For the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA), New Zealand provides a particularly relevant case study for neighbouring governments that continue to prohibit or heavily restrict lower-risk nicotine products. Executive Coordinator Nancy Loucas argues that the results challenge predictions that regulated vaping access would derail progress against cigarettes.

Smoking decreases as vaping increases (worldwide)

These figures contrast dramatically with the U.S. youth smoking epidemic of previous decades. They also complicate the argument that introducing alternative nicotine products must inevitably renormalise cigarette smoking. Naturally, population trends alone cannot prove vaping caused declining smoking rates; taxation, smoke-free laws, changing social attitudes, prevention campaigns and other factors all contribute.

That distinction is really important. While it’s crucial to prevent young people from starting nicotine, tackling vaping and eliminating smoking are not the same public health goals. Cigarettes are especially dangerous since the combustion process creates a toxic mix that leads to most tobacco-related diseases.

Evidence for vaping as a smoking cessation tool keeps strengthening

In seven trials with 2,544 participants, nicotine vaping increased quit rates by 59% compared to NRT. To put it simply, about eight to ten out of every 100 people using nicotine e-cigarettes managed to quit for at least six months, while roughly six out of 100 who used patches, gum, or other NRT were successful.

That places vaping firmly within the evidence-based smoking cessation toolkit rather than merely making it an alternative consumer product.

A model to follow

New Zealand has increasingly attempted to combine adult access with measures intended to prevent youth uptake. Its government explicitly recognises less harmful alternatives such as vaping as practical tools for smokers trying to quit. CAPHRA argues that this approach deserves particular consideration across Asia, where millions continue to smoke while several governments favour prohibition or severe restrictions on vaping.

There are important qualifications. New Zealand authorities acknowledge that illicit cigarettes could account for part of the accelerated reduction in legal tobacco sales, while persistent smoking inequalities remain, particularly among Māori and more deprived communities. These challenges reinforce the need for targeted cessation support rather than complacency.

The undeniable case for tobacco harm reduction

New Zealand’s experience may not prove that vaping alone caused its remarkable decline in smoking. However, it does show that widespread access to vaping goes hand in hand with decreased smoking rates.

Punished for Success? New Zealand’s “Dirty Ashtray” Reveals The FCTC’s Embedded Bias

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California should ease up on taxes for marijuana businesses like the one they own together, Woody Harrelson and Bill Maher say.

The actor and comedian jointly complained about the state’s harsh cannabis taxes in a podcast interview released on Monday, known as the unofficial marijuana holiday 4/20.

“California sucks as far as—look, all businesses, but certainly this one,” Maher said on the episode of his Club Random podcast. “They still treat it like it’s poison.”

Harrelson agreed, saying, “They treat it like you’re lucky that we allow you to do this, and so we’re going to tax you 35 percent, which is way more—it’s more than double anything.”

“I don’t even know what’s the second” in terms of highly taxed items, the actor said, citing guns and beer as facing lower rates than cannabis.

“It’s ridiculous that they can just tax the fuck out of you and make it so hard,” he said. “Anyway, I don’t want to bitch and moan. I’m a happy person, generally.”

But Maher said, “I’m not happy about this.”

“I’m never happy when anybody fucks with my money,” he said. “I’m gangster like that.”

Harrelson and Maher own The Woods, a dispensary and cannabis consumption lounge in West Hollywood, where the two smoked joints while filming the new podcast episode.

In California, cannabis faces a 15 percent state excise at the point of purchase, as well as local excise taxes that vary from jurisdiction to jurisdiction. There are also regular state and local sales taxes that apply, plus taxes at other points of the supply chain such as at the cultivation level. Marijuana businesses can additionally face steep licensing fees in order to do business.

Harrelson further complained during the interview with Maher that “they also don’t allow you to write anything off,” an apparent reference to the federal provision known as 280E that blocks marijuana companies from taking tax deductions that are available to businesses in other sectors.

California lawmakers, however, like those in a number of other legal cannabis jurisdictions, have taken steps to decouple the state tax code from the federal policy, allowing operators to write off business expenses on their state taxes.

Maher, for his part, also noted the cannabis industry’s banking access issues.

“For the longest time, it was a very risky business because you couldn’t put the money in the bank, right?” he said. “The banks wouldn’t take ‘your dirty fucking pot money that you fucking hippies got by smoking pot.’”

“And everybody would have truckloads of cash around,” Maher said. “So of course, they were a target for robbers.”

To that point, Harrelson and Maher’s dispensary was burglarized in what appeared to be part of a string of crimes targeting cannabis businesses in the region.

While the situation is changing and more banks are taking on cannabis clients, as the two noted in the new interview, federal legislation to provide a broad fix for the issue has remained stalled for years.

Maher and Harrelson have long publicly embraced their cannabis consumption.

Last year, when Harrelson was asked to pick anyone living or dead he would like to patronize the dispensary’s cannabis cafe, he zeroed in on marijuana icon Bob Marley. But the actor also conceded that he doesn’t think he could go “toke-for-toke” with the late reggae star.

The actor also got involved in marijuana reform advocacy in California, calling on Gov. Gavin Newsom (D) to sign a bill legalizing marijuana cafes that passed in 2024, which he did end up approving.

Earlier this year, Harrelson joked about his experiences getting kicked out of two bars for smoking marijuana indoors with the mother of fellow star Matthew McConaughey.

Harrelson separately disclosed in 2017 that used cannabis to help get through a dinner with President Donald Trump.

Last year, Maher said he didn’t get high before attending a dinner with Trump at the White House, joking that it was a “missed opportunity.”

Image element courtesy of Angela George.

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Where safer nicotine use goes up, smoking goes down

GSTHR analysis found that increasing use of safer nicotine products has coincided with declining smoking prevalence across 28 countries. In several nations—including Sweden, Norway, Iceland, New Zealand and the UK—use of safer nicotine products has already overtaken smoking.

Nevertheless, the international pattern provides strong evidence that consumers can substitute lower-risk nicotine products for cigarettes when those alternatives are accessible and acceptable. The scale of this transition is now difficult to dismiss. GSTHR’s peer-reviewed estimates indicate that approximately 129 million people vaped in 2025, while around 78 million used heated tobacco products in 2024, in addition to tens of millions using snus and nicotine pouches.

The evidence for vaping as a cessation tool is undeniable

Recent research is also adding to the evidence on toxicant exposure. A randomised clinical trial published in JAMA Network Open found that adults who switched from cigarettes to a nicotine pod-based e-cigarette experienced reductions in certain biomarkers associated with cigarette smoke exposure. The study concluded that effective nicotine delivery may help facilitate both smoking cessation and reductions in toxicant exposure.

Prohibition has never decreased demand

But prohibition does not necessarily eliminate demand. The US provides a useful illustration. Research published in the American Journal of Preventive Medicine found that the amount of nicotine contained in e-cigarettes sold monthly increased by 249.2% between February 2020 and June 2024, while standardised unit sales rose by only 34.7%. Disposable products accounted for much of this expansion.

The inequality problem

Change is already underway. Will lawmakers choose to keep up?

Smoking remains one of the world’s largest preventable causes of death, responsible for millions of deaths every year. The economic consequences are similarly enormous, including healthcare expenditure, lost productivity and premature mortality. Yet tobacco control policy frequently focuses on reducing nicotine use rather than prioritising the elimination of the most dangerous form of nicotine consumption: combustible tobacco. Emerging evidence suggests these objectives should not be confused.

The Recent Motions Across the Globe Keeping Cigarettes on Top and Safer Alternatives Underground

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South Korea has made substantial progress against smoking over recent decades. Higher tobacco taxes, smoke-free laws, graphic warnings, public education and cessation programmes have all contributed to falling cigarette use. Yet smoking still causes a major burden of preventable disease, and the decline appears increasingly difficult to sustain. The debate is therefore no longer simply about whether South Korea needs stronger tobacco control. It is about which policies will actually reduce smoking fastest without creating damaging unintended consequences.

A case to follow

Sweden’s experience does not necessarily indicate that snus and nicotine pouches alone caused its low smoking prevalence. Culture, taxation and conventional tobacco-control measures matter too. Nevertheless, Sweden demonstrates something highly relevant to South Korea: widespread use of nicotine does not necessarily require widespread cigarette smoking.

Still, this doesn’t completely address concerns about youth vaping. Other research conducted in New Zealand has pointed out issues regarding adolescent vaping patterns, emphasising the necessity for strong age limits and targeted protections for young individuals. The lesson is not unrestricted nicotine access. It is risk-proportionate regulation.

The prohibition problem

Applied to nicotine, Koumal highlighted an obvious contradiction: cigarettes remain legally available while products expected to pose considerably lower risks are sometimes prohibited or heavily restricted. That matters because prohibition does not necessarily eliminate demand.

Reversing the risk hierarchy

This is particularly relevant to South Korea’s treatment of newer nicotine products. South Korea already has substantial experience with alternatives to cigarettes, especially heated tobacco products. But regulation should increasingly distinguish products by their likely health risks and encourage complete substitution, rather than prolonged dual use.

This balanced approach aligns with Koumal’s “sweet spot”: not a completely hands-off market or outright prohibition but a regulated environment focused on measurable health outcomes. Additionally, South Korea should keep assessing whether these interventions are effective. If tighter restrictions lead to more illegal purchases or higher rates of smoking relapse or cigarette use, regulators ought to be ready to make adjustments instead of measuring success just by how many legal nicotine products are sold.

Smoking, not nicotine, should be the target

No problem, smokers who want and can handle complete nicotine abstinence should receive counselling, NRT and cessation medicines. But those unable or unwilling to quit nicotine should have accurate information and regulated pathways towards substantially lower-risk products.

South Korea has shown the positive outcomes that traditional tobacco control can bring. The next step forward might hinge on blending these policies with harm reduction strategies, striking a balance in regulation: being strict on cigarettes, cracking down on illegal sellers, safeguarding young people, while also being supportive of adults who are trying to quit smoking.

Foreign Influence, Sweeping Vape Bans and NRT Restrictions: Sounding the Alarm for Asia

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The guidance reflects a broader shift towards tobacco harm reduction, recognising that while nicotine products may not be entirely risk-free, the overwhelming burden of disease comes from inhaling the toxic chemicals created by burning tobacco rather than from nicotine itself. In the United States alone, cigarette smoking is responsible for more than 480,000 deaths each year, while globally tobacco use claims more than eight million lives annually, according to World Health Organization data.

Clinicians need practical guidance

Healthcare providers are rightly encouraged to discuss the full range of evidence-based options, including nicotine replacement therapies such as patches, gum, lozenges and inhalers, prescription medications including varenicline and bupropion, behavioural counselling and, where appropriate, nicotine-containing e-cigarettes. Importantly, the guidance stresses that these recommendations apply specifically to adults who currently smoke cigarettes and are not intended to encourage nicotine use among people who have never smoked or among young people.

Why do smokers find vaping effective?

Traditional cessation medications primarily address nicotine withdrawal, while vapes also replicate many of the behavioural aspects of smoking. For long-term smokers, the familiar hand-to-mouth movement, inhalation, visible aerosol and rapid nicotine delivery help satisfy both the physical dependence and the behavioural rituals associated with cigarette use. This combination may explain why many smokers who have been unable to quit using patches or gum successfully transition away from combustible cigarettes after switching to vaping.

Yet not all medical organisations share the same position. Some US health organisations continue recommending only FDA-approved cessation medications, citing concerns about the long-term effects of vaping and the presence of residual toxic compounds in aerosol.

Helping smokers make informed choices

Ultimately, the new recommendations do not position vaping as a universal solution or a replacement for established cessation therapies. Rather, they acknowledge that smokers differ, and that successful quitting often requires multiple approaches.

For clinicians, the message is straightforward: provide patients with accurate, balanced information about the benefits and risks of every evidence-based option.

The Cost of Bad Science: How Flawed Studies And Anti-Nicotine Bias Are Shaping European Tobacco Policy

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While smoking has declined dramatically across many developed countries, prevalence among people with schizophrenia, bipolar disorder and other serious mental illnesses remains disproportionately high.

UK public-health data have estimated smoking prevalence at around 40% among people with serious mental illness, while people with mental health conditions overall are almost 2.5 times as likely to smoke as the general population. Smoking is also considered a major contributor to the 10-to-20-year life-expectancy gap experienced by people with poor mental health.

Against that background, growing evidence suggests that tobacco harm reduction—including vaping and other smoke-free nicotine alternatives—deserves a much larger role in mental health care.

The close knit relationship between Schizophrenia and smoking

Why Vaping May Offer Something Different

Promising results with vaping

The study was small and lacked a control group, so the figures should not be interpreted as definitive cessation rates. Nevertheless, the results demonstrate something important: even smokers with schizophrenia who were initially uninterested in quitting were willing and able to substantially replace cigarettes with a non-combustible product.

Vaping for smoking cessation: the wider evidence

These findings are consistent with the much larger evidence base in the general smoking population. The latest Cochrane living systematic review analysed 104 studies involving more than 30,000 adults and concluded that nicotine e-cigarettes help more people stop smoking for at least six months than conventional nicotine replacement therapy.

A major systematic review published in the BMJ found that people who stopped smoking experienced reductions in anxiety, depression and stress alongside improvements in psychological quality of life compared with people who continued smoking. The pattern was similar in people with and without psychiatric conditions. That challenges the assumption that cigarettes provide a net psychological benefit to people experiencing mental illness.

Harm Reduction offers an alternative to abstinence

Tobacco harm reduction offers another route: if complete nicotine abstinence is not currently achievable, eliminate the combustion first. Cigarette smoke—not nicotine itself—causes most smoking-related disease. Vapes avoid burning tobacco and therefore eliminate exposure to tar and carbon monoxide while substantially reducing exposure to numerous other toxicants. The NHS consequently describes vaping as likely to be far less harmful than smoking and recommends it as one option for adults trying to quit. Other smoke-free options, including nicotine pouches and traditional NRT, could similarly expand choice for people who find inhaled products unsuitable.

Mental health services should offer choice, not therapeutic neglect

The emerging evidence suggests mental health services should stop treating smoking as an unavoidable feature of serious psychiatric illness. Rather than insisting on a single cessation pathway, services could offer behavioural support alongside vaping, NRT and approved cessation medicines, allowing patients to choose an approach compatible with their circumstances and preferences. NICE already recommends offering smokers a choice of interventions based on previous experience, health and social circumstances.

https://www.vapingpost.com/2026/03/03/nicotine-addiction-isnt-one-size-fits-all-genetics-brain-science-and-mental-health-differences-shape-dependance/

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Vaporizing marijuana releases far fewer harmful chemicals than smoking joints does, according to a new study.

“These results demonstrate that combustion—not cannabis itself—is the primary driver of harmful inhalation byproducts, and that controlled vaporization can significantly reduce exposure to these compounds,” the study conducted and self-published by the vape device company PAX found.

Lighting marijuana on fire through smoking releases a number of harmful or potentially harmful compounds (HPHCs)—including benzene, formaldehyde and acetaldehyde. Vaporization, in contrast, heats cannabis to below the point of combustion while still releasing cannabinoids and terpenes.

The research—conducted by Richard Rucker, who serves as PAX’s director of product integrity, and Derek Shiokari, a senior chemist and data scientist at the company—compared aerosol generated by PAX’s dry herb vaporization device (FLOW) and its oil vaporization device (TRIP) with smoke from combusted marijuana joints.

The team compared levels of 16 HPHCs between the methods of consumption, all using the same batch of ground Lemon Cake Batter cannabis from Humboldt Farms.

“Across all measured analytes, vaporization reduced harmful byproducts by up to 99% compared to joint smoke,” they concluded.

Via PAX.

“Combustion produces harmful byproducts—whether it’s tobacco, wood or cannabis,” Rucker said in a press release. “By heating cannabis without burning it, vaporization significantly reduces the formation of these toxic compounds. It’s the same plant, but completely different exposure. This research helps quantify the difference, giving consumers clearer information about how their choices impact exposure.”

When cannabis is lit on fire via smoking, its components like cannabinoids, terpenes, lipids, proteins and carbohydrates experience thermal degradation and oxidation. That leads to the formation of particulate matter and generates additional compounds such as volatile organic compounds, aromatic hydrocarbons and nitrogen-containing compounds, among others, the study said.

“Combustion of cannabis plant material produces a complex aerosol containing numerous harmful byproducts generated through pyrolysis and oxidation. Under matched puffing conditions, vaporization of cannabis flower reduced exposure to these harmful compounds by up to 99% compared with joint smoke. These findings demonstrate that combustion is the primary source of toxic chemical exposure during cannabis smoking, and that vaporization technologies can substantially reduce formation of these byproducts.”

“Across the sixteen quantified HPHCs, vapor aerosol contained up to 99% lower concentrations compared with joint smoke,” the paper concluded. “These results demonstrate dramatic reductions in key combustion markers including aromatic hydrocarbons and aldehydes.”

Photo courtesy of Mike Latimer.

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A significant shift is provided by a summary spearheaded by Angela Difeng Wu at the University of Oxford, which collated results from 14 systematic reviews between 2014 and 2023. By focusing on the highest-quality data, the researchers definitively sliced through years of competing interpretations. They revealed a clear trend: nicotine vaping products are more effective than any pre-existing method for cessation.

There is no shadow of a doubt: Vaping works

This is consistent with previous work from the Cochrane Collaboration, whose living systematic review has consistently found greater quit rates among smokers using nicotine e-cigarettes compared to other cessation aids. Likewise, clinical trials published in high-impact journals such as the New England Journal of Medicine show vaping can nearly double quit success rates compared to traditional NRTs under real-world conditions.

Where vaping goes up, smoking goes down

This long-term drop in smoking — down from more than 40 per cent of adults in the 1960s to about 10 per cent today — is largely due to various factors, including public health campaigns. But vaping seems to be accelerating this trend among certain groups, especially among those having a tough time quitting by traditional means.

Addressing the “Evidence Gap”

The evidence supporting the role of vaping in smoking cessation is now strong, but remains woefully incomplete. The Oxford University overview introduced an “evidence and gap map” to show where more research is needed.

Also, most previous studies were conducted in high-income countries. That leaves open the question of how applicable the findings are to low- and middle-income settings, where smoking practices, health care systems and access to alternatives may be lacking.

In fact, the main reason vaping should be considered is to reduce exposure to combustion-related toxins. This distinction is fundamental. Policies or messaging that confuse smoking and vaping jeopardise harm reduction efforts by discouraging smokers from switching to safer alternatives.

The latest science reveals a clear winner in quitting success rates

This emerging consensus around the efficacy of vaping marks a dramatic shift in the anti-tobacco landscape. There has been uncertainty shaping debates for years. Today, the balance of evidence is tipping in a similar direction. Nicotine vapes may not be a miracle solution, but for adult smokers wanting to quit, they are pretty close. They provide a potentially effective alternative, one backed by both clinical evidence and real-world results.

For the harm reduction community, one path ahead is obvious: promote access to safer alternatives, responsible use, and ensure that evidence-based public health strategies are grounded in evidence, not perception.

Understanding the Different Types of Scientific Studies on E-Cigarettes

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The scientific discourse about nicotine is changing quickly. Previously seen through a narrow prism of addiction, new research from a range of fields — from neuroscience to clinical medicine — is painting a much more multifaceted picture. For proponents of tobacco harm reduction (THR), this expanding body of evidence confirms a familiar maxim: it is not the nicotine per se, but rather its delivery mechanism that largely dictates harm.
Sadly, this distinction is seldom reflected in public messaging and policy frameworks. And in some instances, it is even hidden — a risk that could hinder efforts to shift smokers away from cigarettes that burn.

More flawed vape research

..if research does not clearly distinguish between product categories, it risks perpetuating the myth that all nicotine use is equally harmful.

A recent observational analysis published in The American Journal of Physiology Heart and Circulatory Physiology shows just how easily nuance can go missing. The study found a link between nicotine use and increased blood pressure levels. But many leading experts, including Nicola Lindson, Jamie Brown and Peter Hajek, were quick to point out a serious error.

The study design was flawed, and the participants had only been asked about nicotine use in the most recent five days, which meant that they hadn’t provided information about long-term smoking history. This is a major limitation, considering that dozens of vapers are former smokers, and inflation of these histories makes it more challenging to disentangle the effects of vaping itself.

For one thing, lumping together smokers and vapers into the same analytical categories threatens to distort results. The harmful effects of smoking are already well known as major cardiovascular risk factors. That means that the stronger bad effects resulting from smoking will inform these groups and outweigh the relatively weak signalling coming from vaping when they are combined. In fact, experts said the results for exclusive vapers were not statistically significant and much less pronounced than in smokers.

Public health agencies and peer-reviewed research have consistently highlighted the risk gradient between smoking and vaping. But if research does not clearly distinguish between product categories, it risks perpetuating the myth that all nicotine use is equally harmful.

Nicotine and cognitive health

In addition to risk reduction, new research is delving into nicotine’s potential effects when used under controlled conditions.
Carefully administered low doses of nicotine have been found to improve factors like working memory and mood in people with mild cognitive impairment. A more general review published in Frontiers in Ageing Neuroscience emphasises nicotine’s effects on the brain’s cholinergic system, an important system for attention and learning. This body of work suggests a dose-dependent relationship, with modest levels potentially enhancing cognitive performance. Yet, higher doses induce diminishing or negative effects.

Neuroscience discussions, including in outlets popularised by Andrew Huberman, have also explored the effects of nicotine on acetylcholine receptors and dopamine pathways, which are permissive of focus and motivation. And while researchers emphasize that nicotine should not be recreationally used for cognitive enhancement, they do highlight that the effects of nicotine are not uniform. Its impact is highly context-dependent, shaped by dose and delivery.

This expanding complexity poses a challenge for regulators.
In clinical environments, nicotine can be prescribed in specific, controllable doses. In the real world, though, that ability to regulate how much you consume is influenced by what products exist. Traditional cigarettes leave little room for control and deliver a host of harmful byproducts with nicotine.

In contrast, many reduced-risk products allow tighter control over dosage and usage behaviours. Limiting access to those alternatives may thus make it harder, not easier, for individuals seeking to align their use with safer parameters. The dissonance between our understanding of science and the constraints we face in the real world is becoming increasingly clear.

More insights from medical research

Interestingly, similar advances in other areas of biomedical research demonstrate that compounds once thought straightforward or well understood can unlock unexpected therapeutic potential. According to a recent study published in Liver Research, nicotinic acid—a variant of vitamin B3—was shown to mitigate liver damage from ischemia-reperfusion injury (IRI) markedly. This potentially life-threatening complication can occur during surgical or transplant procedures. Nicotinic acid helped protect the liver in both animal studies and human liver cells. It worked as well as, or even better than, well-known antioxidants like N-acetylcysteine.

What makes it interesting is how it works. Instead of just acting as an antioxidant, nicotinic acid directly supports the health of mitochondria—the parts of cells that produce energy. It helps remove damaged mitochondria and supports the body’s creation of new, healthy ones. As a result, researchers observed reduced inflammation, decreased cell death, and lower levels of ferroptosis, an iron-mediated form of cell injury. Liver cells also maintained better energy balance, which helped keep their normal functions.

Meanwhile, new research into the wider effects of nicotine emphasises that in both science and policy, precision matters — as does context and proportion. The story has changed around nicotine. From cardiovascular studies to neuroscience and cellular biology, discoveries are upending old assumptions and exposing a more complicated reality.

The policy disconnect that needs correcting

For policymakers, the challenge is not to discount risk but to properly recognise it—and to design systems that accurately account for relative harm. For the harm reduction community, the narrative is unchanged: access to safer alternatives in a supportive environment with straightforward messaging and evidence-based information about compliance products is a critical driver for mitigating disease burden from smoking.
Science is ever-evolving, and regulations need to keep pace.

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