Too Many U.S. Physicians Remain in the Dark About Nicotine and FDA-Authorized Smoke-Free Alternatives
New White Paper Reveals the Dangers This Poses to Adult Smokers Seeking Better Options
STAMFORD, Conn., Aug. 18, 2025 /PRNewswire/ -- America's next urgent challenge in ending smoking is ensuring that physicians and other medical providers understand the science behind tobacco harm reduction. This will require education and guidance from a source these professionals trust: the U.S. Food and Drug Administration (FDA).
In a new white paper that draws on findings from a survey of healthcare practitioners across the U.S., Philip Morris International's U.S. businesses (PMI U.S.) detail the confusion and persistent misperceptions that prevent many providers from offering fully informed counsel to their patients who smoke.
"The FDA understands the vital role smoke-free alternatives can play in helping adults who smoke leave cigarettes behind, which has the potential to improve both individual and public health," said Dr. Matthew Holman, Chief Scientific & Regulatory Strategy Officer, PMI U.S. "The next step is for the agency to share this information with the healthcare professionals on the front line. These are the people smokers are most likely to turn to for help in ending their cigarette use."
The white paper, "Getting Smart on Reduced Harm," is informed by survey results showing that far too many medical professionals are unfamiliar with the science supporting smoke-free products and tobacco harm reduction. This is especially apparent regarding nicotine. As the FDA has acknowledged, nicotine doesn't cause the most serious health effects associated with smoking, including fatal lung diseases and cancer.1 The real culprit is the thousands of chemicals contained in tobacco smoke. That's why eliminating combustion (the burning of tobacco) is a critical component in harm reduction. Concerningly, around half of healthcare practitioners—rising to nearly 60 percent of those who treat a significant number of cigarette smokers—mistakenly believe that nicotine is a carcinogen.
This information gap is having real-world consequences for adults who smoke and who might be willing to switch to a better alternative if given the facts. While quitting tobacco and nicotine entirely is the best choice a smoker can make, scientific evidence shows that those adults who choose to continue to use nicotine can significantly reduce the harm they're exposed to by switching from traditional cigarettes to an FDA-authorized smoke-free alternative.
"These are critical pieces of information in the fight to end the harm of cigarettes," the white paper concludes. "It is urgent that the FDA get the word out so that medical professionals, in their role as trusted advisers, can offer fact-based guidance to their adult patients who smoke and help them move away from combustible cigarettes."
The white paper also examines the issue of healthcare providers' lack of awareness of which nicotine products have been reviewed by regulators for safety and efficacy. Many providers don't even know that combustible cigarettes are by far the most harmful way to consume nicotine and that FDA-authorized smoke-free alternatives would be a much better choice for their patients aged 21 and older compared with continuing to smoke.
The issue isn't a lack of interest or concern. More than nine in 10 medical professionals surveyed (93 percent) believe that if the FDA finds that a specific smoke-free product presents less risk of cancer, cardiovascular disease, or chronic obstructive pulmonary disease (COPD) compared with continued smoking, it has an obligation to convey that information to them. And 95 percent said they would pass this information along to their patients who smoke.
Legal-age nicotine users need to be able to consult reliable sources, including their doctors and the FDA, to learn about better alternatives to cigarettes if they don't intend to quit nicotine altogether and why these products are a better choice. Moreover, it would be in the interest of public health for the FDA to improve the process by which it reviews, authorizes, and makes available better alternatives to nicotine users aged 21-plus, the white paper says, while continuing to protect those under the legal age from accessing any nicotine product.
Under the current circumstances, the United States is falling far behind many other countries in introducing scientifically validated smoke-free products and encouraging their use by adults who smoke. As Dr. Tom Price, former Health and Human Services (HHS) Secretary and current adviser to PMI U.S., has said, "Science ought to be dictating our policy. And sadly, from a health standpoint, science hasn't dictated policy in the area of tobacco consumption, especially with [authorized] smoke-free products."
The white paper is available here.
Invested in America
Philip Morris International Inc.'s U.S. businesses (collectively, "PMI U.S.") are on a mission to improve public health in America by providing the ~30 million legal-age consumers who still smoke traditional cigarettes with better, smoke-free alternatives. PMI U.S. is committed to responsible marketing practices that help prevent access to its products by people under the age of 21. PMI U.S. businesses employ more than 2,900 people across America and operate product manufacturing facilities, including in Owensboro, Kentucky, and Wilson, North Carolina. Since 2022, PMI U.S. has contributed approximately $25 million to charitable causes, amplifying the good work of organizations already active within communities through financial contributions and volunteering. For more information, please visit www.uspmi.com and www.pmiscience.com.
References to "PMI" mean the Philip Morris International family of companies. "PMI U.S.," "we," "our," and "us" refer to one or more PMI U.S. businesses.
SOURCE PMI US Corporate Services, Inc.
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