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A MedPage Today opinion article by tobacco communication researchers argues that clinicians and public health agencies need clearer ways to explain differences in risk across nicotine products. The authors say cigarettes are especially harmful, no nicotine product is risk-free, and the best way to communicate relative risks without encouraging new use remains uncertain.
Three tobacco communication researchers are urging clinicians and public health agencies to explain how health risks differ across nicotine products, arguing that mixed messages leave people unsure how cigarettes compare with products such as e-cigarettes, nicotine pouches and heated tobacco. In an opinion article published by MedPage Today on November 8, 2026, the authors stress that no tobacco or nicotine product is harmless and say the best way to communicate relative risks without prompting nonusers to start remains unsettled.
Authors Ying Zhang, Andy Tan and Meghan Moran describe a marketplace that includes cigarettes, e-cigarettes, nicotine pouches, smokeless tobacco, snus and heated tobacco products. They argue that people encounter competing messages: broad warnings against tobacco use, reports about potential smoking-cessation benefits of e-cigarettes, and marketing that presents some products as “smoke-free” or “cleaner.” Those messages, they write, can obscure the fact that products do not all carry the same risks.
The authors say the advice differs depending on a person’s circumstances. People who do not use nicotine or tobacco should not start, they write, and nicotine is addictive. For people who smoke, quitting entirely is the best option; the article points to approved nicotine replacement products, including patches, gum and lozenges, and prescription medicines as first-line cessation approaches. For smokers who cannot or are not ready to quit, the researchers say understanding the risks of continuing to smoke compared with using noncombustible products may matter.
The article says the U.S. Food and Drug Administration has recognized that combustible products such as cigarettes pose the greatest health risks and has authorized certain products to carry modified-risk claims. Those claims concern reduced risk when the authorized product is used instead of cigarettes, according to the authors. They caution that switching completely matters: using cigarettes alongside another nicotine product does not provide the same reduction in exposure to cigarette smoke.
Clearer Guidance for Smokers
The debate has practical consequences for people who smoke and their clinicians. If health professionals avoid discussing relative risk, the authors warn, advertising, social media and informal advice may become the sources people rely on. But oversimplified messaging can also mislead: treating every product as equally harmful may hide meaningful differences, while presenting alternatives as safe could encourage use or downplay addiction and other risks.
The researchers call for communication that distinguishes between reducing some risks and eliminating risk. Their argument is not to promote vapes, pouches or smokeless tobacco, but to help smokers understand product differences while keeping the recommendation not to start clear for people who do not use nicotine. That balance is relevant to public health campaigns as well as one-on-one clinical discussions.
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Why Product Messages Conflict
The opinion article describes a rapidly changing U.S. market in which products differ in how they deliver nicotine and whether tobacco is burned. It says promotional messages can emphasize appealing flavors, lifestyle imagery or the absence of smoke, while product warnings communicate health risks. The authors argue that these contrasts make it harder for consumers to interpret relative harm.
The researchers also refer to a recent op-ed attributed to former Health and Human Services Secretary Tom Price. They say a disclosure at the end indicated that it was produced in partnership with and paid for by PMI Corporate Services Inc., part of Philip Morris International. The authors use the example to argue that information about product risk should come from credible, independent sources without a financial stake in sales. The source article does not provide a separate FDA announcement or new clinical study; its central development is the researchers’ call for better communication.
““For someone who does not use any nicotine or tobacco products, the advice is straightforward: Don’t start.””
— Ying Zhang, Andy Tan and Meghan Moran, writing in MedPage Today
How Risk Messages Should Work
The authors say it is not yet known which communication approach works best. Options could include clinician-patient conversations, public education campaigns, an accessible trusted information source, or a combination. Each has trade-offs involving reach, cost and possible unintended effects, the article says.
The source does not quantify how much lower the health risks are for particular noncombustible products, nor does it establish that any one alternative is safe or suitable for every smoker. It also does not report results from a study comparing communication strategies. The researchers say evidence is needed on whether risk explanations can help smokers understand product differences without increasing nicotine use among people who otherwise would not start.
Evidence Needed for Public Guidance
The researchers call for studies to test how different messages and channels affect people’s understanding of relative risk, smoking cessation and nicotine uptake among nonusers. Until that evidence is available, they argue that clinicians and public health agencies should communicate what is known carefully, distinguish authorized product-specific claims from general assurances, and rely on independent, credible sources.
The article does not announce a new program, regulatory change or research deadline. The next step it identifies is building evidence about which approaches can inform smokers without unintentionally encouraging others to use nicotine products.
Key Questions
What did the researchers call for?
They called on clinicians and public health agencies to explain differences in risk across nicotine and tobacco products using clear, independent information.
Do the authors say nicotine products are safe?
No. They state that no tobacco or nicotine product is completely safe and that nicotine is addictive. Their argument is that risks vary across products, not that alternatives are harmless.
What do they recommend to people who do not use nicotine?
The authors say people who do not use nicotine or tobacco should not start.
What do they say about smokers who use another product as well?
They say complete switching matters. Continuing to smoke while also using another nicotine product does not provide the same risk reduction as replacing cigarettes entirely, according to the article.
Is there an established best way to communicate these risks?
Not yet. The researchers say evidence is needed to determine whether clinician discussions, public campaigns, a trusted information source or a combination best communicates relative risk without encouraging nonusers to start.
Source: medpagetoday.com
