Is the Future Smoke-free?

Smoking has grown into a global epidemic, with the WHO counting over 1.3 billion tobacco users worldwide. It’s a public health threat that kills more than 8 million people a year, and the global number of smokers is forecast to continuously increase between 2023 and 2028 by 12.6 million individuals. The range of tobacco products is growing as well, including forms such as waterpipe tobacco, cigars, and many others beyond regular cigarette smoking.

At first glance, these numbers paint a dismal future for public health. Fortunately, the spread of key measures to reduce the demand for tobacco is also consistent. 100% smoke-free environments are being enforced by local state policymakers while tobacco taxes and comprehensive bans on tobacco advertising continue to grow. There are also novel and emerging nicotine and tobacco products being released in the market.

All of these efforts work together in hopes of ensuring a smoke-free future. Let’s take a closer look at this progress below.

Why cessation doesn’t always work



Approximately 30% to 50% of US smokers make a quit attempt in any given year, according to 2022 data from the CDC. However, John P. Pierce, Ph.D. from the UC San Diego School of Medicine stresses that the perceptions of younger smokers make it difficult for professionals to motivate themselves to quit.

Younger smokers tend to see the health consequences of smoking as a far-off, distal concept. Without a proximal goal, it is tempting for these smokers to abandon a quit attempt. This contributes to the fact that, despite a high percentage of attempts, only 7.5% of smokers manage to succeed in cessation.

Latest methods for cessation



Recent decades have been pivotal in introducing new methods of smoking cessation. Since the release of the first nicotine replacement therapy (NRT) product in the 1970s, numerous forms of NRT have been available in the market after research found that they increase the rate of quitting by 50 to 70%.

The pioneer nicotine gum by Nicorette continues to be a popular aid recommended by health professionals. Smokers who prefer a cleaner cessation experience tend to be partial to smoke-free and tobacco-free ZYN pouches, which are commended for their high-tech distillation procedures. This procedure carefully extracts and purifies nicotine from the tobacco plant, ensuring higher quality with fewer side effects. With some states like Los Angeles completely banning flavored tobacco products, manufacturers have also come up with new alternatives such as King Palm’s line of flavored tipped rolls. This offers a vape-like experience for people who prefer flavored smoke, without harmful additives and tobacco.

If the discipline to wean yourself off nicotine is too much of a challenge, medication options are also available. Chantix and bupropion are available with a doctor’s prescription, and scientists continue to look for more effective formulas. The Raleigh testing site of Wake Research is fine-tuning Cytisinicline, a medication that is currently licensed in eastern Europe but not in the U.S. This targets nicotine receptors in the brain and blocks the “buzz” so that cravings are satiated without the need to consume any nicotine at all.

Different therapeutic approaches are constantly being explored as well. The possibilities of using VR within therapy, for one, have been examined since the mid-nineties — as we’ve explained previously in The Power of VR. In 2021, researchers are looking into the effect of virtual reality (VR) cue exposure therapy on long-term smoking behavior. Behavioral therapies such as a VR approach-avoidance task or gamified interventions are less common but have reported positive results so far.

The future of public health

It is key that public health campaigns heavily promote the availability of these various methods and incorporate a target age of 25 for quitting in their efforts to motivate cessation. Compared with the rest of the US, the California Tobacco Control Program’s social norm campaign saw higher rates of successful quitting in this youngest group of smokers.

This data suggests that targeting 50% of smokers to quit before age 35 may be challenging yet achievable. While progress is slow, with these targeted campaigns and developments in cessation tech a smoke-free future could soon be within reach.

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