1) What happens when a less-harmful alternative nicotine product (ANP) displaces tobacco smoking in a population?

We can learn a lot from the case of snus in Norway, as I just presented at #SRNT2024 as a personal side project with @LundKarl

osf.io/preprints/osf/…
2) There are concerns about ANP uptake by smoking-naïve individuals (both for snus back then, and for e-cigs now).

Uptake by smoking-naive folks CAN be a bad thing if it's adding to smoking, but in many countries, smoking is declining faster than ever.

What gives?🤔

1/15 “Gateway” fears about e-cigarette use leading to cigarette smoking are a major justification for restrictive policies on e-cigarettes. But what does the actual evidence say about “gateway”? 2/15 First off, there is undoubtedly an *association* between e-cigarette use and cigarette smoking among youth. But does this mean e-cigarette use CAUSED these youth to smoke?

1/15: My new paper in Harm Reduction Journal simulates what the US situation might look like if we promote e-cigarettes as a harm reduction policy: rdcu.be/cg94K . Hint: #VapingSavesLives 2/15: In system dynamics modeling, it’s important to focus on a specific, measurable problem to solve. Here, it’s the combustible tobacco-related death burden (~480,000 lives/year).

1/14 How do e-cigarettes (ECs) affect cigarette smoking among youth? My new paper with @FloeFoxon simulates each scenario and finds out which one best matches actual trends... onlinelibrary.wiley.com/doi/abs/10.111… @jgitchell @mikepesko @SwitchFinder @jkelovuori @TobPolicy @Clive_Bates 2/14 First, let's talk about why this question is so difficult to answer: COUNTERFACTUALS. We can't know the alternate-reality answers, like which smokers would have never started in a world without ECs, and which nonsmokers would now be smoking without ECs as an option.