The Risk Continuum

The continuum of risk is a cornerstone of a nicotine-based framework for public health proposed by the FDA in 2016. The idea is that products that deliver nicotine fall on a spectrum of risk based on toxicity and addictiveness. Combusted tobacco products such as cigarettes pose the highest risk, both in toxicity and addictiveness. An exception is the very low nicotine content cigarette, which is has high toxicity, but low addictiveness, and if mandated by regulation would be expected to promote smoking cessation or switching to less harmful nicotine products. Non-combusted nicotine products are less toxic, and if smokers cannot or do not want to quit smoking, switching to these products would benefit their health. This presentation will review the risks as well as potential benefits of nicotine delivered from sources other than combusted tobacco. It will also consider how risks of nicotine compare to other widely used drugs, such as alcohol and cannabis.