Researchers from the Society for Research on Nicotine and Tobacco Treatment Network published new recommendations in the JAMA encouraging healthcare providers to discuss nicotine e-cigarettes as a potential harm reduction option for adults who smoke and have been unable or unwilling to quit using FDA-approved cessation methods. The guidance, published July 30, emphasizes patient-centered, shared decision-making and is intended only for adults who smoke, not for youth or non-tobacco users. The authors stress that completely quitting combustible cigarettes remains the preferred outcome and that adults who switch to e-cigarettes should fully replace cigarette smoking rather than continue dual use.
Among the authors is Patricia Cioe, professor and associate dean for research and scholarship at the University of Rhode Island College of Nursing, who was the only nurse scientist on the expert panel. Cioe said her perspective on tobacco harm reduction evolved through years of clinical practice and research, including interviews with adults who described repeated unsuccessful quit attempts despite strong motivation to stop smoking. She said those experiences underscored the need for clinicians to “meet patients where they are” by discussing all evidence-based options that may reduce the harms of continued cigarette smoking.
The recommendations reflect growing discussion within the medical community around tobacco harm reduction while reaffirming that smoking cessation remains the optimal health goal. The authors say clinicians should individualize treatment conversations based on each patient’s circumstances, particularly for smokers who have not succeeded with conventional cessation therapies.