A Path Forward: Making Smoke-Free Nicotine Products More Accessible to America’s 25 Million Adults Who Smoke
A Path Forward: Making Smoke-Free Nicotine Products More Accessible to America’s 25 Million Adults Who Smoke
THE CHALLENGE
Cigarette smoking is still America’s leading preventable cause of death.
Every year, nearly half a million Americans die from smoking-related diseases. Cigarette smoking persists as the nation’s leading preventable cause of death – particularly among communities that keep America running: veterans, construction workers, healthcare workers, first responders and rural and low-income populations.
Veterans face an elevated risk, smoking at rates roughly 40 percent higher than the general population. Adults earning under $60,000 annually smoke at nearly three times the rate of those earning $120,000 or more. Rural smokers face a roughly 15 percent prevalence compared to roughly 9 percent in cities. The vast majority of these 25 million adults who smoke want to leave cigarettes behind. But wanting to transition away and having the tools to succeed are two different things.
~500K
Americans die each year from smoking-related disease
25M
U.S. adults currently smoke cigarettes
+40%
Higher smoking rate among U.S. veterans
3x
Smoking rate for adults earning under $60K vs. $120K+
WHAT THE SCIENCE SHOWS
The U.S. Food and Drug Administration (FDA) has recognized that smoke-free nicotine products carry a reduced level of risk when compared to cigarettes.
Other countries are seeing results:
SWEDEN
Achieved Europe’s lowest smoking rate through widespread adoption of smoke-free nicotine products.
JAPAN
Experienced a roughly 40 percent decline in cigarette sales between 2015 and 2023 after heated tobacco products became available.
BARRIERS TO PROGRESS
Two main obstacles stand in the way.
Misinformation
More than half of Americans incorrectly believe nicotine causes cancer. More than 6 in 10 physicians share this misconception. This false belief directly prevents adults who smoke from considering smoke-free nicotine products as a path forward.
Lack of Choices
Slow FDA review processes mean adults who smoke encounter limited smoke-free nicotine options in their communities compared to other nations.
WHAT MUST HAPPEN
A practical agenda for progress.
Educate healthcare providers
Doctors and healthcare providers require accurate, current information about smoke-free nicotine products.
Accelerate regulatory review
The regulatory review process needs to accelerate while maintaining scientific integrity.
Expand adult access
Smoke-free nicotine products must become more accessible for adults – particularly among veterans, rural communities and low-income workers.
Protect youth, stop illegal products
Continued strong youth protection efforts and crackdowns on illegal products must continue.
THE OPPORTUNITY
When adults have access to science-backed smoke-free nicotine products, they can be more likely to make the transition away from cigarettes.
Progress is possible – and urgently needed. Add your voice today!

