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But the percentage of Americans who smoke has started to level off the past few years (it actually grew by 0.1 percent from 2021 to 2022) and precisely how much e-cigarettes are contributing to the overall decline, versus changes in the population or other smoking cessation tactics, can be difficult to discern

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"If someone is already using nicotine pouches and has been able to quit tobacco, I would suggest weaning off them with the goal of nicotine freedom entirely." Approved nicotine replacement therapies include nicotine patches, gum, lozenges, nasal spray and nicotine inhaler

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This placed public health interventions, especially those seeking to intervene in the lives of children, and by extension the private realm of the nuclear family, on shaky ground