New Report Assesses the Risks and Benefits of Non-Cigarette Nicotine Products | Center on Addiction

New Report Assesses the Risks and Benefits of Non-Cigarette Nicotine Products

New Report Assesses the Risks and Benefits of Non-Cigarette Nicotine Products


This week, The National Center on Addiction and Substance Abuse published a new report, Beyond Cigarettes: The Risks of Non-Cigarette Nicotine Products and Implications for Tobacco Control, which provides the most current information available about the use of a range of non-cigarette nicotine products, including e-cigarettes, hookah, pipes, cigars, little cigars, and smokeless tobacco. 

Much of the attention during the past few years has been on the growing popularity of e-cigarettes and other electronic nicotine delivery systems, as documented in a recent comprehensive report by the U.S. Surgeon General. But along with e-cigarettes, a broad range of other nicotine products is increasingly taking the place of cigarettes. Although we can confidently assert that most of these products are less harmful than cigarettes, inconsistent evidence about these products and their effects have created confusion about just how concerned people should be about their growing popularity and use, especially among young people.

Research shows that regardless of the device through which it is delivered, nicotine is not harmless. It can have serious health effects, is highly addictive, and is associated with the use of other addictive and harmful substances.

The new report provides the most current information available about the types of non-cigarette nicotine products that are on the market, who uses them, how they are used, and their relative risks and benefits. It offers concrete recommendations for policymakers, health professionals, and researchers to reduce their use and improve the public health. The report also highlights the gaps in current regulations that allow many of these products to be manufactured and marketed in ways that especially appeal to adolescents and young adults – the age groups most vulnerable to nicotine addiction.

For this report, Center on Addiction conducted analyses of recent, nationally representative data on nicotine product use among middle and high school students (2014) and among adults, aged 18 and older, (2013-2014) in the U.S. Some key findings from the analysis 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. 
   Linda Richter, PhD

   Dr. Richter is Director of Policy Research and Analysis at Center on Addiction





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