Considering what I do more closely reveals a kind of paradox, however.

If I view tobacco harm reduction (THR) from the outside, it seems as if nothing changes. The task—to inform and convince policymakers that THR is simply harm reduction, and that we already have the tools to dramatically reduce the world’s biggest cause of preventable death—is ostensibly a simple one. But the message seems incomprehensible, inconvenient or plain unwelcome to those in power. 

If something’s not stagnant, there is hope: Change requires movement.

If, on the other hand, I step inside the THR world to report on it, I’m never short of things to write about. Why? Because despite the ubiquitous common obstacles, the detailed landscape is mercurial—there’s always something happening. And if something’s not stagnant, there is hope: Change requires movement. Reflecting on this made me realize how much there is to be optimistic about.

Nicotine consumers are at the heart of this optimism, just as they’re at the heart of the THR movement. They’re bombarded with misinformation, stigmatized for their choices and faced with many barriers to accessing products that could save their lives. Yet despite all this, despite the knee-jerk, reactionary anti-THR policies, as many as 150 million people worldwide now use safer alternatives like vapes, snus and pouches or heated tobacco products.

The vast majority have adopted these safer nicotine options in order to quit (or reduce) smoking. In many other cases, the availability of these options for people who may have a “common liability” to nicotine use means they will never pick up cigarettes in the first place.

Yes, the message that safer nicotine products save lives would have gotten through much faster, and to far more people, if governments and health authorities wholeheartedly promoted THR instead of blocking and denigrating it. Yet it is getting through to an extraordinary degree in these circumstances—and given the power of peer-to-peer word of mouth, that is likely to accelerate.

This thought is almost guaranteed to stop me feeling enervated—and that’s just as well.

My THR reporting for Filter stands in stark contrast to the stories published in giant media outlets, which again and again contradict powerful evidence and ignore the human agency of people who smoke, in favor of narratives rooted in hardened ideology. Plenty of times, I’ve wondered if there’s any point in my work when my colleagues and I are up against this misinformation juggernaut. It’s David-and-Goliath when you’re fighting to be heard over the din of the World Health Organization and organizations backed by Bloomberg millions. It’s hard not to feel small and insignificant amid the cacophony of voices hellbent on telling you you’re wrong.

Writing about THR is also about celebrating its wins, which are just as important to report—after all, this is why the movement exists.

But before I get too disillusioned, along comes the news that Sweden has become the world’s first “smoke-free” country because of safer nicotine products. News like that, I’ve always felt, is a privilege to report. This is THR in action: Saving lives, improving quality of life, keeping families together, reducing health inequalities, and carrying special value for populations that have been most sidelined and ignored—such as people with mental health conditions and people who use banned drugs. 

These are stories that need to be written and read. And they remind me that being a journalist in this space is not just about correcting flawed science that somehow managed to get published, or criticizing bad policies, of which there is a never-ending supply. Writing about THR is also about celebrating its wins, which are just as important to report—after all, this is why the movement exists. And there are enough positive stories, even in the last few months, to convince even the most hardened of cynics that the times they are a-changin’.

In July, for instance, I wrote an article on how nicotine pouches are becoming increasingly popular in the United Kingdom. Anti-vape sentiment plays a role here, but the adoption of a new safer nicotine option is a good thing; choice is key. And with women leading the way, I can’t help but be optimistic that perhaps, in the not so distant future, we Brits might replicate Sweden’s success.

In May, I was able to report on how Argentina ended its 15-year prohibition of vapes and other safer nicotine products. Sure, further improvements need to be made, but it’s a big step in the right direction. Things are happening and moving: The landscape is mutable.

That same month, I wrote about calls to integrate THR routinely in HIV care. And yes, much of that article concerned stigma and other barriers to this common-sense approach. Yet in speaking with experts who have witnessed the trajectory of improved HIV care over decades, it was impossible not to entertain the idea that THR, delivered to high-smoking populations, might similarly have a better future.

THR advocates have faced derision, ostracization and slander. They have made things happen all the same. The victories belong to them.

And in April, I reported on an uplifting project, built by consumer advocates, to systematically collate the kind of lived experiences of safer nicotine use that are almost entirely absent from media narratives.

I am not an advocate in the strictest sense of the word, nor (by any stretch!) a scientist. I’ve seen myself as a conduit between the world of THR and those who are open to knowing more about it. To play that role at all effectively requires the help of experts, and I’ve gotten to know many who have inspired me.

People like THR maven Clive Bates, consumer advocate Skip Murray, Michael Siegel of Tufts University School of Medicine and Damian Sweeney of European Tobacco Harm Reduction Advocates (ETHRA) have been integral to my own learning. Their incredible knowledge and perspicacity, generously shared, have helped readers and me to understand nuances of THR, the repercussions of ill-conceived policies and so much more. In a field that can often feel bleak, the passion of these experts, and many others, makes me feel that the future of THR is bright.

THR advocates have fought against the odds for a better world. They’ve faced derision, ostracization and slander. They have made things happen all the same. The victories belong to them—to a whole ecosystem of scientists, policy experts, smoking-cessation advisers and consumer activists determined to help others benefit as they have. This fills me with hope. Sometimes, change comes almost imperceptibly—or perhaps, “gradually, then all at once.” I think we’re on our way. 

Photograph via PublicDomainPictures.net

The post Finding Optimism in the Tobacco Harm Reduction Maelstrom appeared first on Filter.

The government launched a 12-week public consultation on July 10, seeking “views on proposals for vapes and nicotine products,” such as limiting the colors of vaping devices to white, black or gray, and mandating plain white packaging with limited branding and images. Heated tobacco products would have to come in a “drab brown color.”

Flavor names could meanwhile be limited to simple descriptors like “apple,” with a ban on “concept and sensory names” and those that relate to desserts or candy.

Other potential changes include restricting retail displays of vapes to the same degree as those of cigarettes, with this measure also extending to airports.

Underpinning the proposed regulations, which would be imposed under new powers granted by the Tobacco and Vapes Act 2026, are findings from the charity Action on Smoking and Health (ASH UK) that around 1 million 11-17 year olds had tried vaping in 2025.

Health Secretary James Murray said in the press release that “too many young people experimenting with vapes” are being “attracted by the array of flavors, bright colours and marketing displays.”

“We want a healthier future for the next generation, so we must act now to reduce the appeal of addictive vapes to our children,” he added.

“Where does that logic end? Plain packaging for beer and wine?”

But tobacco harm reduction advocates aren’t buying it. Mark Oates, director of the consumer advocacy group We Vape, told Filter that the government’s proposals are “wrongheaded.” It should focus instead, he said, on enforcing existing age restrictions that prohibit vape sales to under-18s. 

“Where does that logic end?” Oates asked. “Plain packaging for beer and wine? These proposals must be stopped before they become the starting point for even more restrictions.” 

Oates urged consumers to respond to the consultation by giving the government a “firm no.”

Advocate Clive Bates, of Counterfactual Consulting, said the research supporting the plain packaging proposal “is risibly weak and inadequate.” It was based, he explained, on immediate responses to questions about how people would react to plain packaging when they were shown different pack designs.

“In the case of questions put to young people, the question isn’t even about what they would do themselves, but what they think others would do,” Bates told Filter. 

“None of the research takes account of the longer-term adjustments that such packaging may cause,” he continued, referring to a dampening effect on tobacco harm reduction. 

“None of the research—none—estimates what would happen to smoking rates if plain packaging for vapes actually works as intended.”

Bates pointed to the other product that has mandatory plain packaging: cigarettes, the leading cause of preventable death and disability in the UK,  responsible for 70,000 deaths annually. 

Having two products with radically different risk profiles share the same packaging, he argued, would do little to quell widespread, damaging misperceptions that vapes are as harmful as cigarettes or worse. 

“None of the research—none—estimates what would happen to smoking rates if plain packaging for vapes actually works as intended,” Bates said.

Even the premise of vapes causing net harm to young people is dubious, when you consider what youth who vape might be doing instead if vapes weren’t available.

“The government just assumes that vaping is a bad thing, and therefore the plain packaging is justified if it reduces the appeal to young people,” Bates said. “But vaping is displacing smoking in young people, and has been beneficial.”

These proposals come on top of other recent restrictions on vapes—which help the majority of British adults who manage to quit smoking. Single-use vapes were banned in 2025. And from October 1, the Vaping Products Duty takes effect, significantly increasing the price of e-liquids. 

“If the government intended to create a policy to confirm that misconception in the minds of the public, the proposals they have suggested are exactly what they would do.”

Advocate Martin Cullip is among the many who were able to quit smoking by switching to vapes. He fears that if the latest proposed measures are adopted, other people who smoke will be deterred from pursuing the same opportunity to improve their health.

People who smoke are already told by friends and colleagues that vaping is worse for you than smoking, Cullip noted, and large numbers of people who smoke believe this to be true. What these measures would do, he said, is validate misinformation instead of correcting it.

“If the government intended to create a policy designed to confirm that misconception in the minds of the public, the proposals they have suggested are exactly what they would do,” Cullip told Filter. 

Oates agreed that making vapes less visible and attractive will point adults who smoke in only one direction, perpetuating harm.

“Can you imagine the complexity of asking to buy a ‘DD1’ flavoured vape?” he asked. “You just wouldn’t bother; you’d continue smoking.”

Image (cropped) via United States Food and Drug Administration

The post Plain Packaging and “Drab” Colors: The UK’s Latest Anti-Vape Plan appeared first on Filter.

A recent survey of over 2,000 British pouch users—from Haypp, an international e-commerce company specializing in safer nicotine products, and its subsidiary Northerner.com—explored how and why nicotine pouches were being used. The resulting Nicotine Pouch Report 2026 additionally looked at purchasing data for over 50,000 UK customers from December 2025 to January  2026.

“The UK nicotine pouch market is expanding rapidly,” it concluded, saying that demand for pouches on the company’s platforms grew by 60 percent in 2025.

Respondents viewed pouches as “healthier,” “more discreet” and “less intrusive to others.”

But why pouches, more than other options? According to the report, it’s a mixture of practicality and “perceived health benefits.” Survey respondents viewed pouches as “healthier” (64 percent), “more discreet” (also 64 percent) and “less intrusive to others” (52 percent), compared to other nicotine products.

That makes sense, when research has found pouches to be at the very lowest end of the nicotine-products continuum of risk, and clearly they don’t produce smoke or vapor that other people might object to.

The report found that 48 percent of pouch consumers used the products to quit smoking —unsurprisingly, given pouches’ success for smoking cessation in other countries. But perhaps more surprising is that 40 percent began using pouches in order to quit vapes, which have been the UK’s most successful smoking-cessation tools.

“This isn’t about pouches replacing vapes,” Marina Murphy, Haypp’s director of scientific affairs, told Filter. “Different tools work for different people, and both are doing important work getting people off cigarettes.”

But Murphy said pouches appeal to a particular kind of quitter: “someone who wants something private, with no vapor and nothing to change or refill.”

That resonates with Jessica Harding, a director of the Global Forum on Nicotine (GFN Ltd.). After 26 years of smoking and many attempts to stop, she was finally able to quit in 2011 when she was persuaded to try vaping, as she once described for Filter. Harding continued to vape for years—but now exclusively uses pouches.

The fact that they’re discreet is a big plus in a world that loves to criticize women’s choices, Harding said.

“The benefits of pouches for me are they are low-tech and simple, so there’s a lot less to carry around with you and you don’t need to think about charging or mixing,” she told Filter.

Hayyp’s report indicated that women are leading the way in migrating to nicotine pouches—with purchases by women more than tripling in 2025, compared to a 25 percent increase among men. This phenomenon has previously been seen in Sweden.

Harding can understand why pouches are particularly appealing to women. They’re less “geeky” and “fiddly” than vapes, she said, and the fact that they’re discreet is a big plus in a world that loves to criticize women’s choices.

“Getting a vape out these days is a license for someone to tell you that ‘those things are worse for you than smoking’—which is absurd, but gets a bit wearing,” Harding said.

While pouches have many benefits for people who smoked, this hints at another factor that might be prompting people to switch from vapes: misinformation about the latter.

Cullip is unsurprised that people are switching from vapes to pouches. “It’s undoubtedly because they think vapes are harmful,” he said.

Tobacco harm reduction advocate Martin Cullip uses both. He prefers vapes, but uses pouches in places where vaping isn’t permitted, such as on planes. He’s unsurprised that people are switching from vapes to pouches. “It’s undoubtedly because they think vapes are harmful,” he told Filter.

Recent research shows the majority of people in the UK incorrectly believe that vapes are either just as harmful as combustible cigarettes or worse. Demonization by the media and political moves to restrict vapes have fueled these damaging misperceptions.

However, Dr. Thomas Nahde, head of harm reduction and engagement at Imperial Brands Science, a division of the tobacco company that develops safer nicotine products,  cautioned against jumping to the conclusion that this is the whole explanation for the vapes-to-pouches trend.

“Without further data it’s hard to know if that’s reflecting misconceptions around the risks of vaping or many other potential reasons,” he told Filter. “These could include format, flavors, taste, social acceptability, or simply curiosity to trial a newer nicotine category.”

Some of those factors match Harding’s experience; she said her switch to pouches largely happened simply because she was looking to expand the ways she could consume nicotine safely.

It should also be noted that pouch uptake among people who vape often doesn’t mean they’re quitting vapes entirely. Most of Harding’s friends, she said, oscillate between the two products depending on where they are, much like Cullip.

“As regulatory pressure on vaping products increases … many consumers are looking for alternatives.”

But to the extent the transition is happening, it’s driven in part by regulations restricting vapes, said Stephen Buss, a researcher with a specialization in tobacco harm reduction who has worked for a number of different companies and organizations.

“As regulatory pressure on vaping products increases through disposable vape restrictions, environmental legislation and evolving regulatory frameworks, many consumers are looking for alternative reduced-risk nicotine products,” Buss told Filter.

In April the Tobacco and Vapes Bill became law in the UK. It will restrict the visibility and variety of vapes, banning advertising and limiting flavors. What’s more, in October the new Vaping Products Duty will add £2.20 per 10ml in tax to the cost of e-liquids, doubling the price of some bottles.

Pouches, as Murphy noted, “aren’t touched by the tax.”

“Combine that with the Tobacco and Vapes Act, which introduces a dedicated regulatory framework for pouches for the first time, and you’ve got a real cost-effective and legitimacy shift happening at the same time,” she said.

“I’d expect more smokers to find pouches the simpler, more affordable option—alongside vapes, rather than instead of them.”

Buss sees it similarly. “As restrictions tighten around one reduced-risk nicotine category, many adult nicotine users will naturally explore other legally available alternatives,” he said, adding that the regulatory challenge is to ensure legislation is “proportionate and evidence-led.”

Whatever the combination of reasons, Murphy expects that the popularity of nicotine pouches will continue to grow in the UK.

“Pouches don’t need to take over vapes to matter here,” she said. “But as vaping gets more expensive and people become more familiar with pouches, I’d expect more smokers to find pouches the simpler, more affordable option—alongside vapes, rather than instead of them.”

Photograph by Jakubdrastich2 via Wikimedia Commons/Creative Commons 4.0

The Influence Foundation, which operates Filter, has received donations from GFN Ltd. Filter‘s Editorial Independence Policy applies.

The post What’s Behind the UK’s Migration to Nicotine Pouches? appeared first on Filter.

The Public Health (Single-Use Vapes) Bill 2025 completed Ireland’s parliamentary process at the Oireachtas on July 7. It currently awaits the signature of President Catherine Connolly, which is expected to be a mere formality. Retailers will be given a six-month period to shift existing products, with the new law taking full effect in January 2027. 

“By banning single-use vapes, we are helping to prevent nicotine addiction before it starts and creating a cleaner environment for everyone,” said Health Minister Carroll MacNeil, echoing talking points that have driven disposable vape bans in countries such as the United Kingdom.

The new ban is only part of Ireland’s wider crackdown on nicotine vapes. In 2025, for instance, the country imposed the European Union’s highest tax rate on e-liquids. 

Meanwhile, the Public Health (Tobacco Products and Nicotine Inhaling Products) (Amendment) Bill 2026, introduced earlier in the year, seeks to further restrict safer nicotine products that have helped millions quit smoking. Ireland’s smoking rate of about 18 percent remains vastly higher than the government’s target of below 5 percent—which it was supposed to reach by 2025.

“This now looks certain to go through, with little pushback from the opposition.”

That bill would limit vape flavors to tobacco or unflavored e-liquids only. It would additionally restrict colors and imagery on devices and packaging, and ban retail outlets from advertising nicotine products, among other measures. It would give ministers the power to regulate flavor descriptors and to amend the law to cover any future nicotine products.

Having recently passed the lower house, the bill is due to be debated in the upper house, the Seanad, later in July. An EU notification process would need to be completed before it can be enacted, but the government plans for it to take effect before the end of 2026.

“This now looks certain to go through, with little pushback from the opposition apart from [political party] Sinn Fein,” Tom Gleeson, a trustee of the New Nicotine Alliance Ireland charity, told Filter. 

“This move by the health minister will result in the first minister for health to leave office with a higher rate of smoking than when they took office,”said Gleeson, who credits vapes with helping him quit smoking. “Given the clear evidence that restrictions on reduced-harm products benefit smoking, it’s puzzling that they are willing to take that risk.”

“The lack of support for vaping from our health bodies has already reduced the impact of safer products on smoking rates,” he continued, “with Ireland lagging behind places like our close neighbors in the United Kingdom.”

In the UK, most people who quit smoking do so with the help of vapes. Though politicians there have also turned against tobacco harm reduction in recent years, the country has a prior track record of embracing it. The UK now has a significantly lower smoking rate than Ireland, and Brits are more likely to vape than to smoke.

Dr. Garrett McGovern, an Irish addiction medicine specialist and tobacco harm reduction advocate, told Filter that “flavors are an essential component of helping smokers quit”—an assertion that’s supported by substantial evidence. 

“They have not considered the unintended consequences: increased smoking rates across the age spectrum and a burgeoning illicit market.”

McGovern described the current bill as a “missed opportunity.” It makes the assumption, he continued, that a “so-called youth epidemic” of vaping entails harms that are somehow comparable to those caused by cigarettes. This is not true. 

In reality, McGovern said, “youth e-cigarette use is experimental, transient and in the vast majority of cases unproblematic, and not a gateway to cigarette smoking. Despite this, policymakers have decided that vaping is the enemy and needs to be eradicated.” 

The Healthy Ireland Survey 2025 found that 50 percent of Irish people who vape formerly smoked and have now quit combustible tobacco entirely. Another 33 percent vape and smoke—so-called “dual use,” which typically involves reducing the number of cigarettes smoked, and is often part of a journey to complete smoking cessation. 

Just 17 percent of people who vape in Ireland have never smoked—and even with them, there’s the question of what they would be doing if vapes weren’t available, given evidence of “common liability” to both vaping and smoking. 

When the most effective smoking-cessation aids are made not only more expensive but less visible and less enjoyable, advocates say that damaging outcomes are inevitable.

“They have not considered the unintended consequences: increased smoking rates across the age spectrum and a burgeoning illicit market to fill the void left by the unregulated one,” McGovern said.

Photograph (cropped) by Ecig Click via Flickr/Creative Commons 2.0

The post Disposables Banned, Flavors Next: Irish Vape Crackdown Gathers Pace appeared first on Filter.

When her husband quit smoking, it had a profound impact on their whole family. “I don’t think either of us realized just how much it affected our lives until he finally stopped,” Gorley said.

Her husband lives with PTSD; like many people experiencing mental health challenges, he depended on cigarettes. But smoking being a large part of her husband’s life meant it featured heavily in hers, too. “Every outing, every holiday, every family event revolved around cigarette breaks,” Gorley said.

Then he switched to a much safer, smoke-free form of nicotine use: vaping. Gorley was initially cautious—vapes get a lot of bad press, after all—but soon found that it transformed family life. “He seems more present, more engaged, and enjoys being active in a way that wasn’t as common before,” she said.

“When we talk about quitting smoking, we typically focus on the person quitting, but not necessarily how it can impact their closest loved ones.”

Besides the positive health implications and the absence of secondhand smoke from their house and clothing, Gorley credits her husband’s switch with strengthening their relationship and their family. She particularly values a better quality of time without the cigarette breaks, especially when she and her husband recently became grandparents. “Being able to spend uninterrupted time with our granddaughter has meant the world to us.”

The Gorleys live in Melbourne, Australia, where vapes are heavily restricted and can only be obtained through participating pharmacies or a doctor’s prescription. This very limited access costs other families the chance of similar outcomes.

“When we talk about quitting smoking, we typically focus on the person quitting, but not necessarily how it can impact their closest loved ones,” Todderick Prochnau, a pharmacist in Canada who has run smoking-cessation clinics, told Filter. “Importantly, quitting can improve the health of those that they live with too!”

Prochnau said that 1 percent of all deaths internationally are due to secondhand smoke exposure—some estimates put it even higher—and transitioning to smoke-free options, like vapes, pouches or heated tobacco products, removes that risk for loved ones.

The results overwhelmingly indicate positive changes in emotional wellbeing, sociability, quality of life and shared experiences.

But the fact that it’s not only about eliminating passive smoking is illustrated by a recent survey, published by the research and media organization We Are Innovation. 

Aiming to measure “the perspectives of friends, partners, and family members on the transition from traditional cigarettes to innovative nicotine products,” the survey involved 4,000 respondents in five countries to find out what “quitting looks like from the outside.” The results overwhelmingly indicate positive changes in emotional wellbeing, sociability, quality of life and shared experiences.

These knock-on benefits of smoking cessation are often overlooked. Asked why the survey focused on the loved ones of people who quit smoking, Federico Fernandez, CEO of We Are Innovation, replied: “Because nobody has asked them before.”

“Every survey on smoking cessation asks the smoker how they feel,” Fernandez told Filter. “Nobody asks the partner who used to smell of smoke on every hug, or the daughter who could not have friends over because the house smelled like an ashtray—these people live with the change too.” 

Policymakers who determine people’s access to smoking-cessation tools need to hear these important voices, Fernandez added.

Caz Humphreys works at a smoking-cessation clinic in Leicester, England. In her 18 years as a stop-smoking advisor, she has witnessed the introduction and development of vapes. 

Humphreys recalled an occasion when a woman brought her father into the clinic, an ex-servicemember who had served in the Falklands War. He had spent most of his adult life self-medicating his stress with cigarettes.

“This case changed my mind completely about vaping as a method to quit smoking,” Humphreys told Filter.

“Of course he has benefited, but so have I. I have a partner who is fit and well, and I’m not his carer, which I may have become.”

“Within just one week, he entered the clinic looking totally different,” she continued. “Upright, breathing easier, pink in hue with much more energy.” This, she said, was “positively life-changing” for his family.

Another client of Humphreys who switched to safer nicotine products was then able to play soccer with his son—something he had struggled with before. With the money he saved from quitting cigarettes, he took his son to tournaments and bought tickets to watch a soccer game abroad. 

Stories like these are close to Humphreys’ heart when she lost her own father to a smoking-related illness. Her partner, who also smoked, switched to vapes after she suggested it to him. He now walks in the hills with her, after joining her walking club.

“Of course he has benefited, but so have I,” Humphreys said. “I have a partner who is fit and well, and I’m not his carer, which I may have become. Money saved has also made a good impact on family finances.”

There are so many more stories like these. Grove Mitchell smoked for 30 years until he switched to vapes. “A smoker leads a whole other second life, away from everyone but other smokers, huddled around an ash bin in the freezing cold,” he told Filter. 

“Partners that both smoke now have more options available: One may quit nicotine altogether and the other may successfully transition to a smoke-free form.”

Alongside the other benefits, switching made Mitchell feel more connected to those closest to him. “A huge increase in the baseline feeling of wellbeing leads one to be open to more activities with the family,” he said.

While the loved ones of the person who smoked stand to benefit greatly, it is often their support that is critical to the person being able to make such a positive change. Prochnau noted that in his practice he has witnessed how, if a couple both smoke, it is difficult for one of them to quit if the other has not made the same decision. “Data also shows that it is much harder to successfully quit smoking if your partner continues to smoke,” he said. 

“Smoke-free forms of nicotine provide another option to those partners who may not be able to quit smoking by conventional means,” Prochnau continued. “Essentially, partners that both smoke now have more options available: One partner may quit nicotine altogether and the other partner may successfully transition to a smoke-free form of nicotine, allowing substantial improvement in risk and health for both partners.”

All in all, Fernandez said, the testimonies of partners, family members and friends emphasize one important reality: “Quitting is not a solo act.”

Photograph by Alberto Casetta on Unsplash

The post “Not a Solo Act”—The Impacts of Smoking Cessation for Loved Ones appeared first on Filter.

On June 17, the European Commission’s proposal, calling for a tax hike on all nicotine products irrespective of risk profile, was heavily defeated by 439 votes to 181. Earlier that day, a report from the parliament’s economic and monetary committee (ECON) report—calling for relatively scaled-down tax increases on alternative nicotine products, based on a “less harm, lower tax” principle—had also been rejected, but by a much narrower margin: 308 in favor and 320 against.

At stake is the revision of the EU Tobacco Taxation Directive (TTD) to include newer nicotine products, which will affect people’s access to tobacco harm reduction in the world’s highest-smoking region.

Tobacco harm reduction advocates are generally united in condemning taxation levels that could reduce people’s incentive to switch from deadly products to safer ones. But given the nuances of the ECON report, they have expressed differing views on that vote.

Some unequivocally welcomed the rejections of a “misguided attempt to impose higher taxes” on safer nicotine products. Others have accused the EU of prioritizing “politics over public health” by rejecting the ECON report, because of its “recognition that different nicotine products carry different levels of risk”—a groundbreaking acknowledgement by EU standards—and despite its proposal of a tax hike on vapes.

The European Commission proposal has long been criticized for excessive tax increases that advocates say would dissuade switching and boost illicit markets, while failing to recognize the huge risk differences between combustible and non-combustible products. The ECON report sought to address some of these concerns.

“This means almost half of the EU parliament actually has a positive opinion on harm reduction products that are on the market now.”

To add to the confusion, observers note that a parliament member’s (MEP) stance on tobacco harm reduction might not be the only motivation behind each vote. The Swedish parliamentary delegation, for instance, voted against the ECON report. Sweden has achieved the world’s lowest smoking rate due to snus and nicotine pouches, so those MEPs probably didn’t object to the relative-risk language. But Sweden also has an election coming up, so a likely factor is that any kind of tax increase on popular products may not be conducive to winning votes.

Stefan Mathisson, editor-in-chief of Vejpkollen, a tobacco harm reduction-oriented publication in Sweden, was in favor of the ECON report, and said the “close call” of the vote makes him feel hopeful.

“This means almost half of the EU parliament actually has a positive opinion on harm reduction products that are on the market now,” he told Filter.

“Even though this feels like a backlash in the short term,” he continued, “it also means the pressure and advocacy from consumers, scientists, as well as industry, actually has an impact on MEPs.”

Mathisson concluded that he believes this “bodes well” for upcoming negotiations over revisions to the Tobacco Products Directive, which regulates nicotine products across the EU.

Whatever advocates’ views on the implications for future EU nicotine policy, it should be remembered that the parliament’s opinion here is non-binding.

“This is a tax matter; the [European] Council must pass it unanimously and is only required to obtain an opinion from Parliament,” Peter Beckett, an EU policy expert and co-founder of the Clearing The Air blog, told Filter. “Parliament gave its opinion in its resolution, and that’s it.”

The European Council, made up of ministers from the 27 member states, will now have the job of reaching a consensus on nicotine tax rates before adopting a directive.

But Beckett shares Mathisson’s view that the voting has significance as a litmus test—and that both the split on the ECON report and the emphatic rejection of the European Commission proposal indicate that numerous MEPs do recognize tobacco harm reduction.

Photograph (cropped) by Marina Bauer via Wikimedia Commons/Creative Commons 4.0

The post EU Nicotine-Tax Doubts After Parliamentary Rejections appeared first on Filter.

On June 10, the Republic of Palau, an island nation in the Western Pacific with a population of 18,000, formally applied for a World Health Organization review of nicotine, under Article 2 of the 1971 UN Convention on Psychotropic Substances. This would have the potential to place nicotine under similar international drug restrictions to GHB, say, or methamphetamine—making the sale of non-medical nicotine products illegal.

The government of Palau, which banned vapes in 2023, argues that current efforts to protect people from combustible tobacco need to be sweepingly updated to include newer, safer products such as nicotine pouches and vapes.

“We may be a small nation, but the scale of a problem has never determined who acts on it,” said President Surangel S. Whipps, Jr. He urged governments around the world to follow suit in asking the United Nations “to finally treat nicotine like the toxic and addictive drug that it is.”

“Think of the consequences of prohibiting nicotine in international conventions just like cannabis, cocaine, heroin and so many other drugs.”

Ethan Nadelmann, founder and former director of the Drug Policy Alliance in the United States, said the initiative “may well be one of the most foolish in modern or even ancient history.”

“Think of the consequences of prohibiting nicotine in international conventions just like cannabis, cocaine, heroin and so many other drugs,” he told Filter. “All those drugs became far more popular after their criminalization than before, and far more dangerous.”

Prohibition generates vast illicit markets, corruption, violence and human-rights violations, he continued, “filling prisons with non-violent human beings whose only offense was to grow, possess, buy or sell a psychoactive substance that had long been legal.”

With nicotine, there’s additionally the critical harm reduction role of safer alternatives to smoking.

Smoking rates may be declining worldwide, but 1.3 billion people still use tobacco in risky forms, causing over 7 million deaths each year. Key to reducing this toll is the speed at which people who are unable or unwilling to quit nicotine transition to the safer products that over 100 million already use.

Nadelmann pointed to Sweden and New Zealand as countries that have “dramatically reduced cigarette smoking in recent decades without resorting to criminalization.”

“They claim it is an ‘initiative of the Republic of Palau,’ but it looks more like Palau is the willing puppet for a new billionaire-funded crusade.”

As part of its initiative, Palau’s government presented a scientific dossier and a website making the case against public access to nicotine. One of tobacco harm reduction’s most prominent voices labels this a “false operation.”

“They claim it is an ‘initiative of the Republic of Palau,’ but it looks more like Palau is the willing puppet for a new billionaire-funded crusade,” advocate Clive Bates, of Counterfactual Consulting, told Filter.

“The website is too slick, the lengthy science briefing was prepared in Europe, and an American activist group is involved,” he continued. “There is no disclosure about who is funding and organizing the campaign, but we can be pretty sure it isn’t the taxpayers of Palau with a population of 18k.”

It’s been reported that Palau’s application was put together by individuals who have been heavily involved in lobbying against safer nicotine products in Europe.

“What’s upsetting is that the anti-nicotine agenda being pushed on/by Palau … will do nothing to assist the people who are using deadly oral products.”

Just under 43 percent of Palau’s adult population legally and regularly consume gutka, a chewing tobacco mixed with betel (areca) nut, as David Zaruk described in Firebreak. The highly carcinogenic product is banned in many countries. Curiously, the dossier fails to mention the use of gutka, which is far more prevalent in Palau than smoking.

“What’s upsetting is that the anti-nicotine agenda being pushed on/by Palau … will do nothing to assist the people who are using deadly oral products,” Nancy Loucas, executive coordinator of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA), told Filter. 

Loucas added that denying people access to much less harmful products is contrary to basic human rights and the World Health Organization’s own harm reduction mandate. When Palau banned vaping, an option that has helped millions migrate from deadly forms of tobacco, it did so through according to the WHO’s MPOWER strategy. US billionaire Michael Bloomberg, a dedicated opponent of access to safer nicotine products, is a major funder of the WHO.

“Whether for money, for fame or other favors, there are countries willing to pawn their sovereignty and offer their place at the intergovernmental table to aggressive philanthro-colonialists, frustrated that billionaire money alone does not give them the standing and access of a nation state,” Bates commented.

Whether nicotine gets put on the UN’s scheduled list would depend upon a medical and scientific assessment by the WHO Expert Committee on Drug Dependence. That process would conclude in March 2028, subject to the votes of 53 member states.

“If the government of Palau’s proposal ultimately leads to a global prohibition of nicotine, and drug wars resembling those that have caused such devastation around much of the world in recent decades,” Nadelmann said, “then it will go down as a perpetrator of one of the most deadly war crimes in history.”

Photograph (cropped) of Koror, Palau, by Mandrusian via Wikimedia Commons/Creative Commons 4.0  

Update, June 25: This article has been edited to credit David Zaruk’s article for information concerning gutka use and policy in Palau.

The Influence Foundation, which operates Filter, previously received a restricted grant from the Drug Policy Alliance. Filter‘s Editorial Independence Policy applies.

The post Tiny Pacific Nation Applies for Global Nicotine Ban. Who’s Behind It? appeared first on Filter.

Stimson, a public health social scientist and emeritus professor at Imperial College London, was speaking at the Global Forum on Nicotine (GFN) in Warsaw, Poland, in early June. He emphasized the extremely high prevalence of tobacco smoking, and related harms, among people who use banned drugs.

“Smoking rates amongst people who use drugs or people in drug treatment are two to four times higher than the general population,” Stimson said. Of 100,000 people who used heroin in the United Kingdom, according to research he cited, 63 percent were projected to die before the age of 70, compared with 16 percent of the general population. While 27.6 percent of the projected premature deaths were attributed to factors around banned drug use, 23.6 percent were attributed to smoking.

“We’re all aware of drug-related deaths,” said Stimson, who helped pioneer harm reduction approaches to drug use in the UK in the 1980s. “But the fact is, in this population, there are nearly equal numbers of deaths from smoking.”

Such figures are “stunning,” Stimson said, yet remain “invisible.”

“We can’t talk about harm reduction without tobacco harm reduction.”

The GFN panel, titled “Drugs and Tobacco Reduction: Shared Challenges, Shared Solutions,” highlighted how ignoring this intersection is one major way in which people who use drugs are denied the right to health. And the relationship is so obvious.

Nicotine use and use of other drugs go together so often that, “We can’t talk about harm reduction without tobacco harm reduction,” said panelist Magdalena Bartnik.

Bartnik is the founder and director of PREKURSOR, a Polish organization providing harm reduction services and advocacy for people who use drugs. She sees safer nicotine products as essential resources. “Cigarettes are an important part of people’s lives, a way of coping with stress,” she told the audience, “so tobacco harm reduction allows for the mitigation of health risks without the need to quit using nicotine.”

Marianna Iwulska, another of the panelists, has first-hand experience of that. She’s a drug-user activist who chairs the board of EuroNPUD, and a peer worker at PREKURSOR. She switched from cigarettes to vapes, and said her health has improved immeasurably as a result. But she did so without any encouragement from those who should be looking out for her health.

“When it comes to tobacco harm reduction, I have déjà vu. I am seeing the same arguments thrown about as with opiate substitution therapy.”

“No doctor ever asked me, even, if I am smoking, throughout my 26 years of [opioid] substitution treatment in Poland,” Iwulska told the audience. And that silence reflects what she described as a culture of hostility towards safer nicotine options, similar to that seen against medications for opioid use disorder.  

“When it comes to tobacco harm reduction, I have déjà vu,” she said. “I am seeing the same arguments thrown about as with opiate substitution therapy, when people were saying, ‘It’s the same, it’s like drug use, you are not recovering at all.’ But harm reduction is about meeting people where they are, not expecting miracles—not, ‘You have to stop first, then we treat you.’ I think it will be very, very beneficial to drug users to implement tobacco harm reduction to services.”

There have been some signs of momentum, with more groups concerned with drug-user rights and health recognizing the importance of tobacco harm reduction in recent years. In the United States, for instance, the National Harm Reduction Coalition has been working on it, as has the Urban Survivors Union, among others. Prominent supporters include Mark Tyndall, a Canadian physician with a long background in “drug” harm reduction.

A recent briefing paper from Global State of Tobacco Harm Reduction (GSTHR)—a project of Knowledge-Action-Change (KAC), which Stimson co-founded—highlights some of the reasons nicotine and other drugs often go together. 

“One of the problems is that drug services are often in a different silo, with different budgets from smoking cessation.”

Many people find nicotine relieves symptoms of withdrawal from other drugs, the paper notes. Smoking cigarettes before and after can be part of people’s ritual of drug use, “reinforcing both habits,” while nicotine may enhance people’s experiences of using drugs such as cocaine or opioids, as it “increases the body’s uptake of one or both substances.” Yet at the same time, data show that many people—including up to 80 percent of those in substance use treatment—do have a desire to quit smoking.

An accompanying GSTHR briefing paper offers ideas on how drug services could incorporate tobacco harm reduction to help people who smoke—by displaying information on safer nicotine options, for instance, and creating a smoking-cessation community that shares the same goals. 

This kind of integration would be fairly straightforward and wouldn’t cost much. “It’s a lot simpler than trying to persuade governments that you want to prescribe methadone, or persuading governments that you want to give out needles and syringes,” Stimson said. 

So why is tobacco harm reduction not already routinely included in most harm reduction and drug treatment services?

“One of the problems is that drug services are often in a different silo, with different budgets from smoking cessation, and people are focused on their own targets and priorities,” KAC Director David MacKintosh told Filter.

Harm reduction services are typically very stretched, dealing with acute crises such as overdose with scarce funding, he acknowledged, “so it’s understandable it’s not the priority, even though it will kill half of those who continue to use combustible nicotine.”

“I think the way to bring change is within community-based organizations upwards.”

Change requires support from leadership. MacKintosh moderated the GFN panel, where he said the idea of tobacco harm reduction remains “abstract” for many, and needs to be made more concrete in decision-makers’ minds.

“Whether you’re working with national politicians, public health people, whoever it is, they have their own interests,” he told the audience. Advocates, he said, need to appeal to those interests, to sell the idea of tobacco harm reduction and its benefits for individuals and local communities to the people who fund harm reduction services.

“We have to build from the ground up and help policymakers and public health leaders find their confidence to do what’s right around THR, rather than ignoring the potential, which can seem safer and easier,” MacKintosh told Filter after the event.

This grassroots approach is something Stimson agrees with. He told the GFN audience that getting THR into drug services can be a “bottom-up way to influence donors and international organizations.” 

“I think the way to bring change is within community-based organizations upwards,” he said. 

Photograph by Irina Iriser on Unsplash

The Influence Foundation, which operates Filter, has received donations and grants from KAC and from GFN Ltd. Filter‘s Editorial Independence Policy applies.

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The EU-wide TPD determines what will or won’t be legally available, and how it can be sold. Tobacco harm reduction advocates fear the upcoming revisions may contain damaging restrictions on safer nicotine products, such as a bloc-wide ban on vape flavors, in the region with the world’s highest smoking rates.

In that context, those advocates describe the questionnaire as a sham, its questions skewed in order to favor an anti-nicotine ideology.

The questionnaire was released on May 22 by the European Commission, the EU’s executive arm, which will be collecting answers until August 14. The stated aim is to give “stakeholders”—including national health authorities, NGOs, businesses, academics and private citizens—“the opportunity to express their views on the current rules and suggest possible changes to them.”

“It looks like it is designed to bolster support for simplistic policies that restrict or ban nicotine products that are far safer than cigarettes.”

But consumer group European Tobacco Harm Reduction Advocates (ETHRA) swiftly issued a scathing response, stating that “the survey is impossible to answer for anyone with an understanding of the differences in risk between different tobacco and nicotine products and a rational public health interest in the role that low-risk alternatives to smoking could play in reducing the burden of … disease.”

Tobacco harm reduction advocate Clive Bates, of Counterfactual Consulting, similarly sees the questionnaire as unfit for purpose. It “looks like it is designed to bolster support for simplistic policies that restrict or ban nicotine products that are far safer than cigarettes,” he told Filter.

ETHRA’s detailed response identifies eight generic failings in the nature of the questions asked. These include inadequate breadth or subtlety of available multiple-choice answers; inappropriate aggregation of very different products; no recognition of likely unintended consequences of policies; ignoring the counterfactual likelihood that many youth who vape would be smoking if vapes weren’t available; no recognition of trade-offs in framing questions; asking for opinions on factual matters; ignoring respondent risk perceptions; and no options to deregulate, for example by ending the EU’s existing ban on snus.

The critique additionally gives individual commentary on all 23 questions in the survey. One question, for instance, asks: “How important is it to you that the EU tobacco control legislation supports the following objectives with regard to tobacco, nicotine and non-nicotine products?”

“The question is heavily loaded. It does not differentiate between different products that have very different levels of risk” and “misses major outcome objectives.”

The eight available answers include “Preventing the initiation of use,” “Supporting the cessation of use,” “Ensuring that these products do not have attractive features” and “Minimizing the administrative burden on Member States”—but nothing about reducing deaths. 

“The question is heavily loaded,” ETHRA comments. “It does not differentiate between different tobacco and nicotine products that have very different levels of risk.” And it “misses major outcome objectives (reducing the burden of smoking-related disease) that can be attained by switching from high-risk to low-risk products.” 

Though around 700,000 EU residents die of smoking-related diseases each year, the survey, ETHRA states, “betrays a lack of seriousness about the size of the population, the toll of disease and death, and the options available to address it.”

The stakes are extremely high, advocates note, when around 100 million EU adults currently use nicotine in different forms. The nature of the revised TPD will heavily influence whether they, and future consumers, use safer products or deadly cigarettes.

“The survey is a window on the Commission’s thinking, and we can already see that they will do more harm than good if they get their way.”

“The survey is a window on the Commission’s thinking, and we can already see that they will do more harm than good if they get their way,” Bates said. As well as negative public health impacts, he predicts a much bigger illicit market if this happens—when the Commission should view safer nicotine options as a public health opportunity. 

ETHRA said the questionnaire illustrates “contemptuous attitudes towards the views of citizens who have an evidence-based, nuanced public-health case for tobacco harm reduction.” The intent, it said, is not a “genuine” consultation, but to “frame questions” to create a mere “illusion” of openness.

Despite this, Bates still intends to participate, believing that having some kind of a say is better than none. He plans to attach ETHRA’s critique as a file upload with his completed form.

“I urge everyone with an interest in sound regulation to do the same,” he said, “unless you have a more personal statement to upload.” He plans to assume that each question relates only to products useful to consumers for harm reduction, and answer accordingly.

“We need to square up for a new fight, but this time the opposition is better organized and financed.”

“Where there is an opportunity to oppose a measure that damages consumer interests, I will take it,” Bates said. “I will not allow any answers to be misconstrued as support for excessive measures against vapes, pouches, snus or heated tobacco.”

Bates also counsels against despondency, noting that previous EU battles have been won despite seemingly dire prospects. 

There was a time in 2012, he recalled, during the formation of the TPD, when the European Commission was planning to regulate vapes as medicine—hugely restricting access for people who smoke—and had the backing of many influential bodies. But consumers pushed back hard, and the outcome was a TPD that was far less damaging than anticipated.

“We need to square up for a new fight,” Bates concluded, “but this time the opposition is better organized and financed. Everyone needs to get ready, join or form consumer groups, and start getting busy.”

Photograph (cropped) via RawPixel/Public Domain

The post EU’s “Loaded” Public Questionnaire Pushes Anti-Nicotine Agenda appeared first on Filter.

That included her doctor. She recalled going to see him when she came down with bronchitis one time. “The doctor said to me, in a really grumpy voice, ‘I told you a year ago that you’re going to keep getting sick if you don’t stop smoking.’” 

When Murray explained how many times she had tried to do just that, and how her most recent attempt had only lasted two days, the doctor just said, “I think you should try harder next time.”

“He did not offer me any medication or suggest nicotine replacement therapy,” Murray said. “If he’s not willing to offer tools to help me succeed, how am I supposed to believe I’m worth helping?”

The doctor’s “quit or die” attitude left her feeling a “failure,” and she never made another attempt to quit. After more than 50 years of smoking, she eventually stopped “accidentally,” after she started working at a vape shop and tried the products herself—a journey that led her to become a tobacco harm reduction advocate, who has written for Filter.  

“Urban smokers are nearly twice as likely to quit as rural smokers.”

Murray lives in a rural part of Minnesota, a few miles from a town called Brainerd. She’s far from alone among rural residents—who have higher smoking rates than their urban counterparts—in facing particularly high barriers to quitting. And while a lack of helpful smoking-cessation advice in rural medical settings is part of the story, there’s a lot more to it.

Smoking rates in the United States have taken a significant tumble in recent years, in large part due to uptake of safer nicotine products, like vapes and pouches. In 2024, the country achieved its lowest smoking rate up to that point, of 9.9 percent. But in some groups, smoking rates remain stubbornly high. Providing them with accurate information and effective options is vital, when an estimated 25-30 million US adults still smoke, and the country’s biggest cause of preventable death still claims close to 500,000 lives each year.

“Urban smokers are nearly twice as likely to quit as rural smokers,” noted a recent report, “The Forgotten Smoker,” published by the tobacco and nicotine products company Philip Morris International (PMI), which also focused on people with mental health conditions and veterans. 

There’s a temptation to assume rural areas’ higher average age might account for this. According to the last US Census, the median age in rural and small-town communities was 41.3, compared to 38.8 for the whole population. The 45-64 age group has the highest smoking rate in the US; and people aged 65-plus, though smoking at a lower rate, are the most vulnerable to smoking-related disease and death. The “forgotten smokers” among these older age groups were discussed at the Nicotine Summit in Washington, DC, in May. 

“Older age distribution in rural areas may play a role, but it is only likely one part of a much more complex picture.”

But according to Lorna Bittencourt of the University of Minnesota’s School of Public Health—lead author of a study titled, “Smoking Quit Attempts and Associated Factors Among Rural Adults Who Smoke Daily in the United States,” which was cited in the PMI report—taking this as the whole explanation for the rural-urban disparity would be reductive.    

“Older age distribution in rural areas may play a role,” Bittencourt told Filter, “but it is only likely one part of a much more complex picture involving socioeconomic conditions, health care access and longstanding tobacco-related disparities.”      

Rural communities, she continued, often face reduced access to healthcare and smoking cessation services, transportation barriers, economic stressors and fewer tobacco treatment resources.

Other researchers paint a similar picture. Dr. Ruoyan Sun is an assistant professor with the Department of Health Policy and Organization at the University of Alabama at Birmingham, whose work has also covered smoking behaviors by location. She was among the speakers at the recent Nicotine Summit, and like Bittencourt, she warns against oversimplified explanations. 

“One important lesson is that rurality is more nuanced than simply labeling areas as ‘urban’ or ‘rural,’” Sun told Filter. She said binary classifications risk masking important variations.      

“Higher smoking prevalence in rural areas is partly explained by socioeconomic and demographic factors,” she continued, “but these do not fully explain why adults in rural areas are less likely to quit.”

“I called this person when I was still smoking, requesting help. The best they could do was to tell somebody to drive up to 100 miles to pick up brochures.”

The point about lack of access to smoking-cessation resources rings true to Marc Slis, who lives in the small community of Hancock on Michigan’s Upper Peninsula. Trying to quit smoking there, with a health system ill-equipped to help him, was excruciatingly difficult, he told Filter. “What I found was that there were little or no smoking cessation resources available in the area.” 

Slis explained that the health department in question covers five counties of about 71,000 residents across roughly 14,000 square miles. Faced with extremely high smoking rates in such a thinly spread population, the health department designated one person, with no formal training or experience, to be the smoking-cessation coordinator. 

“I called this person when I was still smoking, requesting any help they could give me,” Slis said. “The best they could do was to tell somebody to drive up to 100 miles to pick up brochures.”  

“In other words, there is no smoking-cessation help available in the five-county area that I live in,” he continued. “It illustrates that the number one cause of preventable death is not only not a priority for a five-county health department, but also not even on their radar.”

Like Murray, Slis ran his own vape shop for years; discovering vapes had finally enabled him to quit smoking. But he’s still exasperated by the lack of help communities like his get from health authorities.

“If this is the state of things in other rural areas,” he concluded, “I think this alone may be responsible for much of the low quit rates and high smoking rates seen in rural areas.”

“Tobacco product regulation could be an opportunity to advance health equity in rural America, particularly if paired with efforts to improve access to support and health care.”

Another important issue Bittencourt pointed to is that tobacco-related inequities in rural communities are often overlooked in tobacco control conversations. 

“In a recent paper, we discussed how tobacco product regulation could be an opportunity to advance health equity in rural America, particularly if policies are paired with efforts to improve access to cessation support and health care infrastructure,” she said.

The internet is one obvious place to find tools and information, especially for people in remote areas, but here too there’s a disparity. According to the Federal Communications Commission, over 22 percent of people in rural areas of the US, and almost 28 percent living on Tribal lands, “lack coverage from fixed terrestrial 25/3 Mbps broadband.”  

One study tested three strategies to promote engagement with an online program to encourage rural adults to quit smoking. Printed materials; printed materials plus a loaned iPad with data plan coverage; or print materials, the iPad, plus up to six individualized coaching calls to support technology needs. It found that those who received the coaching support “had improved smoke-related outcomes.”

“Our study provides a better understanding of the resources needed to support digital access in rural populations,” the authors concluded, “and the results could be used to improve approaches to encourage people living in rural areas to stop smoking.”

“One important takeaway is that reducing rural smoking disparities will likely require more than individual-level interventions alone.”

Murray agrees. “So much of health care and cessation is now digitalized,” she said. “If a person doesn’t have good internet or cell service, it is next to impossible for them to have access to modern health care and cessation services. I am fortunate to have reliable internet access and can take advantage of telehealth, because I would not be able to drive for several hours just to attend an appointment.” 

But no single intervention is likely to end a rural smoking disparity that translates into a severe health disparity. Instead, it would take a range of far-reaching changes.

“I think one important takeaway is that reducing rural smoking disparities will likely require more than individual-level interventions alone,” Bittencourt said.

“Addressing these disparities will also require structural approaches,” she continued, “including improving access to evidence-based cessation treatment, expanding health care access in rural communities, and ensuring that tobacco regulatory policies consider the unique needs and contexts of rural populations.”

People’s desire to stop smoking is evident in all parts of the country: The PMI report cited CDC data showing that over 67 percent of US adults who smoke would like to quit. Rather than implying that people in rural areas—or anywhere else—just need to “try harder,” it’s imperative to make sure they have the right tools.

Photograph via PublicDomainPictures.net

The Influence Foundation, which operates Filter, has received unrestricted grants from PMI. Filter‘s Editorial Independence Policy applies.

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