A new survey, funded by Philip Morris International’s U.S. affiliates (PMI U.S.), has found that 47% of U.S. healthcare practitioners—rising to 59% among medical professionals who indicate that half or more of their patients smoke cigarettes—mistakenly believe nicotine is a carcinogen, despite scientific consensus that the harms of smoking primarily stem not from nicotine but from the burning of tobacco. Another 19% are unsure. Practitioners surveyed generally agree that smoke-free products—such as nicotine pouches and other noncombustible alternatives— are addictive and not risk free but still pose less risk than cigarettes. However, the survey results also show that misconceptions about nicotine persist and are obstructing progress on tobacco harm reduction.
Povaddo LLC fielded the survey among 1,565 medical professionals, including physicians, nurses, and mental health practitioners, across the United States between March 10 and April 5, 2025. The survey results highlighted that:
- More than two-thirds of medical professionals want the U.S. Food and Drug Administration (FDA) to share clinical evidence that demonstrates the role of smoke-free products in harm reduction (69%) and clear guidance on counseling patients about transitioning to smoke-free alternatives as part of harm reduction strategies (68%).
- 95% would share FDA-provided information on smoke-free products with their patients.
- 77% of medical professionals believe addressing smoking and tobacco use should remain a “high priority” for the U.S. government.
Despite decades of research as part of tobacco control efforts, misconceptions about nicotine are pervasive among healthcare professionals and others. The survey findings demonstrate an urgent need for healthcare regulators to provide unbiased, scientifically substantiated information about nicotine and nicotine products to the healthcare community. Many clinicians report uncertainty about which products are FDA-authorized and point to a lack of up-to-date information as barriers to more frequent and informed patient guidance regarding authorized smoke-free products. This is critical at a time when an estimated 480,000 Americans die each year from smoking-related illnesses.
“Healthcare professionals are at the heart of patient care and need reliable, science-based information to help their patients make informed choices,” said Stacey Kennedy, CEO of PMI U.S. “These findings reinforce the urgent need for transparent, evidence-driven communication from the FDA and other health authorities about the full spectrum of tobacco and nicotine products. We encourage the agency to provide timely, scientifically validated guidance to healthcare practitioners on FDA-authorized smoke-free alternatives. Ensuring clinicians have access to accurate information is essential to help adults 21+ who smoke make better choices and improve public health.”
This need for clear, science-based information is especially urgent given the survey’s findings about persistent misconceptions within the medical community that may result in incomplete or inaccurate information being shared with patients.
“One of the most striking findings from this research is the prevalence of misinformation about nicotine—even among otherwise well-informed healthcare professionals,” said Matt Holman, vice president of U.S. scientific engagement and regulatory strategy at PMI U.S. and former director of the Office of Science at the FDA. “Addressing these misconceptions with robust, evidence-based communication from authorities like the FDA is crucial to helping providers guide their patients and support harm reduction.”
PMI has invested more than $14 billion globally in innovative smoke-free products and remains committed to giving adults 21+ access to FDA-authorized better alternatives.
Read the full findings of the Tobacco Harm Reduction: U.S. Medical Professionals Survey (2025) at https://www.pmi.com/us/medical-professionals-see-greater-role-for-FDA. Access PMI’s science at www.pmiscience.com and fact sheet on nicotine here.
