Smoking Cessation on Farsalinos

SRNT Recommendations to US Physicians on Nicotine E-Cigarettes

Wed, 02 Sep 2026 00:00:00 +0000

The international Society for Research on Nicotine and Tobacco (SRNT) recently published in JAMA its recommendations for U.S. clinicians on e-cigarettes and smoking cessation. Here, I examine the scientific, clinical, and ethical foundations behind these guidelines. They mark a landmark shift toward active harm reduction for adult smokers in the United States, weighing robust clinical trial evidence against complex public health values.

Why were new recommendations for e-cigarettes & smoking cessation needed?
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Combustible tobacco remains the leading cause of preventable death in the U.S., claiming nearly 500,000 lives each year. Although over 68% of adult smokers wanted to quit in 2022 and more than half attempted to do so, fewer than 10% succeeded. This high failure rate highlights the need to broaden the clinical toolkit with alternative strategies.

News-Week, August 20–26, 2026

Fri, 28 Aug 2026 00:00:00 +0000

Covering news published August 20–26, 2026

Regulators, Researchers Issue Dueling Signals on Safer Nicotine Products
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U.S. regulators kept expanding the market for lower-risk nicotine products in the final week of August 2026, even as major pediatric and public health bodies published sobering evidence on vaping’s effects on young people — and a landmark evidence review reaffirmed vaping’s edge as a quit-smoking tool for adults.

Nicotine Replacement Therapy (NRT)

Thu, 27 Aug 2026 00:00:00 +0000

Nicotine Replacement Therapy (NRT) represents one of the most significant pharmacological advances in public health and tobacco control. For smokers seeking a medically supervised path to a smoke-free life, NRT provides a way to manage withdrawal symptoms without the thousands of toxic chemicals in tobacco smoke. By delivering nicotine in controlled doses, NRT helps individuals break the physiological addiction to cigarettes. Here are five key points on the nature, history, and function of NRT.

Dual Use is Not a Failure

Wed, 26 Aug 2026 00:00:00 +0000

This pattern often marks the path out of smoking. If you smoke some days and vape on others—or vape while still having the occasional cigarette—you’ve probably heard this proves vaping fails. Worse, some claim dual use is more dangerous than smoking alone. Critics present it as evidence of failure or added risk. The science tells a different story: for many, dual use is a transitional stage toward complete switching.

What the Evidence Shows
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England’s Smoking Toolkit Study (Jackson et al., 2025) reveals a meaningful shift between 2016 and 2024: dual-use patterns moved from “daily smoking with occasional vaping” toward “occasional smoking with daily vaping.” That direction matters—it reflects people progressively loosening cigarettes’ grip, not the reverse. Toxicant research (Xue et al., 2025) confirms harm among dual users tracks mainly with how much they keep smoking: those who substantially cut cigarettes move toward biomarker profiles of people who quit entirely.

Nicotine Vapes and Smoking Cessation

Wed, 26 Aug 2026 00:00:00 +0000

Ten out of 100 smokers quit with nicotine e-cigarettes. Only six in 100 succeed with patches or gum. That is the headline finding of the latest Cochrane review — the most rigorous form of evidence synthesis in medicine — updated in August 2026 with data current to January 2026.

What the review examined
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The Cochrane Collaboration maintains this as a ’living’ systematic review: researchers screen new trials monthly and update whenever relevant evidence appears. This update pooled 80 randomised controlled trials involving 29,861 adults who smoke — nine trials added since the previous version. The conclusions did not change. Randomised trials are the gold standard for answering whether a treatment works, and GRADE certainty ratings tell us how much to trust each result.

Nicotine pouches

Sun, 23 Aug 2026 00:00:00 +0000

Nicotine pouches are small pouches—smaller than a tea bag—placed under the upper lip for about 30 to 60 minutes.

What are the Key Characteristics & Ingredients?
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Tobacco-Free: This is their fundamental difference from traditional Swedish snus.
Composition: They contain plant fibers (cellulose), pharmaceutical-grade nicotine, flavorings, sweeteners, glycerin, and potentially pH regulators.
Nicotine Content: Ranges from 2 to 16 mg per pouch, though products with much higher levels have appeared on the market.

How did they Evolve Historically?
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Ancestors: Oral tobacco use spans centuries. Chewing tobacco, highly popular in America, spread to Europe around 1600. In Scandinavia, a variation mixed tobacco with salt and water for under-the-lip use. This wet snus became highly popular in the United States during the 19th century. However, it was impractical—it caused significant saliva production that couldn’t be swallowed without nausea, forcing users to spit.
The 1970s: Scientist Curt Enzell placed tobacco inside tea-bag pouches, tested them on himself, and finding they worked, paved the way for Scandinavian Snus.
The 2008 Breakthrough: Karl Fagerström—creator of the Fagerström Test for Cigarette Dependence and pioneer of medical nicotine replacement therapy—developed the first tobacco-free nicotine pouch.

What are the Main Differences from Cigarettes?
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Slower Nicotine Absorption: Unlike conventional cigarettes, where nicotine absorption is extremely rapid—reaching peak blood levels in about 5 to 6 minutes—nicotine pouches take five to ten times longer. Studies show maximum blood concentration is reached in 30 to 60 minutes.
The Satisfaction Drawback: This slower absorption is considered a disadvantage. The rapid, sharp spikes in blood nicotine levels satisfy smokers and provide smoking’s greatest pleasure. Electronic cigarettes, by contrast, achieve nicotine delivery speed and quantity comparable to traditional cigarettes.

How About Safety and Public Health?
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High Safety Profile: Among all tobacco harm reduction alternatives, nicotine pouches carry the highest safety profile. However, because they can still cause addiction, they are not recommended for non-smokers.
The “Swedish Success Story”: Sweden is the ultimate public health example—the only country in Europe (and likely the world) that is practically smoke-free, with a smoking rate under 5%. It achieved this milestone exclusively through widespread adoption of snus and nicotine pouches.
Different Delivery, Immense Benefit: While Sweden’s overall nicotine-use rate resembles the rest of Europe, Swedes consume it orally instead of burning and inhaling it. Consequently, Sweden records by far the lowest rates of cardiovascular and cancer mortality in Europe.
Combination Use for Cessation: Many smokers find standard nicotine replacements insufficient to stop cravings. For these individuals, combining electronic or heated cigarettes with nicotine pouches can successfully suppress the urge to smoke.

Smoking Cessation on Farsalinos

SRNT Recommendations to US Physicians on Nicotine E-Cigarettes

Why were new recommendations for e-cigarettes & smoking cessation needed? #

News-Week, August 20–26, 2026

Regulators, Researchers Issue Dueling Signals on Safer Nicotine Products #

Nicotine Replacement Therapy (NRT)

Dual Use is Not a Failure

What the Evidence Shows #

Nicotine Vapes and Smoking Cessation

What the review examined #

Nicotine pouches

What are the Key Characteristics & Ingredients? #

How did they Evolve Historically? #

What are the Main Differences from Cigarettes? #

How About Safety and Public Health? #