Stories

A new guideline published in CMAJ provides effective options for quitting tobacco smoking, a leading cause of preventable disease and death in Canada. The guideline includes behavioral and medication choices as well as a natural health product, tailored to personal preferences. It aims to address the challenges of quitting smoking, which is highly addictive and increases the risk of various diseases. Clinicians are advised to assess patients' smoking status and offer recommended cessation options through shared decision-making. The guideline recommends against certain smoking cessation methods and suggests using e-cigarettes only as a last resort. Overall, the guideline supports efforts to reduce smoking prevalence and offers practical tools for clinicians to assist patients in quitting smoking effectively.

Sweden’s success with snus and now nicotine pouches proves tobacco harm reduction is a model for helping millions quit smoking. But there’s a secret behind this success. Shot on location at GFN 2025 in Warsaw, Poland, we speak with Anna Franzén and Tomas Hammargren of Emplicure about the big questions surrounding nicotine policy and the realities of recreational use.

A new Canadian guideline advises against using e-cigarettes or vapes as a first choice to quit smoking, recommending proven methods like medications and counseling instead. Despite declining smoking rates, tobacco remains a top cause of preventable cancer deaths. The guideline highlights the risks of vaping, citing lack of long-term safety data and stresses the effectiveness of nicotine replacements like patches. It discourages alternative treatments and notes the need for further research, including on the efficacy of AI-based therapy. Overall, quitting smoking is challenging but achievable with the right support and strategies.

Australia has the world's priciest cigarettes due to a 340% excise increase over 20 years. However, this led to a rise in illegal cigarette consumption. Economist Chris Richardson estimates a yearly $10 billion loss in government revenue. Vaping restrictions and high tobacco prices fuel a violent black market, contrasting with New Zealand's successful vape policies. Political parties overlook this issue while tobacco companies shift to safer products. Australia debates harm reduction, lacking evidence against vaping's benefits. Following New Zealand's lead could curb the black market.

Sweden's successful move towards becoming smoke-free is influencing Asia, particularly the Philippines, where Japan Tobacco International (JTI) introduced nicotine pouches. With only 5.4% daily smokers in Sweden, the country attributes this to strict regulations and alternative options. JTI's Nordic Spirit, produced in Sweden, has gained popularity in the Philippines. JTI focuses on former smokers in Sweden, with positive results. The Philippines' familiarity with oral products made Nordic Spirit well-received. JTI tailored the product for the local market with affordable pricing. This initiative competes with other similar products, signaling a potential shift in global tobacco trends and a new direction for Asian markets.

It has now been a year since then–Health Minister Mark Holland introduced a federal order that limited the sale of nicotine pouches—used as smoking-cessation aids—to behind-the-counter access in pharmacies. The measure removed them from convenience stores nationwide in Canada and restricted permitted flavours in pharmacies to only mint and menthol.

The European Union is considering imposing high taxes on safer nicotine products, sparking opposition from tobacco harm reduction advocates and scientists. The plan includes minimum taxes of 40-55% on vaping e-liquids, nicotine pouches, and heated tobacco products, which critics argue will hinder efforts to reduce smoking rates. Some EU member states, including Portugal, have raised objections to the tax proposal, stating that taxing less harmful smoking alternatives may discourage smokers from switching. Unanimous agreement from all 27 EU nations is needed for the proposal to become law. Critics emphasize the importance of promoting safer nicotine products to achieve the EU's smoke-free goal and warn against the potential negative impact of the tax plan.

The text warns about the dangers of high nicotine levels in alternative tobacco products for young brains. Trends show most youth start with e-cigarettes, not to quit smoking. Nicotine pouch use is rising, with Zyn being popular among youth. Nicotine impacts young brains differently, making them more vulnerable to addiction. The tobacco industry targets young people, knowing they're more likely to get addicted. Teaching kids to see through industry manipulation is vital. Education, not shaming, is key in tobacco prevention. Parents must be aware and listen to kids using nicotine for stress. Understanding the risks and effects of nicotine is crucial for youth health and prevention efforts.

A study found that low-income adults who used the Smart-T smartphone app for smoking cessation were 1.81 times more likely to quit smoking at 26 weeks than those using the QuitGuide app. Smart-T users accessed quit tips more, used the call counselor feature, and requested nicotine replacement therapy frequently. They also felt more aware of their behaviors and found the intervention useful. The researchers suggest that Smart-T could be a cost-effective tool to help reduce smoking-related health disparities. The study, led by Emily T. Hébert, was published in JAMA Network Open. Limitations included the need for a specific quit date and Smart-T's availability only on Android devices.

Dr. Paige Lemen, a harm reductionist and Tennessee researcher, was arrested while transporting a drug sample for testing. Suffering from an illness, she failed a sobriety test and faced multiple charges including intent to sell drugs. Police seized her lab equipment, medications, and mocked her during the arrest. Despite paying bail, her community work was hindered by increased police surveillance. The case highlights legal uncertainties around harm reduction practices. Lemen aims to prove her innocence in court but fears the outcome's impact on future drug checking cases. She stresses the importance of understanding and supporting harm reduction efforts.