New Report Highlights The Risks of Non-Cigarette Nicotine Products | Center on Addiction

New Report Highlights The Risks of Non-Cigarette Nicotine Products

New Report Highlights The Risks of Non-Cigarette Nicotine Products 

New  York, N.Y., March 8, 2017

A new report published today by The National Center on Addiction and Substance Abuse, Beyond Cigarettes: The Risks of Non-Cigarette Nicotine Products and Implications for Tobacco Control, provides the most current information available about e-cigarettes and other vaping devices, hookah, smokeless tobacco, pipes, and cigars. It examines who uses these products, how they are used, what their effects are, and how the government regulates them.  

“The goal of this report is to help the public, policymakers, and health professionals make sense of the often-confusing and contradictory information that is available on the risks and benefits of these very different products and recommend reasonable strategies for limiting their recreational use,” said Samuel A. Ball, PhD, President and CEO at The National Center on Addiction and Substance Abuse. “This comprehensive review is the first to examine the use of all non-cigarette nicotine products among youth and adults.”

The report highlights the barriers to stemming the tide of non-cigarette nicotine product use, especially the growing influence of big tobacco companies and their role in limiting government regulation of these products. The tremendous popularity of e-cigarettes and some other non-cigarette nicotine products raises an alarm that the remarkable progress made over the past decades in reducing tobacco use could be stalled or even reversed.

“Almost on a daily basis, new evidence emerges questioning the safety of non-cigarette nicotine products,” said Linda Richter, PhD, Director of Policy Research and Analysis at the Center, and lead author of the report. “Regardless of the device through which they are delivered, nicotine and the other ingredients in these products are not harmless. Public education, quality research, and well-informed regulations are critical for ensuring that we do not undo years of progress in reducing smoking rates by allowing this to become our nation’s next avoidable public health problem.”

The report features an extensive set of research-based recommendations directed towards policymakers, health care providers, and researchers aiming to ensure that their response to non-cigarette nicotine products is effective, scientifically sound, and appropriately cautious in terms of balancing the need to reduce tobacco use with the need to prevent a new generation of young people from getting hooked on nicotine. 

Notable Findings: Prevalence and Patterns of Use

The landscape of nicotine product use is changing. Fewer people in the U.S. are smoking cigarettes while more people, particularly youth, are using non-cigarette nicotine products. The Center conducted analyses of recent, publicly available, nationally representative data from the U.S. Centers for Disease Control and Prevention on nicotine product use among middle and high school students from 2014 and among adults, aged 18 and older, from 2013-2014. Highlights include:   

  • Prevalence. An estimated 16 percent of adults and 15 percent of middle and high school students reported current use of at least one non-cigarette nicotine product.
  • Most Commonly Used Nicotine Products. The most commonly used nicotine products among adults, after cigarettes (18 percent), were cigars (7 percent) and e-cigarettes (7 percent). Among middle and high school students, they were e-cigarettes (9 percent) followed by water pipe/hookah (6 percent) and cigarettes (6 percent). 
  • Multiple Product Use. More than one-third (38 percent) of adults and half (50 percent) of middle and high school students who reported current use of cigarette or non-cigarette nicotine products indicated that they used more than one product. Among current users of nicotine products, 8 percent of adults and 20 percent of students said they used more than one non-cigarette product. The use of multiple nicotine products elevates the risks of nicotine addiction, alcohol and other drug use, and other harmful consequences.
  • Nicotine Addiction. An estimated 5 percent of adults who reported using only non-cigarette nicotine products (and not cigarettes) in the past 30 days met criteria for nicotine addiction. More than half of adults and half of middle and high school students who used only non-cigarette nicotine products reported at least one symptom of nicotine addiction.  

Beyond Cigarettes: The Risks of Non-Cigarette Nicotine Products and Implications for Tobacco Control is available for download and can be found on our website at:

About The National Center on Addiction and Substance Abuse

We are a national nonprofit research and policy organization focused on improving the understanding, prevention and treatment of substance use and addiction. Founded in 1992 by former U.S. Secretary of Health, Education, and Welfare, Joseph A. Califano, Jr., our interdisciplinary experts collaborate with others to promote effective policies and practices. We conduct and synthesize research, inform and guide the public, evaluate and improve health care, and analyze and recommend policies on substance use and addiction. For more information, visit


Andrea Roley
Director of Digital Communications
The National Center on Addiction and Substance Abuse
Phone: (212) 841-5225

Michelle Conley
Communications and Digital Manager
The National Center on Addiction and Substance Abuse
Phone: (212) 841-5206



Director of Digital Communications

(212) 841.5225


Media Specialist

(212) 841.5206 ​


Communications and Digital Associate

(212) 841.5206

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