Stories

The US FDA is signalling a shift towards recognising the continuum of risk in tobacco and nicotine regulation.

At the Global Tobacco and Nicotine Forum in Lisbon, the agency outlined plans to accelerate product authorisations, reconsider its approach to flavoured e-cigarettes and improve communication about the relative risks of nicotine products.

The proposed changes also place greater emphasis on helping adults who smoke switch to lower-risk alternatives while maintaining safeguards against youth uptake. Integrating tobacco harm reduction into regulatory decisions could represent an important development in US tobacco control policy.

Smoking-related deaths in the United States remain concentrated among older adults, yet this population receives comparatively little attention in tobacco control research.

While teenage smoking has fallen to historic lows and youth vaping has declined substantially, smoking rates among older adults are improving more slowly.

The contrast raises important questions about research priorities and the allocation of public health resources. Greater attention to older smokers, effective cessation support and access to lower-risk nicotine alternatives could help address the population bearing the greatest burden of smoking-related disease.

Nicotine's future may extend beyond its traditional role as a smoking cessation aid. As cigarette use declines, a growing market for smoke-free nicotine products raises questions about consumer choice, regulation and the long-term place of nicotine in society.

A new policy analysis proposes a separate US regulatory framework for lower-risk consumer nicotine products, distinguishing them from combustible tobacco and medicinal nicotine.

The approach emphasises proportionate safety standards, accurate information and age restrictions, while recognising that tobacco harm reduction and informed adult consumer choice are related but distinct policy considerations.

Six weeks without cigarettes followed by a return to smoking should raise questions about what changed, rather than simply being recorded as an unsuccessful quit attempt.

Twelve key principles of tobacco harm reduction highlight the importance of understanding individual behaviour, access to affordable alternatives and the difference between trying a smoke-free product and switching completely.

The central message is that tobacco policy should measure meaningful outcomes, including sustained smoking cessation and reduced exposure to combustion, rather than relying solely on sales figures, restrictions or short-term statistics.

Spain is reportedly threatening to block the EU’s proposed Tobacco Tax Directive unless minimum excise rates on rolling tobacco are reduced.

The position contrasts with Spain’s support for tighter restrictions on smoke-free nicotine products, including flavour limitations and a potential freeze on new products entering the market. Sweden has also raised objections to the proposed directive, but over taxation of lower-risk alternatives.

With EU finance ministers due to discuss the proposal on 9 November, the disagreement highlights questions about consistency in European nicotine taxation and the importance of recognising differences in product risk.

Azerbaijan, Armenia and Georgia are taking markedly different approaches to nicotine regulation across the South Caucasus.

Azerbaijan's nationwide vape ban has raised concerns about illicit sales, while Armenia is introducing tighter technical standards and higher excise duties. Georgia has avoided sweeping vaping restrictions, despite calls for tougher controls, while offering preferential taxation to domestic cigarette manufacturers.

These contrasting policies highlight the challenges of balancing youth protection, market oversight and tobacco harm reduction. Their longer-term outcomes may offer valuable insights into how regulation affects access to lower-risk nicotine alternatives and the growth of illicit markets.

The UK's contrasting treatment of snus, nicotine pouches and heated tobacco raises questions about the consistency of its approach to tobacco harm reduction.

Despite Sweden's experience with smoke-free nicotine products, snus remains banned for sale in Britain, while cigarettes continue to be widely available. Consumer advocates argue that these restrictions can make it harder for smokers to find alternatives that suit their needs.

The debate highlights the importance of consumer choice, proportionate regulation and access to different lower-risk products. Smoking cessation strategies should recognise that no single alternative works for everyone.

A new study published in BMC Pulmonary Medicine, involving 1,519 adults across six world regions, found no clinically meaningful difference in respiratory symptom frequency between exclusive vapers and non-vapers without an established smoking history.

Although vapers reported slightly more frequent symptoms, the difference remained below the established threshold for clinical significance. The findings offer further insight into the respiratory effects of vaping, while highlighting the need for longer-term research.

For tobacco harm reduction, the distinction between statistical significance and clinically meaningful outcomes is particularly important when interpreting scientific evidence.

New UK rules effective from the end of October restrict the sale and promotion of vaping and nicotine products. Sales are limited to adults aged 18 or over, and adults cannot buy them on behalf of minors. Vending machines selling these and related products are prohibited, as are promotional free samples, substantial discounts and coupons. Enforcement authorities can issue fixed penalty notices for a range of offences.

The Chartered Trading Standards Institute welcomed the closure of longstanding loopholes and urged retailers to check ages, train staff and update policies. ELFBAR also welcomed the rules but called for a retail licensing system, arguing that it would enable earlier action against repeat offenders.

Claims about vaping-related cardiovascular harm have been challenged following a study involving just 17 vapers, 19 smokers and 22 non-users.

Although researchers observed differences in blood vessel function and fitness, independent experts highlighted important limitations, including the small sample size, previous smoking history and the inability to establish causation.

The criticism reinforces the need for larger, longer-term studies and careful interpretation of findings. Accurate tobacco harm reduction research must distinguish potential health risks from demonstrated harm without overlooking the broader evidence on switching away from cigarettes.