Recent data from the U.S. Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) show that youth tobacco use has fallen to historically low levels. This progress, achieved through years of prevention efforts and regulation, is a significant public health victory. However, adult smoking remains the leading cause of preventable death in the U.S., and experts argue that a balanced approach is needed to help adult smokers transition to less harmful alternatives.
According to the CDC, cigarette smoking is the leading cause of preventable disease and death in the United States, accounting for more than 480,000 deaths annually. While quitting completely is the best option for health, many adults struggle to quit. For those who cannot or will not quit, access to scientifically substantiated smoke-free nicotine alternatives is crucial.
In a recent development, the FDA issued modified risk orders for 20 ZYN nicotine pouch products, allowing them to be marketed with a specific FDA-authorized claim: 'using ZYN instead of cigarettes puts adults at lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and chronic bronchitis.' This does not mean the products are safe, but it acknowledges the relative risk reduction for adults who switch completely from cigarettes.
Dr. Matthew Holman, vice president and chief science and regulatory strategy officer for PMI U.S., emphasized that these products are not for youth, non-users, or those trying to quit nicotine entirely. 'Nicotine products are addictive and not risk-free,' he said. 'But science-based policy should recognize meaningful differences in risk between cigarettes and smoke-free nicotine products for adults who switch completely.'
The latest youth tobacco data, from the 2025 National Youth Tobacco Survey, show that current use of tobacco products, combustible tobacco products, and e-cigarettes declined between 2022 and 2025. FDA also reported that youth use of nicotine pouches remained low and stable, with 1.7 percent of students reporting current use in 2025, compared to 1.8 percent in 2024. These numbers indicate that low youth use can coexist with a marketplace that includes FDA-authorized smoke-free alternatives for adults.
Holman stressed the importance of continued prevention measures. 'Keeping youth use low requires continued discipline from regulators, retailers, manufacturers, parents, educators, and public health leaders,' he said. PMI U.S., the company behind ZYN, has implemented responsible marketing practices, including advertising only with individuals aged 35 or older, age verification on websites, and restrictions on social media. The company also supports a 10-point approach to underage prevention, which includes retail support programs, monitoring, and collaboration with FDA.
The challenge now is to protect the progress made in reducing youth tobacco use while addressing the persistent problem of adult smoking. Holman believes that a mature tobacco policy should do both: prevent young people from starting and help adults who continue to smoke move to better alternatives. 'Those goals belong together,' he said.
Dr. Holman, who previously served as chief scientist at the FDA's Center for Tobacco Products, underscores the need for continued regulation and innovation. The FDA's recent action on ZYN is a step forward in providing adults with accurate information about relative risks, potentially reducing the harm caused by combustible cigarettes.
