JAMA Study: Alternative Tobacco Products Should Be Considered for Smoking Cessation
An evidence-based approach is increasingly needed to assist adult smokers wishing to quit. New evidence was presented in a study published in the Journal of the American Medical Association (JAMA) on 30 July 2026, titled ‘Nicotine E-Cigarettes for Cigarette Smoking Cessation: Recommendations to US-Based Clinicians’.
The study, led by Eleanor L. S. Leavens from the University of Kansas Cancer Center, recommends that clinicians and healthcare professionals include alternative tobacco products in discussions as an option to help adult smokers transition away from smoking. This approach emphasises the importance of providing adult smokers with various evidence-based options while considering the benefits and risks of each.
“There is no single approach that can help all smokers quit. However, by providing adult smokers with various options and involving them in discussions regarding risks and benefits, they have a greater chance of truly quitting smoking and potentially improving overall health,” stated Eleanor, as quoted on Monday (14/9).
Researchers emphasised that alternative tobacco products are not inherently safe or risk-free. Therefore, a shared decision-making approach is vital so that clinicians and adult smokers can consider their goals, preferences, health conditions, and the benefits and risks of the available options. The focus is on helping more smokers transition from combustible cigarettes, which produce thousands of harmful substances.
These recommendations also address the need for clearer guidance for clinicians when discussing alternative tobacco products as an option for adult smokers.
“Adding clear guidance on alternative tobacco products provides clinicians with practical tools that can help people transition from combustible tobacco towards better health,” said Eleanor.
In the context of alternative tobacco products, the category includes electronic cigarettes (vapes), heated tobacco products, and nicotine pouches. Eleanor emphasised that each has different usage characteristics and risk profiles. Therefore, specific understanding is required, particularly for adult smokers, as an effort to transition away from smoking.
This risk-based approach is relevant not only in general clinical practice but also from a dental and oral health perspective.
Dr Indra Mustika, an academic from the Faculty of Dentistry, Padjadjaran University, assessed that the differences between cigarettes and alternative tobacco products must be understood when healthcare professionals provide information to adult smokers.
“Healthcare professionals in Indonesia need to be capable of conducting evidence-based communication that is not biased towards any product, but also does not equate all tobacco products as having identical risks,” explained Indra on Monday (14/9).
According to him, communication with adult smokers should use a risk-level-based approach, rather than simply categorising products as “safe” or “unsafe”.
“If adult smokers who have tried to quit have not been successful, clinicians need to explain that transitioning entirely from cigarettes to alternative tobacco products is a lower-risk step compared to continuing to smoke,” he explained.
Indra also referred to clinical research he has conducted on smokers and groups of smokers who transitioned to alternative tobacco products. The research showed improvements in several biological indicators in the oral cavity, including an increase in Total Antioxidant Oxidative Capacity (TAOC) and a decrease in TNF-α and micronucleus (MNC) cells in the group that transitioned to alternative tobacco products.