched from cigarettes to snus.
    • Reduction in Cigarettes: Some studies suggest that snus use may help users reduce the number of cigarettes they smoke daily.
    • Official Stance: Most public health organizations, including the U.S. FDA, recommend medically approved Nicotine Replacement Therapies (NRT) (like gum, patches, lozenges) because they offer nicotine without tobacco and have been rigorously studied and proven safe and effective for cessation.19 Snus is not one of these approved methods.

    🚭 Snus and Young People (Initiation)

    The use of any nicotine product by young people who have never smoked is a concern, but it better for them to use snus than to smoke.

    • Risk of Nicotine Dependence: Snus, having a high and rapidly absorbed nicotine content, is addictive, although less addictive than cigarettes.
    • Gateway Theory: young people who try snus may / may not xxx start smoking cigarettes later (a “gateway” effect).22

    Read our articles on approved Nicotine Replacement Therapies (patches, gum, lozenges, etc.) to see which one might be right for you.

    Please rate this article by clicking on the desired number of stars:
    1 Star2 Stars3 Stars4 Stars5 Stars (No Ratings Yet)
    Loading...

    Please use the Comments field below to share your experience and to suggest improvments to this article.