October 2025: 70% of Policy Experts Misidentify Nicotine as Primary Cause of Smoking-related Diseases
Based to a multi-market survey of 450 policy experts conducted across 15 different markets in 2024/25, British American Tobacco (BAT) stated that 70% of policy experts continue to misidentify nicotine as primary cause of smoking-related diseases. The research also highlighted regional disparities in nicotine risk perception due to regulatory barriers and lack of medical guidance.
According to BAT, erroneous perceptions of nicotine health risks continue to persist despite of the growing scientific consensus that nicotine is not a primary cause of smoking-related disease and the increased availability of smokeless alternatives to conventional cigarettes. In addition to the survey, the in-depth interviews revealed that while half of medical professionals discussed smokeless alternatives to cigarettes weekly with their patients, only 21% feel well-informed enough to recommend them.
Conducted by a third-party market research firm, Kantar, on behalf of BAT, the research also showed indications of improved perception of smokeless products, in particular vaping products among nicotine users.
Key research findings: Tobacco Harm Reduction
– Nicotine misperception is the highest among Policy Experts, with 70% attributing smoking-related diseases primarily to nicotine
– 50% of Medical Professionals discuss smokeless alternatives to cigarettes weekly, yet only 21% feel well-informed enough to recommend them
– More than 75% of Medical Professionals trust scientific and public health messaging on Tobacco Harm Reduction (THR) but their awareness on the topic is low: only around 20% feel informed, familiar with the relevant scientific literature, or able to invest time in learning more
– 65% of Policy Experts support cigarette-equivalent or stricter regulation for smokeless products
– Across the cohorts, nicotine pouches have the most favourable THR perception, followed by vapes & heated tobacco.
Key research findings: Regional Disparities
– Markets surveyed: Australia, U.S., UK, Canada, France, Germany, Italy, Poland, Romania, Sweden, Brazil, Japan, South Korea, Pakistan, and New Zealand
– Japan & Pakistan: Indications of improvement in harm perception of nicotine pouches among Medical Professionals and Policy Experts
– Australia & New Zealand: Directionally negative trend in harm perception of vaping products among Medical professionals, potentially linked to tighter regulation
– Sweden: Around 80% of Policy Experts, Medical professionals and Active users of category have favourable harm perception of nicotine pouches
– France: 89% of Medical Professionals believe that vaping products are potentially less harmful than cigarettes
– UK: More than 60% of smokers perceive nicotine pouches as potentially less harmful than cigarettes
– US, France & UK: The highest level of nicotine health impact misunderstanding among Policy Experts (>85%) across measured markets.
February 2025: Understanding the Demand‐Side of an Illegal Market: A Case Study of the Prohibition of Menthol Cigarettes
Cornell University researchers examined the effects of prohibiting menthol cigarettes in the U.S. Given that nearly 19 million Americans smoke menthol cigarettes, the proposed ban aims to reduce smoking rates, prevent youth initiation, and address racial health disparities. However, the study explores potential unintended consequences, such as the rise of an illegal market.
The researchers conducted an online discrete choice experiment (DCE) where adult menthol smokers were asked to choose between legal and illegal menthol cigarettes, non-menthol cigarettes, e-cigarettes, or quitting altogether. The study varied product legality and price to assess consumer behavior under different regulatory scenarios. Key findings:
– Consumers dislike illegal markets, but many are still willing to purchase illegal menthol cigarettes, especially if menthol e-cigarettes are also banned.
– llegal retail and state markets reduce demand for menthol cigarettes by 15.4% and 21.6%, respectively, due to consumer hesitation to make an illegal purchase.
– A 50% increase in the price of illegal menthol cigarettes reduces demand for illegal menthols by 18-22%, depending on the market scenario (illegal retail or state market, e-cigarettes allowed or banned).
– If illegal prices remain the same as legal prices, the illegal market could retain 59-92% of the current legal market size.
– If menthol e-cigarettes are also banned, the illegal menthol cigarette market could be as large as 69-100% of the current legal market size.
– Given that 85% of Black smokers prefer menthol, enforcement of a menthol ban may disproportionately target Black communities. Moreover, the study finds that black smokers are more likely to seek illegal menthol cigarettes compared to non-Black smokers. Under an illegal street market, demand from Black smokers for illegal menthols is predicted to be 88% of the current market, compared to 80% for non-Black smokers.
The study highlights the trade-offs policymakers face in banning menthol cigarettes. If the illegal market develops as predicted, the effectiveness of the prohibition in reducing smoking-related harms may be weaker than anticipated. The findings suggest that policymakers should carefully consider enforcement strategies, racial justice implications, and alternative harm-reduction approaches such as promoting menthol e-cigarettes instead of banning them.
Download the Research Paper
November 2024: Online Retailer Nonadherence to Age Verification, Shipping, and Flavor Restrictions on E-Cigarettes
A recently published study1 explored whether online vaping retailers adhered to age verification, shipping method and flavor restrictions. The research team attempted to purchase flavored vaping products online and have them delivered to residential households in San Diego, California, which has a flavor restriction policy that encompasses e-commerce. Of 156 attempted transactions 73% were processed and 67% were delivered.
The 2022 California Senate Bill SB-793 prohibited the sale of flavored tobacco products but left e-commerce restrictions ambiguous. Due to the ambiguity in California law, the researchers aimed to test differences in compliance with local tobacco e-commerce ordinances. Eight buyers were from the City of San Diego, where an ordinance restricts the sale of flavored tobacco products, including online sales. The other eight were from other County of San Diego communities, which do not have the same restrictions. Delivery did not differ significantly between buyers in these two jurisdictions. As a side note, California lawmakers recently approved SB-1230, Strengthen Tobacco Oversight Programs (STOP) and Seize Illegal Tobacco Products Act, to strengthen state tobacco oversight programs, including a ban on online sales of flavored tobacco products. The law will go into effect on January 1, 2025.
To curtail youth access to vaping products, the 2020 Preventing Online Sales of E-Cigarettes to Children Act implemented a ban on the use of the United States Postal Service (USPS) to ship vaping products and mandated identification (ID)-scan authentication of age on delivery. Researchers identified that 81% of deliveries were made via the USPS and 9% of the deliveries arrived via couriers (UPS, FedEx, DHL) with policies restricting shipping tobacco. Moreover, only 1% of buyers had their IDs scanned. 78% of buyers reported no interaction with delivery personnel, 15% of buyers spoke with delivery personnel but did not have their IDs checked and 6% of buyers had their IDs checked but not scanned.
Online sales of new nicotine products, both vapes and nicotine pouches, is a fast growing segment in the US. In September 2024, in order to clamp down on the online sale of flavored ZYN pouches, San Francisco filed a lawsuit targeting the online retailers violating the prohibition on flavored tobacco products. The lawsuit, filed in the San Francisco County Superior Court, alleges that Northerner Scandinavia (part of Haypp Group), Lucy Goods, Rogue Holdings and Swisher International sell flavored ZYN products online to San Franciscans despite the ban. Read more: ZYN Lawsuits.
Online shopping for tobacco products following the flavored tobacco ban in California
UC San Diego researchers examined whether the exclusion of e-commerce in the definition of “tobacco retailer” might have resulted in a shift in consumer behavior towards e-commerce following California’s implementation of a statewide flavor restriction2. They identified that shopping queries were 194% and 162% higher than expected for cigarettes and vapes, respectively, on the week of implementation. Queries remained significantly elevated for 6 and 11 weeks for vapes and cigarettes, receptively. All search results contained links to websites that offered flavored vaping products and/or menthol cigarettes to Californian consumers.
Researchers note that
– California’s flavor restriction is enforced through its tobacco retailer licensing programs which can be an effective method of enforcing tobacco control laws (but, most programs do not require e-commerce retailers to obtain licenses)
– their findings raise concerns about potential loopholes in policy enforcement created by the absence of explicit regulations on e-commerce sales in retailer licensing programs
– strengthening regulations to include e-commerce and monitoring e-commerce compliance may enhance the impact of laws enforced through retailer licensing programs.
New “Non-menthol” cigarettes
Following California’s December 2022 menthol ban, RJ Reynolds (BAT) and ITG (Imperial Brands) introduced non-menthol cigarettes offering “a new fresh twist” and “a taste that satisfies the senses”. The records of ingredients show that the Camel Crisp and the Newport EXP contain a synthetic cooling agent called WS-3. In a recent study3, Duke University researchers found that the added amounts of synthetic cooling agent robustly activate the cold/menthol receptor and are sufficient to produce robust cooling sensations (- in some cases, even more than the menthol cigarettes).
WS-3, or N-ethyl-p-menthane-3-carboxamide, is one of the most used cooling agents in the food and beverage industry. Unlike menthol, WS-3 is virtually nonvolatile, odorless and tasteless – thereby, providing a cooling sensation without affecting the taste or aroma of the final product. It’s known for its clean, immediate cooling impact and has been found to cool primarily the roof of the mouth, the back of the mouth and the back of the tongue.
WS-3 is commonly used in gums/candies/mints, carbonated & alcoholic beverages, toothpastes and mouthwashes. WS-3 is considered safe for consumption by the US Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA). However, its safety for inhalation is unknown.
In an earlier study4, Yale University researchers found that the European version of JUUL Mint pods contained WS-3 (- presumably, to keep the cooling effect and lose the distinct minty odor of menthol). The substance was absent in the US/Canadian JUUL Mint pods.
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