Current Abstracts — September 2026
Monthly tobacco research digest  ·  Ontario Tobacco Research Unit
384
Articles
32
Reviews
24
Canadian
263
Open Access
18
In the News
🔥 Hot Topic — covered by 2+ news outlets🔓 Open Access — free full text🍁 Canadian — Canadian author or institutionSR — systematic review / meta-analysis
Generated 2026-10-06
🔥 Hot Topic
Bueno Lopez C, Iona A, Turnbull I, et al. JAMA Neurol. 2026. PubMed
# Spotlight Summary

A large Chinese cohort study of over 500,000 adults found that exhaled carbon monoxide levels—a marker of smoking exposure—were associated with lower Parkinson disease risk, potentially explaining the long-observed but unexplained inverse relationship between smoking and this neurodegenerative disease. While this finding may advance scientific understanding of Parkinson disease mechanisms, it does not support smoking as a preventive strategy, given smoking's well-established severe health harms that far outweigh any potential neurological benefits. Public health practitioners should be cautious about communicating this research to avoid misinterpretation that smoking could be protective, instead emphasizing that understanding disease biology through such studies may eventually lead to safer therapeutic interventions. Further research is needed to clarify the biological pathways involved and determine whether the observed association reflects causation or residual confounding.

In the News 18

Research articles from this digest that have been covered by news media.

Bueno Lopez C, Iona A, Turnbull I, et al. JAMA Neurol. 2026. PubMed
🔥 Hot Topic 🔓 Open Access
Summary
A large Chinese cohort study of over 512,000 adults found that higher exhaled carbon monoxide (CO) levels were associated with lower risk of Parkinson disease, particularly among never-smokers, suggesting a potentially protective role of CO in Parkinson disease development. While regular smoking was associated with increased risks of lung cancer, heart disease, and stroke, it showed a lower risk of Parkinson disease, an association that may be explained by CO exposure rather than other smoking mechanisms. These findings support investigating carbon monoxide as a potential therapeutic agent for Parkinson disease treatment.
Ganapathy V, Chengizkhan G, Manyanga J, et al. Ecotoxicol Environ Saf. 2026. PubMed
🔥 Hot Topic 🔓 Open Access
Summary
Prolonged exposure to e-cigarette aerosol at nicotine levels comparable to user plasma levels triggered protective antioxidant responses in human oral and lung cells, but simultaneously activated inflammatory signaling pathways and increased the expression of stem cell markers. These cellular changes—which include enhanced capacity to form spheroids and increased stemness—may represent early steps in the development of oral and lung cancer, suggesting that chronic e-cigarette use carries risks beyond acute toxicity.
Rivera TC, Schweitzer KS, Cornell C, et al. JCI Insight. 2026. PubMed
🔥 Hot Topic 🔓 Open Access
Summary
E-cigarette vaping causes injury to distal lung cells and triggers persistent stress responses that can last for days after exposure, even from brief use. The research found that vaping suppresses the immune system's ability to fight viral infections like COVID-19 and influenza, potentially increasing vulnerability to severe respiratory illness. These findings suggest that e-cigarette use may increase susceptibility to viral infections and contribute to long-term lung disease through multiple biological mechanisms.
Ali FRM, Mahoney M, Seaman Jones EL, et al. JAMA Netw Open. 2026. PubMed
🔥 Hot Topic 🔓 Open Access
Summary
Three US states (Alabama, Oklahoma, and Louisiana) enacted laws allowing sales of e-cigarettes not approved by the FDA if listed on state directories. This study found that these directory laws did not produce lasting reductions in flavored e-cigarette sales, as manufacturers simply shifted to selling unlisted products that remained outside the directory system. By the end of the study period, more than half of e-cigarette sales in all three states were for products not on the directories, suggesting these policies may be ineffective at controlling access to flavored products.
Eom TI, Jang PK, Nam J, et al. ACS Chem Neurosci. 2026. PubMed
🔥 Hot Topic
Summary
Using a rat inhalation model, researchers found that menthol aerosol enhances nicotine's effects on body temperature and strengthens the brain's perception of nicotine's presence, potentially through interactions with specific nicotine receptors (α4β2*). These findings suggest that menthol may increase nicotine's addictiveness in e-cigarette products by amplifying and prolonging nicotine's effects in the body.
Show 13 more
Leavens ELS, Pebley K, Smith TT, et al. JAMA. 2026. PubMed
🔥 Hot Topic 🍁 Canadian
Summary
A working group of tobacco research experts developed clinical recommendations for US-based healthcare providers on discussing nicotine e-cigarettes as a smoking cessation tool with adult patients. The evidence shows that e-cigarettes are less harmful than cigarettes and more effective for quitting than FDA-approved nicotine replacement therapies, though clinicians and the public often misunderstand their risks. The recommendations encourage providers to include e-cigarettes in shared decision-making conversations about evidence-based cessation treatments and offer practical guidance for patients considering this option.
Doo JH, Yu J, Park SJ, et al. Respir Med. 2026. PubMed
🔥 Hot Topic
Summary
A large Canadian cohort study found that people newly diagnosed with COPD who quit smoking for at least 2 years had a significantly lower risk of developing depression compared to those who continued smoking. The protective effect of sustained cessation was particularly strong in patients with severe COPD, suggesting that long-term smoking cessation should be emphasized as part of comprehensive COPD care to improve both mental and physical health outcomes.
Green M, Harper S, Telfer-Thomas E, et al. Lancet Reg Health Eur. 2026. PubMed
Summary
A cost-effectiveness analysis found that integrating smoking cessation services into cancer care pathways in the NHS is economically justified and produces substantial health benefits. For patients with lung, head and neck, and general cancers, the intervention costs between £2,606 and £5,495 per quality-adjusted life-year gained, well below the NHS willingness-to-pay threshold, while extending life expectancy by 2-8 months and slowing cancer progression.
Tu Q, Zhang X, Zou Y, et al. Front Public Health. 2026. PubMed
Summary
This UK study of over 270,000 people found that both active and secondhand smoke exposure were associated with increased mortality risk, particularly among those with idiopathic pulmonary fibrosis (IPF), a serious lung disease. Notably, maternal smoking during pregnancy showed a stronger combined effect with IPF on respiratory mortality than would be expected from either exposure alone, suggesting early-life smoke exposure may have particular consequences for individuals who develop IPF later in life.
Faisal A, Giles A, Jones S, et al. ERJ Open Res. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Young adult e-cigarette users showed significantly reduced exercise capacity, oxygen uptake, and ventilatory efficiency comparable to conventional cigarette smokers, with both groups experiencing impaired vascular function (reduced blood vessel flexibility) and higher symptoms of breathlessness and leg discomfort during exercise compared to never-smokers. Despite similar nicotine exposure between e-cigarette and conventional cigarette users, both demonstrated early cardiovascular and respiratory harms after at least 18 months of use.
Cho A, East KA, Borland R, et al. Addiction. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Smoking-induced deprivation (continuing to smoke despite lacking money for household essentials) affected 13.6% of adult smokers in Canada, the US, England, and Australia in 2024, remaining higher than 2016 levels despite a slight decline from 2022. The phenomenon disproportionately affects younger adults (18-24 years), those with low income and education, and people with high nicotine dependence, and while it was associated with more quit attempts, smokers experiencing this deprivation were significantly less likely to successfully quit.
Bhamare A, Mane A, Telvekar P, et al. J Appl Toxicol. 2026. PubMed
Summary
Cigarette butts are a major source of pollution in aquatic environments, with an estimated 4.5 trillion discarded annually worldwide. These butts release numerous toxic chemicals including nicotine, heavy metals, and polycyclic aromatic hydrocarbons, as well as microplastic fibres, which harm aquatic organisms ranging from fish to plankton and can accumulate through food webs. The review identifies source-reduction strategies, improved waste management, and extended producer responsibility as key mitigation approaches, while emphasizing the need for more long-term ecological studies to fully understand the risks.
Matsumura K, Tabuchi T, Imano H, et al. Hypertens Res. 2026. PubMed
Summary
A Japanese cohort study of nearly 31,000 adults found that current heated tobacco product (HTP) users had a 23% higher risk of developing hypertension compared to never-smokers, similar to but slightly lower than the risk for cigarette smokers. While the study demonstrates an association between HTP use and incident hypertension, it cannot establish whether HTPs directly cause this cardiovascular effect.
Lawton R, Dowd JB, Skinner J, et al. PNAS Nexus. 2026. PubMed
Summary
Research using national health survey data found that the mortality risk associated with smoking increased by nearly 50% between 1987-1990 and 2012-2013. Rather than being caused by changes in how people smoke or smoking-related health behaviors, this growing gap between smokers and nonsmokers was primarily driven by shifts in who smokes—specifically changes in the age distribution of the smoking population over time.
Abbadi A, Alnaimat T, Al Nahar J, et al. Tob Control. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers examined how 189 countries define tobacco and nicotine-containing products in their national laws, finding significant gaps and inconsistencies in regulatory definitions. While 89% of countries defined tobacco products, only 30% fully aligned with the WHO Framework Convention's definition, and just 10% defined nicotine-containing products broadly—creating potential loopholes that could allow the tobacco industry to circumvent regulations through new or undefined products.
Kim J, Kwon H. Healthcare (Basel). 2026. PubMed
Summary
Adults with lower health literacy in Korea had modestly higher smoking rates, with a 3.34 percentage point difference in smoking prevalence between those with lower versus higher health literacy scores. The association suggests that accessible and tailored smoking prevention and cessation services may be particularly important for individuals with limited health literacy, though further research is needed to understand whether health literacy influences smoking behaviour or vice versa.
Kim Y, Kang H. Geroscience. 2026. PubMed
Summary
This study examined whether smoking-induced biological aging can be reversed after quitting by analyzing DNA methylation patterns in nearly 1,900 US adults aged 50-84. Former smokers who had quit for 20 or more years showed substantial improvements in biological aging markers, approaching the levels of never smokers, with the greatest improvements occurring during the first decade after cessation. These findings provide biological evidence that sustained smoking cessation can reverse smoking-related aging at the cellular level, supporting long-term health benefits of quitting.
Vadibeler S, Mustafa K, Dondo TB, et al. Arch Dis Child. 2026. PubMed
Summary
A 10-year study of over 41,000 paediatric intensive care admissions in England found that children living in neighbourhoods with higher cigarette smoke exposure had a 30% increased risk of requiring critical care for respiratory illness. The research also identified significant health inequities, with children of Asian and Black ethnicity and those from economically deprived areas facing substantially higher admission rates and mortality, suggesting that community-level tobacco control measures could meaningfully improve child respiratory health outcomes.
Reviews & Meta-Analyses 32
Show all 32 reviews
Cessation—Behavioural Interventions
Ho LKL, Phiri L, Rana T, et al. J Pediatr Nurs. 2026. PubMed
Summary
A systematic review of 10 randomized controlled trials found that smoking cessation interventions combining motivational interviewing and child-specific health information effectively increased abstinence rates among parents of children with chronic disease in the short term (immediately after and at first follow-up), but these effects did not persist long-term. Notably, interventions had limited impact on reducing children's secondhand smoke exposure, and hospital visits were identified as potentially valuable settings where nurses could deliver such interventions.
Parida S, Ameral V, Wolkowicz N, et al. Am J Addict. 2026. PubMed
Summary
A systematic review of 25 studies examined smoking cessation treatments for people with opioid use disorder, who have notably higher tobacco use rates and lower treatment success than the general population. Pharmacological approaches were largely ineffective, while contingency management (incentive-based) interventions showed some promise but did not sustain smoking cessation after incentives ended. The findings highlight that standard smoking cessation approaches fail for this population and indicate an urgent need for novel interventions integrated into existing opioid treatment programs.
Cessation—Pregnancy
Barrera B, Ahmed F, Brand T, et al. Public Health Rev. 2026. PubMed
Summary
This systematic review of 58 studies examined behavioral and psychosocial smoking cessation interventions for pregnant people, with a focus on approaches tailored to vulnerable populations and involving expectant fathers. Individual counseling proved most effective for maternal smoking cessation, while socioeconomically inclusive interventions showed the strongest results among vulnerable subgroups. Father-directed interventions were highly effective for paternal cessation, though involving fathers did not significantly improve pregnant people's quit rates.
Tatton C, Melendez-Torres GJ. Tob Use Insights. 2026. PubMed
Summary
A systematic review analyzed how smoking cessation interventions for pregnant people were tailored to address health disparities, examining 54 randomized controlled trials. While tailored interventions showed effectiveness for both quitting during pregnancy and staying smoke-free after birth, the analysis could not pinpoint which specific tailored components were most responsible for success, though the framework identified promising approaches including adapted communication, habit-building support, social network involvement, and removal of practical barriers to care.
Thimkorn P, Booncharoen C, Chaipitak P, et al. Addict Behav. 2026. PubMed
Summary
A systematic review of 11 randomized controlled trials found that combining nicotine patch and gum, as well as e-cigarette use, significantly improved smoking cessation rates in pregnant women compared to usual care. Nicotine gum was also associated with improved birth outcomes, including higher birthweight and lower preterm birth risk, though the researchers noted that findings are based on a limited number of studies and more high-quality research is needed.
Cessation—Youth
Hoo Chuin Shen M, Gabriel MM, Wilde N, et al. Arch Dis Child. 2026. PubMed
Summary
This scoping review identified only eight studies of vaping cessation interventions for youth under 18 years delivered in healthcare settings, all from North America. Most interventions combined behavioural support with nicotine replacement therapy and achieved quit rates between 16.7% and 37%, but uptake of cessation support was consistently low and no structured cessation pathways have been tested in routine clinical practice. The review highlights an urgent need for adequately powered trials, evaluation of clinical pathways, and research across different healthcare systems to address this emerging gap in youth vaping cessation care.
Park JY, Koh SJ. J Subst Use Addict Treat. 2026. PubMed
Summary
A meta-analysis of five randomized controlled trials involving 717 youth and young adults (ages 12–26) found that varenicline was nearly twice as effective as placebo, bupropion, or nicotine patches for achieving smoking abstinence, with safety profiles comparable to alternative treatments. These findings suggest varenicline warrants consideration as a cessation option for young people, including those using e-cigarettes, though further clinical trials in adolescents are needed to confirm effectiveness and safety in younger age groups.
E-cigarettes—Cessation
Reid G, Nightingale G, Maani N, et al. J Public Health (Oxf). 2026. PubMed
Summary
Researchers developed a new statistical method called the 'Test for Dominance' to identify when a single study has an outsized influence on the results of a systematic review. When applied to a review of e-cigarettes for smoking cessation, they found that one study (Hajek et al.) was driving the overall findings, suggesting the review's conclusions should be interpreted cautiously. The authors recommend this new test be used alongside existing quality checks to strengthen how we evaluate evidence on contested topics like e-cigarette effectiveness.
Aihemaiti A, Xie Y, Su Z, et al. J Addict Med. PubMed
Summary
A systematic review of 7 studies with 1,161 participants examined pharmacological treatments to help people quit e-cigarettes. Varenicline (a prescription medication used for smoking cessation) showed effectiveness for e-cigarette cessation, while nicotine replacement therapy did not demonstrate statistically significant benefits. The researchers concluded that while varenicline is promising, more rigorous studies are needed before firmly recommending these medications for e-cigarette cessation.
E-cigarettes—Health Effects
Kruthika K, Aishwarya MU, Vaishnavi K, et al. Front Dent Med. 2026. PubMed
Summary
A scoping review of 10 studies examined how e-cigarette use affects periodontal (gum and tooth support) health compared to conventional smoking and non-smoking. While conventional cigarette smokers showed the most severe gum damage, e-cigarette users demonstrated intermediate periodontal problems including increased pocket depth, gum recession, and inflammation—suggesting e-cigarettes are not without risk to oral health, though potentially less harmful than traditional cigarettes. The review identifies several biological pathways (oxidative stress, immune dysfunction, impaired healing) through which e-cigarettes may damage periodontal tissues, highlighting the need for further research to better understand these effects.
Almeshari MA, Alrashdi AM, Almutairi AG, et al. Tob Induc Dis. 2026. PubMed
Summary
A systematic review of six studies examining whether long-term e-cigarette use causes airway inflammation found inconsistent results across studies, with a meta-analysis showing no significant difference in the inflammation marker FeNO between e-cigarette users and control groups. The findings highlight substantial variability in how e-cigarettes affect airway inflammation, underscoring the need for rigorous, long-term prospective studies to clarify the respiratory health impacts of sustained e-cigarette use.
Di Palo MP, Di Spirito F, Giordano F, et al. Dent J (Basel). 2026. PubMed
Summary
This systematic review of 31 studies examined how different smoking products affect gum and dental implant health. Cigarette smoking caused the most damage, followed by waterpipe smoking, while e-cigarettes and heated tobacco products showed intermediate harms—notably, e-cigarettes unexpectedly demonstrated the highest bone loss around teeth despite lower gum inflammation, suggesting these newer products are not risk-free alternatives to traditional cigarettes.
Gulati I, Kosgoda S, Kundu A, et al. Tob Induc Dis. 2026. PubMed
Summary
A systematic review of 16 cross-sectional studies found that people who use e-cigarettes exclusively are 38% more likely to experience poor sleep health compared to never-users, with consistent findings across both adolescents and adults. This association suggests that vaping may negatively impact sleep quality and duration, highlighting a potential health consequence beyond nicotine dependence that warrants further investigation through longitudinal studies.
E-cigarettes—Products/Marketing
Travis N, Warner KE, Hartmann-Boyce J, et al. Nicotine Tob Res. 2026. PubMed
Summary
This scoping review of 73 new studies examines oral nicotine pouches (ONPs), a rapidly growing nicotine product, finding that their use among youth has slowly increased to 1.8–2.6% prevalence in 2024, while adult use remains low at 0.4–0.8%. ONPs deliver higher nicotine levels than cigarettes, are substantially less toxic, but marketing increasingly uses youth-appealing tactics via social media and online channels; evidence suggests they may reduce smoking in daily smokers but typically result in dual use rather than complete cessation, with long-term health effects remaining unclear.
E-cigarettes—Youth/Adolescents
Seif M, Moghaddam S, Kargar Jahromi H, et al. Subst Use Misuse. 2026. PubMed
Summary
A systematic review of 60 studies involving over 92,000 students across the Eastern Mediterranean Region found that electronic nicotine delivery systems (ENDS) use is highly prevalent, with 21% current use and 24% lifetime use among youth. The analysis revealed a significant gender disparity with males using ENDS at nearly double the rate of females (28% vs. 14%), and countries with lower socioeconomic development showed substantially higher ENDS prevalence rates among students.
Epidemiology—Prevalence
Posse CM, Lira J, Míguez MC. Addict Behav. 2026. PubMed
Summary
A systematic review of 45 studies published between 2015-2025 examined electronic cigarette use among women across different continents, countries, and age groups. The Americas had the highest prevalence rate at 28.8%, with young adults showing the highest usage at 6.2% in the past 30 days, and women overall using e-cigarettes at lower rates than men. These findings can help inform targeted prevention and treatment strategies in regions and populations with higher e-cigarette use among women.
Health Effects—Cancer
Kopa-Stojak PN, Pawliczak R. Toxicol Mech Methods. 2026. PubMed
Summary
This systematic review examined whether alternative tobacco and nicotine products (such as e-cigarettes and snus) affect how well cancer patients respond to chemotherapy. The review found limited evidence overall, with some studies suggesting snus use may reduce survival rates, but inconsistent findings for e-cigarettes—initial concerns about e-cigarette-induced drug resistance were not confirmed in follow-up studies. The authors conclude that more rigorous prospective studies and cancer patient registries are needed before drawing firm conclusions about the safety of using these products during cancer treatment.
Wallace C, Razavi-Shearer D, Hall S, et al. J Viral Hepat. 2026. PubMed
Summary
This meta-analysis of 126 studies compared cancer risks across different causes, finding that viral hepatitis infections (HBV, HCV, and HDV) carry substantially higher risks for liver cancer than smoking carries for lung cancer. While alcohol use and metabolic dysfunction-associated fatty liver disease (MASLD) also increase liver cancer risk, they do so at lower levels than viral hepatitis, highlighting the need for better surveillance and management of viral hepatitis to prevent liver cancer globally.
Jiang Q, Zhang Z, Zhou J, et al. Food Chem Toxicol. 2026. PubMed
Summary
This systematic review identifies how nicotine activates multiple molecular signaling pathways that suppress the p53 tumor suppressor protein across lung, gastric, liver, and cervical cancers, promoting cancer development and progression. The research reveals that nicotine's cancer-promoting effects work differently depending on whether p53 is normal or mutated, raising concerns about the carcinogenic potential of nicotine itself—not just other tobacco smoke components—and alternative nicotine delivery systems. These findings provide a biological foundation for understanding smoking-related cancer mechanisms and support the need for prevention and early intervention strategies.
Health Effects—Cardiovascular
Akagi Y, Arakawa K, Sakima A, et al. Hypertens Res. 2026. PubMed
Summary
A systematic review of four studies with 104 current smokers found that smoking periods were associated with significantly higher diastolic blood pressure and heart rate compared to abstinence periods (ranging from 1 day to 1 week), while systolic blood pressure showed no significant difference. These findings demonstrate measurable cardiovascular stress during active smoking and provide evidence supporting the cardiovascular benefits of smoking cessation.
Sebastian SA, Bimal T, Hart H, et al. Eur J Prev Cardiol. 2026. PubMed
Summary
A meta-analysis of 16 imaging studies involving over 250,000 participants found that cigarette smokers have significantly higher amounts of coronary plaque compared to never-smokers, with smokers showing a higher proportion of non-calcified (soft) plaque. This finding is important because standard coronary artery calcium scoring may underestimate cardiovascular risk in smokers, as soft plaque is less visible on calcium scans yet can still rupture and cause heart attacks.
Hassanpour H, Nasiri L, Mojtahed M, et al. Int J Cardiol Cardiovasc Risk Prev. 2026. PubMed
Summary
This meta-analysis of 55 studies examined how smoking affects heart-related inflammatory markers in the blood. Smoking was found to significantly elevate eight key biomarkers indicating inflammation and heart damage, with current smokers showing the most severe effects, males more affected than females, and some markers remaining elevated even after quitting. These findings provide biological evidence for how smoking increases cardiovascular disease risk and support the critical importance of cessation programs.
Health Effects—Pregnancy/Perinatal
Fielder S, Barnes C, Ormesher L, et al. PLoS One. 2026. PubMed
Summary
A comprehensive review of 64 studies (34 animal, 30 human) examining vaping during pregnancy found significant gaps in current evidence. While animal studies suggest potential biological risks across multiple systems including cardiovascular, respiratory, and neurodevelopmental effects, human studies remain largely observational and rely on self-reported exposure without biochemical validation, limiting the ability to draw firm conclusions about actual health risks to pregnant people and infants. Future research needs prospective designs with objective exposure measurement and assessment of maternal physiological outcomes to better understand vaping's effects during pregnancy.
Skowron K, Godziszewski F, Putyrska A, et al. Int J Mol Sci. 2026. PubMed
Summary
This scoping review examined how maternal stress, psychiatric medications, and smoking during pregnancy affect the biochemical composition of amniotic fluid and fetal development. The analysis of 30 studies found that maternal smoking interferes with metabolic pathways in amniotic fluid related to oxidative stress, while chronic stress and anxiety elevate stress hormones that may influence long-term fetal health outcomes through metabolic programming mechanisms.
Johnstone S, Schenkel A, Canazzi S, et al. Nicotine Tob Res. 2026. PubMed
Summary
This systematic review of 22 studies examined birth outcomes in pregnancies exposed to electronic nicotine delivery systems (ENDS/vaping) compared to non-exposure, nicotine replacement therapy, and cigarette smoking. ENDS exposure was associated with increased odds of preterm birth and lower birthweight compared to no exposure, with risks similar to cigarette smoking, though findings had low to moderate confidence levels. The review highlights that pregnant people using ENDS should be supported to quit, and that alternative smoking cessation approaches need further investigation for use during pregnancy.
Zhu L, Munch IC, Lee SS, et al. Acta Ophthalmol. 2026. PubMed
Summary
A meta-analysis of three birth cohorts (two Danish and one Australian) found that prenatal smoking exposure was associated with measurable deficits in retinal nerve fibre layer thickness in children, with reductions ranging from 8-10% depending on the eye region examined. These structural changes in the retina suggest that maternal smoking during pregnancy may have lasting adverse effects on children's eye development and visual health.
Health Effects—Respiratory
Alrabadi B, Alghzawi Y, Alshakhshir AE, et al. Neurol Sci. 2026. PubMed
Summary
A systematic review of 18 studies examined whether smoking worsens disability outcomes in people with multiple sclerosis (MS). While smoking did not show statistically significant effects on standard disability measures, there were trends suggesting associations with poorer quality of life, increased fatigue, respiratory symptoms, and slower recovery from MS relapses, though evidence remained inconsistent across studies.
Alrabadi B, Matar H, Bandak N, et al. Mult Scler Relat Disord. 2026. PubMed
Summary
A meta-analysis of 10 studies found that smoking does not increase the risk of developing NMOSD or MOGAD, but smokers who do develop these autoimmune neurological conditions experience significantly poorer recovery after disease relapses compared to non-smokers. The negative impact of smoking on recovery was particularly pronounced in MOGAD patients, suggesting that smoking cessation counseling should be integrated into the management of these conditions to help reduce disability progression.
Heimbach NS, Ding J, Eidelman DH, et al. Transl Res. 2026. PubMed
Summary
Researchers analyzed lung cell data from never smokers, active smokers, and former smokers to understand why former smokers remain at higher risk for lung disease even after quitting. While smoking cessation reversed some smoking-related damage in certain lung cells, it failed to fully restore normal function in others and even triggered new molecular problems in some cell types, explaining why former smokers' lungs don't completely recover.
Policy—Marketing/Advertising
Salamanca MV, Galeano MIB, Builes JCC, et al. J Prev (2022). 2026. PubMed
Summary
This systematic review of 12 studies examined how electronic cigarette advertising influences young people's attitudes and intentions to use ENDS products. The research found that e-cigarette ads use emotional persuasion tactics—such as messaging about freedom and social belonging—to create positive feelings and reduce perceived risk, ultimately increasing youth interest in trying these products. The review highlights that current prevention efforts need stronger counter-advertising strategies and stricter regulations on how e-cigarette products are marketed to young audiences.
Other
Holguín Galvis S, Martín-García P, Catalá-López F. Rev Esp Salud Publica. 2026. PubMed
Summary
This overview synthesized six systematic reviews containing 143 studies on the economic costs of tobacco use globally. The research found that tobacco-related diseases cost up to US$1.44 trillion worldwide annually (2012), with most estimates focusing on direct healthcare costs at the national level. However, the reviews identified significant methodological inconsistencies across studies, limiting the ability to compare results and highlighting the need for standardized approaches to measuring tobacco's economic burden.
Feng X, Hou H, Wang C, et al. Biol Psychiatry Cogn Neurosci Neuroimaging. 2026. PubMed
Summary
A brain imaging meta-analysis of 102 studies examined how smoking cues activate neural regions associated with stress threat and reward anticipation in smokers' brains. The analysis found that smoking cues, threat processing, and reward anticipation activate distinct brain regions rather than overlapping ones, though these regions are functionally connected through neural networks. These findings suggest that smokers may experience a shift from stress-driven reward-seeking to cue-triggered craving, pointing to potential brain targets for interventions to prevent relapse triggered by stress.
🍁 Canadian 24

Articles with Canadian authors or institutional affiliations.

Show all 24 Canadian articles
Cessation—Behavioural Interventions
Sheng Y, Zuo Y, Rabinovich NE, et al. Nicotine Tob Res. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers developed and validated the Short Withdrawal Symptom Scale (SWiSS), a brief 28-item tool that measures five key aspects of smoking withdrawal including positive affect, negative affect, fatigue, depression, and craving. The study found that low positive affect (feeling less friendly or upbeat) in the first few days after quitting is an important but underrecognized predictor of relapse risk, and that monitoring both the initial level and recovery rate of positive affect can help identify smokers at higher risk of returning to smoking.
Cessation—Digital/Mobile
Lee JH, Lee SH, Yang J, et al. Neuropsychopharmacology. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers developed a smartphone-based tool that combines brief daily decision-making tasks with ecological momentary assessment to predict smoking cessation success in real-time. Early indicators of cessation success—such as lower delay discounting rates (patience with rewards) and reduced craving and stress—could be identified within the first week of treatment, potentially enabling timely personalized interventions during smoking cessation programs.
Cessation—Health Systems
Japuntich S, Adkins-Hempel M, Sacasa NG, et al. Community Ment Health J. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
A pilot study tested whether a certified community behavioral health clinic could successfully implement proactive smoking cessation treatment for clients with mental health and substance use disorders. The intervention combined staff training in the 5As approach (ask, advise, assess, assist, arrange follow-up) with proactive outreach calls offering cessation support, and was found to be feasible and acceptable to both clients and providers, though the 12-month quit rate was modest at 8%.
Cao P, Smith L, Tian E, et al. JAMA Netw Open. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers evaluated the cost-effectiveness of adding smoking cessation interventions to lung cancer screening programs using data from over 2,500 smokers across 4 clinical trials. Programs combining cessation support with screening were cost-saving compared to screening alone, with high-intensity pharmacotherapy paired with low-intensity counseling providing the best balance of health benefits and costs at roughly $991 per quality-adjusted life year gained.
Cessation—Pregnancy
Porto L, Ordean A, Morin C, et al. J Obstet Gynaecol Can. 2026. PubMed
🍁 Canadian
Summary
This guideline provides evidence-based recommendations for screening and managing nicotine use among pregnant individuals and those planning pregnancy, covering combustible tobacco, e-cigarettes, and smokeless tobacco. Key recommendations include routine screening, behavioural counselling as first-line treatment, cautious use of nicotine replacement therapy or other medications when needed, and continued support postpartum to prevent relapse. Implementation of these recommendations aims to improve cessation rates during pregnancy and reduce adverse maternal and neonatal outcomes.
Sharma E, Powers JM, Maloney S, et al. Nicotine Tob Res. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Among pregnant people who smoked cigarettes before pregnancy, approximately 80% attempted to quit or reduce smoking during pregnancy, with 43.6% successfully quitting. However, menthol cigarette use prior to pregnancy was not associated with differences in quit attempts, successful cessation, or postpartum return to smoking. These findings suggest that smoking cessation interventions for pregnant people should prioritize behavioral and contextual factors rather than focusing on cigarette type alone.
E-cigarettes—Cessation
Nathwani AA, Kundu A, Schwartz R, et al. Tob Induc Dis. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
A smartphone cessation app analysis of 360 vaping users identified past-month vaping frequency as the strongest independent predictor of relapse, with higher frequency associated with increased relapse risk. While other measures like puffs per session and pod depletion time showed some predictive value individually, only past-month vaping frequency remained significant when all usage measures were considered together. These findings suggest that frequency of use should be prioritized as a key assessment metric in vaping cessation interventions and research.
Poliakova N, Bouchard R, Haddad S, et al. Addict Behav. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Over half of adolescents who attempted to quit vaping reported experiencing barriers to cessation, with addiction, mood control difficulties, and fear of failure being most common. Females and older teens faced significantly more barriers and were less likely to achieve abstinence, while youth experiencing material deprivation or using other tobacco products also reported higher barrier scores, indicating that tailored cessation support is needed across different adolescent populations.
E-cigarettes—Co-use
Brouwer AF, Roberts OK, Jeon J, et al. Am J Prev Med. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Using data from 2021-2024, researchers tracked how U.S. adults transition between cigarettes, e-cigarettes, and dual use. The study found that dual use is becoming more persistent, with fewer people moving away from using both products, while e-cigarette adoption continues to be driven primarily by young adults. These trends suggest the need for targeted public health efforts to address persistent dual use and support smoking cessation, particularly among older adults.
E-cigarettes—Health Effects
Faisal A, Giles A, Jones S, et al. ERJ Open Res. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Young adult e-cigarette users showed significantly reduced exercise capacity, oxygen uptake, and ventilatory efficiency comparable to conventional cigarette smokers, with both groups experiencing impaired vascular function (reduced blood vessel flexibility) and higher symptoms of breathlessness and leg discomfort during exercise compared to never-smokers. Despite similar nicotine exposure between e-cigarette and conventional cigarette users, both demonstrated early cardiovascular and respiratory harms after at least 18 months of use.
Gulati I, Kosgoda S, Kundu A, et al. Tob Induc Dis. 2026. PubMed
SR 🍁 Canadian 🔓 Open Access
Summary
A systematic review of 16 cross-sectional studies found that people who use e-cigarettes exclusively are 38% more likely to experience poor sleep health compared to never-users, with consistent findings across both adolescents and adults. This association suggests that vaping may negatively impact sleep quality and duration, highlighting a potential health consequence beyond nicotine dependence that warrants further investigation through longitudinal studies.
E-cigarettes—Products/Marketing
Travis N, Warner KE, Hartmann-Boyce J, et al. Nicotine Tob Res. 2026. PubMed
SR 🍁 Canadian 🔓 Open Access
Summary
This scoping review of 73 new studies examines oral nicotine pouches (ONPs), a rapidly growing nicotine product, finding that their use among youth has slowly increased to 1.8–2.6% prevalence in 2024, while adult use remains low at 0.4–0.8%. ONPs deliver higher nicotine levels than cigarettes, are substantially less toxic, but marketing increasingly uses youth-appealing tactics via social media and online channels; evidence suggests they may reduce smoking in daily smokers but typically result in dual use rather than complete cessation, with long-term health effects remaining unclear.
Le Tu H, Oh JK, Seo HG, et al. J Prev Med Public Health. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
A Korean national survey found that people who use both cigarettes and alternative nicotine products (heated tobacco products or e-cigarettes) perceive these alternatives as significantly less harmful than cigarettes compared to cigarette-only users. Exposure to tobacco advertising was associated with lower perceived harm of these products, highlighting the need for stronger advertising regulation and targeted education to correct misperceptions about the relative risks of alternative nicotine products.
Epidemiology—Disparities
Cho A, East KA, Borland R, et al. Addiction. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Smoking-induced deprivation (continuing to smoke despite lacking money for household essentials) affected 13.6% of adult smokers in Canada, the US, England, and Australia in 2024, remaining higher than 2016 levels despite a slight decline from 2022. The phenomenon disproportionately affects younger adults (18-24 years), those with low income and education, and people with high nicotine dependence, and while it was associated with more quit attempts, smokers experiencing this deprivation were significantly less likely to successfully quit.
Ganz O, Gonsalves NJ, Tomaino M, et al. Psychol Sex Orientat Gend Divers. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
This research examined how different ways of asking survey questions about sexual orientation and gender identity (SOGI) affect estimates of cigarette relighting behaviors among smokers. The study found that the order and wording of SOGI questions significantly changed reported relighting rates in a convenience sample, suggesting that survey measurement choices can substantially influence estimates of health behaviors in sexual and gender minority populations—an important consideration for public health surveillance and research.
Epidemiology—Prevalence
Fatokun BS, Oluyemi SO, Mba OJ, et al. Health Sci Rep. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Despite global declines in smoking rates, Africa's tobacco user population is projected to grow from 57 million in 2015 to 67 million by 2025 due to rapid population growth and weak regulatory frameworks, significantly increasing cardiovascular disease burden across the region. While interventions like public awareness campaigns, graphic warning labels, and progressive taxation show promise, their inconsistent enforcement limits effectiveness. Stronger policy enforcement and multi-sectoral collaboration targeting vulnerable populations are needed to reverse these trends and reduce projected health and economic costs.
Health Effects—Respiratory
Miyamoto A, Uemasu K, Li X, et al. Biochem Biophys Res Commun. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers identified USP19, a protein that helps cells manage stress from cigarette smoke exposure, as a protective factor against lung injury and COPD development. When USP19 levels were reduced or absent, lung cells were more susceptible to damage from cigarette smoke, suggesting that this protein plays an important role in protecting lung epithelial cells from the harmful effects of smoking.
Heimbach NS, Ding J, Eidelman DH, et al. Transl Res. 2026. PubMed
SR 🍁 Canadian 🔓 Open Access
Summary
Researchers analyzed lung cell data from never smokers, active smokers, and former smokers to understand why former smokers remain at higher risk for lung disease even after quitting. While smoking cessation reversed some smoking-related damage in certain lung cells, it failed to fully restore normal function in others and even triggered new molecular problems in some cell types, explaining why former smokers' lungs don't completely recover.
Policy—Regulation
Xu SS, Quah ACK, Fong GT. Tob Control. 2026. PubMed
🍁 Canadian
Summary
China manufactures over 90% of the world's e-cigarettes, with Chinese companies using a fast-moving consumer goods model that enables rapid product changes, extensive flavour variations, and quick adaptation to regulations. Current regulatory approaches designed for traditional cigarettes have failed to address the speed and complexity of this industry, and domestic Chinese regulations in 2022 appear to have accelerated global expansion rather than slow it. Effective tobacco control responses require coordinated, supply-side approaches that strengthen oversight of manufacturing, distribution, and cross-border trade rather than relying on regulations that assume e-cigarettes behave like conventional cigarettes.
Carroll DM, Hatsukami DK, Wackowski OA, et al. Health Aff Sch. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
A commentary argues for implementing a federal nicotine cap in cigarettes and combusted tobacco products as part of the 'Make America Healthy Again' initiative, citing FDA projections that reducing nicotine to non-addictive levels could prevent 4.3 million smoking-related deaths by 2100 and save $1.1 trillion in healthcare costs. The authors recommend pairing a nicotine cap with increased funding for smoking cessation services and public education about the relative risks of different nicotine/tobacco products to maximize health benefits.
Noël A, Kathuria H, Penz E, et al. Ann Am Thorac Soc. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
This article reviews vaping use patterns and regulatory approaches across North and South America, noting that teenagers and young adults have the highest rates of ENDS use and that dual use with combustible tobacco is increasingly common. Evidence suggests that strong anti-tobacco messaging in North America and product bans (as implemented in Brazil and Mexico) have been associated with reduced vaping rates. The authors highlight the need for improved surveillance data, longitudinal research on health impacts, and coordinated regulatory strategies across the Americas to address this growing public health threat.
Abbadi A, Alnaimat T, Al Nahar J, et al. Tob Control. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers examined how 189 countries define tobacco and nicotine-containing products in their national laws, finding significant gaps and inconsistencies in regulatory definitions. While 89% of countries defined tobacco products, only 30% fully aligned with the WHO Framework Convention's definition, and just 10% defined nicotine-containing products broadly—creating potential loopholes that could allow the tobacco industry to circumvent regulations through new or undefined products.
Chung-Hall J, Fong GT, Meng G, et al. Nicotine Tob Res. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
This international study tracked menthol cigarette use across 25 countries from 2005-2023, comparing four countries with menthol bans (Canada, UK, Netherlands, Spain) to 21 without bans. Menthol cigarette market share declined significantly in all ban countries after implementation, while it increased in several non-ban countries, suggesting that menthol bans are an effective regulatory strategy for reducing menthol cigarette consumption.
Other
Ji A, Xu W, Xiong H, et al. Tob Induc Dis. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers identified shared genetic factors between smoking dependence and Crohn's disease by analyzing genetic data from large studies, finding a moderate positive genetic correlation between the two conditions. Three specific genetic regions and four key genes were identified as contributing to susceptibility to both conditions, with evidence pointing to shared immune and inflammatory pathways, particularly involving T-helper 17 cells and inflammatory response mechanisms. These findings suggest that some individuals may have inherited genetic predispositions that increase their risk for both smoking dependence and Crohn's disease through common biological pathways.
Articles by Category 377

Open a category to see its articles. Includes the reviews and Canadian articles listed above.

Cessation—Behavioural Interventions(19)
Bai Y, Huang A, Connolly JG, et al. medRxiv. 2026. PubMed
Summary
Researchers tested whether transcranial magnetic stimulation (TMS) targeted at the default mode network (DMN)—a brain network involved in mind-wandering and cue reactivity—could reduce nicotine cue-reactivity in people with schizophrenia. DMN-targeted TMS significantly decreased brain activity in response to nicotine cues among individuals with schizophrenia, particularly those with higher baseline cravings, whereas standard DLPFC-targeted TMS and both approaches in non-psychosis controls showed no effect.
Imai E, Yamagiwa Y, Aluariachy L, et al. J Epidemiol. 2026. PubMed
Summary
A 10-year study of nearly 18,000 Japanese smokers found that major health events—including heart attack, stroke, cancer diagnosis, and surgery—were strongly associated with long-term smoking cessation, with lung cancer diagnosis and lung surgery showing particularly strong effects. These findings suggest that serious health diagnoses and surgical procedures represent critical "teachable moments" when healthcare providers can effectively intervene to support smoking cessation.
Bück J, Sünkel E, Machulska A, et al. JMIR Form Res. 2026. PubMed
Summary
A qualitative study examined how 11 individuals with mental health conditions experienced a standardized, manual-based cognitive behavioral smoking cessation program, following diverse outcomes including sustained abstinence, relapse, and no quit attempt. Participants found the structured intervention feasible and generally acceptable, but highlighted the need for greater individualization, flexibility in session scheduling, and targeted education to address persistent misconceptions about how quitting smoking might affect their mental health. The findings suggest that while guideline-conform cessation treatment is viable for people with comorbid mental disorders, improvements in treatment adaptations—including extended motivational support and attention to smoking's social and functional roles—could enhance outcomes in this high-risk population.
Sheng Y, Zuo Y, Rabinovich NE, et al. Nicotine Tob Res. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers developed and validated the Short Withdrawal Symptom Scale (SWiSS), a brief 28-item tool that measures five key aspects of smoking withdrawal including positive affect, negative affect, fatigue, depression, and craving. The study found that low positive affect (feeling less friendly or upbeat) in the first few days after quitting is an important but underrecognized predictor of relapse risk, and that monitoring both the initial level and recovery rate of positive affect can help identify smokers at higher risk of returning to smoking.
Leutwyler H, Melino K, Hubbard E, et al. Int Psychogeriatr. 2026. PubMed
Summary
A 12-week group-based smoking cessation program for older adults (aged 50+) with serious mental illness resulted in significant reductions in smoking, with participants decreasing their weekly cigarette consumption by approximately 26–38 cigarettes from baseline through week 12, with 55% completing the full intervention. Key factors supporting engagement and behavior change included program structure, peer support, accessibility, and personal accountability, suggesting that tailored, multifaceted interventions addressing both behavioral and contextual needs can be effective for this high-risk population.
van den Brand FA, Magnée T, van Schayck OCP, et al. PLoS One. 2026. PubMed
Summary
Researchers used a systematic, theory-based approach called Implementation Mapping to design a tailored strategy for delivering workplace smoking cessation programs that offer financial incentives in Dutch companies. The strategy identified company directors and HR managers as key decision-makers, addressed specific barriers to implementation through evidence-based tactics (including training materials, videos, and promotional resources), and demonstrated how engaging stakeholders and addressing workplace-specific challenges can improve the real-world adoption and sustainability of cessation programs in occupational settings.
Baker TB, Bolt DM, Piasecki TM, et al. J Psychopathol Clin Sci. 2026. PubMed
Summary
Researchers tracked 232 people quitting cigarettes without medication during their first week to understand how craving relates to other withdrawal symptoms. While craving increased the most after quitting and was strongly linked to smoking intensity and dependence, it showed weak connections to other withdrawal symptoms and was a poor overall indicator of withdrawal occurrence—though it did reflect how severe withdrawal was when present. These findings suggest craving is a distinct symptom that may be clinically useful for predicting quit success despite not fitting neatly with the broader withdrawal syndrome.
Regnier S, McManus HS, Tillson M, et al. Nicotine Tob Res. 2026. PubMed
Summary
Adults with Intellectual and Developmental Disabilities (IDD) face unique barriers to smoking cessation, including using smoking to cope with stress, difficulty understanding treatment information, exposure to smoking among peers and service providers, and practical obstacles like transportation and cost. Effective cessation interventions for people with IDD should include accessible, tailored materials focused on coping skills training and withdrawal management, developed with input from people with IDD themselves.
Brown RA, Minami H, Shumake JD, et al. Nicotine Tob Res. 2026. PubMed
Summary
A study of psychiatric inpatients who quit smoking found that sustained abstinence was associated with significant improvements in depression and anxiety symptoms over 6 months, with benefits increasing over time. Rather than worsening mental health as sometimes feared, smoking cessation led to large reductions in depressive and anxiety symptoms, with participants improving from markedly elevated baseline levels to near normal population levels. These findings support integrating evidence-based smoking cessation interventions into routine psychiatric care as a way to improve overall treatment outcomes.
Andreasyan A, Khachunts A, Alsina-Jurnet I, et al. J Addict Dis. 2026. PubMed
Summary
Researchers tested whether immersive virtual reality (VR) showing smoking cues in realistic scenarios could trigger cravings in current smokers compared to people who had quit. Current smokers showed higher baseline cravings and anxiety than the comparison group, but the VR experience did not significantly increase cravings beyond their already-elevated baseline levels, suggesting the VR paradigm requires refinement before it can be validated as a tool for studying or addressing smoking cravings.
Ho LKL, Phiri L, Rana T, et al. J Pediatr Nurs. 2026. PubMed
Summary
A systematic review of 10 randomized controlled trials found that smoking cessation interventions combining motivational interviewing and child-specific health information effectively increased abstinence rates among parents of children with chronic disease in the short term (immediately after and at first follow-up), but these effects did not persist long-term. Notably, interventions had limited impact on reducing children's secondhand smoke exposure, and hospital visits were identified as potentially valuable settings where nurses could deliver such interventions.
Yang X, Begh R, Lindson N, et al. Patient Educ Couns. 2026. PubMed
Summary
Researchers analyzed conversations between primary care clinicians and people with severe mental illness (SMI) to understand why smoking cessation advice often fails with this high-risk population. People with SMI resisted quitting advice in two main ways: by prioritizing competing mental health concerns (implicit rejection) or by outright rejecting the advice and viewing smoking as non-negotiable (explicit rejection). Clinicians typically responded passively to resistance rather than engaging further, suggesting that more tailored, responsive communication strategies are needed to address smoking in this vulnerable population experiencing substantial health inequalities.
Khosravani S, Drew W, Apostol MR, et al. Am J Psychiatry. 2026. PubMed
Summary
Researchers tested transcranial magnetic stimulation (TMS) at multiple brain locations in 72 smokers to identify which stimulation sites were most effective for reducing nicotine withdrawal. TMS sites that were most connected to a brain circuit previously linked to smoking cessation showed significantly greater improvements in withdrawal symptoms, suggesting that targeting this specific circuit could improve future TMS-based smoking cessation treatments.
Nist AN, Tegge AN, Fontes RM, et al. Addict Behav. 2026. PubMed
Summary
Veterans seeking to quit smoking who experience multiple vulnerabilities—such as trauma exposure, PTSD, chronic pain, and psychological distress—place significantly higher value on cigarettes and are less responsive to price increases, making quitting more difficult. The cumulative effect of these vulnerabilities on cigarette reinforcement value suggests that standard cessation approaches may be insufficient for this population, and tailored interventions targeting the underlying reinforcement mechanisms may be needed.
Pleym K, Engebretsen I, Sverre E, et al. Addiction. 2026. PubMed
Summary
A hospital-based smoking cessation program combining motivational counselling with referral to community follow-up was found to be highly cost-effective for patients with atherosclerotic vascular disease. The intervention achieved a 49.5% continuous abstinence rate at 6 months (compared to 24.5% with brief advice alone) and cost only €3,094 per life-year gained, with a 90.5% probability of being cost-effective at standard health care thresholds.
Ramos-Carro M, Martínez-Vispo C, López-Durán A, et al. Addict Behav. 2026. PubMed
Summary
A study of 440 adults who completed a cognitive-behavioral smoking cessation intervention found that perceived stress and nicotine dependence interact differently by sex in predicting relapse. Among men, high perceived stress significantly increased the risk of returning to smoking, but only among those with low nicotine dependence; this interaction was not observed in women. These findings suggest that smoking cessation programs should incorporate sex-specific and nicotine-dependence-tailored strategies, with stress management as a key intervention target for men with lower dependence levels.
Patel TA, Sala MC, Zvolenksy MJ, et al. Addict Behav. 2026. PubMed
Summary
Among trauma-exposed individuals with high trait anger, those with greater PTSD symptoms at baseline smoked more frequently and had higher carbon monoxide levels immediately after receiving a computerized anger-focused cessation treatment. These findings suggest that addressing PTSD symptoms alongside anger may be necessary to improve smoking cessation outcomes, as anger reduction alone may not be sufficient for this population.
Jung YJ, Han K, Kim SG. Gut Liver. 2026. PubMed
Summary
Among 27,854 gastric cancer patients who underwent surgery in Korea, those who quit smoking and engaged in regular exercise were significantly less likely to become underweight during recovery. Smoking cessation reduced the risk of postoperative underweight by about 69%, while regular exercise reduced the risk by about 27%, with particularly strong benefits observed in female patients and those under 65 years old.
Parida S, Ameral V, Wolkowicz N, et al. Am J Addict. 2026. PubMed
Summary
A systematic review of 25 studies examined smoking cessation treatments for people with opioid use disorder, who have notably higher tobacco use rates and lower treatment success than the general population. Pharmacological approaches were largely ineffective, while contingency management (incentive-based) interventions showed some promise but did not sustain smoking cessation after incentives ended. The findings highlight that standard smoking cessation approaches fail for this population and indicate an urgent need for novel interventions integrated into existing opioid treatment programs.
Cessation—Digital/Mobile(6)
He AWJ, Cheung FHY, Shao Y, et al. China CDC Wkly. 2026. PubMed
Summary
A comprehensive analysis of 1,728 publications from 1982-2026 examined how artificial intelligence is being used in smoking cessation research globally. Digital interventions represent the primary application of AI in this field, with prediction and diagnosis emerging as important secondary areas, while monitoring and surveillance applications remain significantly underdeveloped. The findings suggest AI technology holds considerable promise for enhancing smoking cessation efforts through tailored digital programs, risk prediction tools, and clinical decision support, though responsible governance frameworks will be essential as these applications expand.
Zhonghua Jie He He Hu Xi Za Zhi. 2026. PubMed
Summary
A new clinical practice guideline recommends using digital health technologies—including smartphone apps, text messaging, web-based interventions, and AI chatbots—as adjunctive tools alongside traditional smoking cessation therapies (behavioral support and medications). The guideline emphasizes that these digital tools are most effective when integrated into a comprehensive "online-plus-offline" platform embedded within routine clinical practice and telemedicine systems, with priority given to apps that incorporate evidence-based psychological and behavioral interventions.
Borrelli B, Endrighi R, Rackoff GN, et al. Nicotine Tob Res. 2026. PubMed
Summary
This study examined unprompted text messages sent by participants in a 4-week automated text messaging cessation program to understand how they relate to quitting outcomes. Participants who sent unprompted messages—particularly those updating their progress or acknowledging program messages—were significantly more likely to use evidence-based cessation treatments and achieve smoking abstinence, suggesting that spontaneous participant engagement may be an early indicator of treatment success.
Bricker JB, Santiago-Torres M, Sullivan BM, et al. JMIR Res Protoc. 2026. PubMed
Summary
IndigeQuit is a culturally adapted smoking cessation app designed specifically for American Indian and Alaska Native adults, developed through community-based participatory research and featuring Native imagery, stories from AI/AN elders, and emphasis on cultural and spiritual values. A randomized clinical trial enrolling 776 AI/AN smokers is testing whether IndigeQuit improves 30-day abstinence rates at 12 months compared to a standard non-tailored cessation app, with results expected by late 2028.
Panisello Royo JM, Cuervo Arribas J, Tárraga Marcos PJ, et al. Semergen. 2026. PubMed
Summary
A randomized controlled trial of 220 smokers in primary care found that adding a digital therapeutic intervention to standard smoking cessation care significantly improved outcomes. Participants receiving the digital therapy had higher abstinence rates at both 3 months (59.1% vs 44.5%) and 6 months (50.0% vs 35.5%), and also achieved greater reductions in daily cigarette consumption compared to those receiving usual care alone.
Lee JH, Lee SH, Yang J, et al. Neuropsychopharmacology. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers developed a smartphone-based tool that combines brief daily decision-making tasks with ecological momentary assessment to predict smoking cessation success in real-time. Early indicators of cessation success—such as lower delay discounting rates (patience with rewards) and reduced craving and stress—could be identified within the first week of treatment, potentially enabling timely personalized interventions during smoking cessation programs.
Cessation—Health Systems(19)
Green M, Harper S, Telfer-Thomas E, et al. Lancet Reg Health Eur. 2026. PubMed
Summary
A cost-effectiveness analysis found that integrating smoking cessation services into cancer care pathways in the NHS is economically justified and produces substantial health benefits. For patients with lung, head and neck, and general cancers, the intervention costs between £2,606 and £5,495 per quality-adjusted life-year gained, well below the NHS willingness-to-pay threshold, while extending life expectancy by 2-8 months and slowing cancer progression.
Marım F, Karadoğan D, Telatar TG, et al. Int J Chron Obstruct Pulmon Dis. 2026. PubMed
Summary
Among smokers with COPD, immediate referral to a specialized smoking cessation clinic more than doubled the likelihood of quitting at one year compared to usual care (25.8% vs. 10.1% quit rates). Patients without comorbidities and those with a history of exacerbation-related hospitalizations were also more likely to successfully quit, suggesting that structured cessation pathways integrated into routine COPD care can significantly improve cessation outcomes.
Mansoor J, Shakil M, Aqil H, et al. BMJ Open. 2026. PubMed
Summary
Healthcare providers in Karachi, Pakistan showed moderate knowledge and favorable attitudes toward smoking cessation counseling using the 5A approach (Ask, Advise, Assess, Assist, Arrange), but their actual practice of these techniques remained suboptimal. Key barriers included patient unwillingness to quit and limited access to cessation resources, while providers identified behavioral counseling, motivational interviewing, and structured training in the 5A framework as their top learning needs to improve implementation.
Watanabe C, Inagaki K, Watanabe Y, et al. Tob Induc Dis. 2026. PubMed
Summary
A survey of 642 female dental hygienists in Japan found a low smoking prevalence of 1.6%, yet approximately 71% held misconceptions about tobacco and nicotine dependence. Only about half of dental hygienists in clinical practice provided smoking cessation support to patients with periodontal disease, suggesting that enhanced tobacco education and training could strengthen their role in supporting patient cessation efforts.
Bartlett GE, York S, Harrison NJ, et al. Aust N Z J Public Health. 2026. PubMed
Summary
Expert stakeholders in Australia identified and prioritized 19 smoking cessation strategies for integration into the national lung cancer screening program, with 12 strategies ultimately recommended for implementation. The priorities span four main areas: delivery mechanisms, equity considerations, policy requirements, and research needs, with recommendations ranging from readily implementable interventions to those requiring long-term systems-level policy changes. These expert-identified priorities provide actionable guidance for embedding cessation support into lung cancer screening to improve participant outcomes.
Kumar R, Gupta R, Sinha P, et al. Monaldi Arch Chest Dis. 2026. PubMed
Summary
The National Tobacco Quitline Services in New Delhi provided telephone-based cessation support to over 505,000 tobacco users between 2016 and 2024, achieving quit rates of 30.53% for smokeless tobacco users and 28.39% for smoking users. Quit rates varied significantly by demographic factors, with adults aged 55+ showing the highest quit success, while young adults (18-24 years) had the highest engagement rates, and government sector employees demonstrated the most consistent cessation efforts.
Campagna D, Cucuzza F, Russo C, et al. Intern Emerg Med. 2026. PubMed
Summary
Emergency departments encounter high numbers of smokers presenting with acute smoking-related conditions, representing a critical opportunity for intervention. Brief counseling combined with medication support and structured follow-up can improve quit rates, but widespread implementation faces barriers including funding constraints, staffing limitations, and poor integration into routine ED workflows. Future evidence is needed through implementation trials to determine whether embedding cessation services in emergency care can sustainably reduce smoking-related harm across diverse healthcare settings.
Sadh P, Sheth S, Sharma M, et al. Spine (Phila Pa 1976). 2026. PubMed
Summary
A retrospective study of 242 cervical spine surgery patients found that smoking significantly reduced the advantages of disc replacement (ACDR) over fusion (ACDF) surgery, with benefits like lower reoperation rates and better physical health outcomes only present among non-smokers. The findings suggest that smoking status should be considered when selecting between surgical procedures and underscore the importance of smoking cessation as part of preoperative surgical planning and counseling.
Japuntich S, Adkins-Hempel M, Sacasa NG, et al. Community Ment Health J. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
A pilot study tested whether a certified community behavioral health clinic could successfully implement proactive smoking cessation treatment for clients with mental health and substance use disorders. The intervention combined staff training in the 5As approach (ask, advise, assess, assist, arrange follow-up) with proactive outreach calls offering cessation support, and was found to be feasible and acceptable to both clients and providers, though the 12-month quit rate was modest at 8%.
He AWJ, Wong NT, Wang MP, et al. Tob Control. 2026. PubMed
Summary
A secondary analysis of two randomized trials in Hong Kong found that smoking cessation outcomes significantly worsened after early COVID-19 policy changes in January 2020, with 6-month biochemically validated quit rates dropping from 12.3% to 6.8%. The findings highlight how public health emergencies can disrupt smoking cessation services and underscore the importance of implementing adaptable support systems, such as telehealth counselling and continued access to quit-smoking medications, to maintain cessation success during crises.
Cihan FG, Küçükceran H, Demirbas N, et al. BMC Prim Care. 2026. PubMed
Summary
A long-term follow-up study of older adults (aged ≥60) in Türkiye who attended a smoking cessation clinic between 2015–2020 found that 36% of interviewed respondents reported not smoking 4.6–9.8 years later, though results were substantially limited by loss to follow-up. Among those still smoking at follow-up, 81% expressed willingness to attempt quitting again, suggesting ongoing potential for re-engagement with cessation services in older populations.
Moore JC, Cesar B, Davis J, et al. J Emerg Med. 2026. PubMed
Summary
Emergency physicians have a critical opportunity to screen, treat, and refer patients with nicotine use disorder, yet this care remains largely underutilized in emergency departments. An expert consensus panel recommends that all emergency department patients with nicotine use disorder be offered evidence-based medications, brief counseling, and referrals to outpatient follow-up care to reduce morbidity and mortality.
Cao P, Smith L, Tian E, et al. JAMA Netw Open. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers evaluated the cost-effectiveness of adding smoking cessation interventions to lung cancer screening programs using data from over 2,500 smokers across 4 clinical trials. Programs combining cessation support with screening were cost-saving compared to screening alone, with high-intensity pharmacotherapy paired with low-intensity counseling providing the best balance of health benefits and costs at roughly $991 per quality-adjusted life year gained.
Camarano J, Naquin J, Sorrentino Z, et al. J Neurosurg Spine. 2026. PubMed
Summary
Insurance policies for elective spinal fusion surgery often treat nicotine replacement therapy (NRT) the same as active smoking, despite limited evidence that therapeutic nicotine harms surgical outcomes. Approximately 62% of analyzed policies required smoking cessation, with 64% of these being unfriendly to NRT use, affecting about one-third of the US insured population. Clearer, evidence-based insurance language that distinguishes NRT from tobacco use could better support patient-centered smoking cessation and align insurance criteria with clinical practice.
Gruber LJ, Martinez Schramm L, Hoene G, et al. Int Dent J. 2026. PubMed
Summary
German dentists frequently ask patients about smoking (97%) and provide basic advice (88%), but rarely deliver structured cessation support such as counselling, goal-setting, or referrals to other services. High motivation to provide cessation counselling was present in only 19% of dentists and was strongly associated with perceived preparedness, clear professional role understanding, and belief in their ability to influence patient behaviour, suggesting that training and system-level support could significantly expand dentists' role in smoking cessation.
Kuikel BS, Shrestha A, Adhikari B, et al. BMJ Public Health. 2026. PubMed
Summary
Among 375 current smokers attending a tertiary hospital in Nepal, 72.5% reported intention to quit smoking, though most were in the early pre-contemplation stage. Key factors associated with higher quit intention included higher education level and moderate nicotine dependence, while having family members who smoke reduced the likelihood of intending to quit. The findings suggest that outpatient cessation programmes in Nepal should include brief healthcare provider advice, quit-line services, and family-focused education to support smokers across different stages of readiness to quit.
Daharlı E, Daharlı C. Thorac Res Pract. 2026. PubMed
Summary
Healthcare professionals working in smoking cessation clinics in Türkiye identified multiple barriers to effective service delivery, including low patient motivation, poor follow-up adherence, heavy workloads, limited consultation time, and inadequate multidisciplinary support and medication access. Professionals sustained their motivation through observing successful patient outcomes and employed strategies such as individualized counseling and digital follow-up systems. Recommendations for improving cessation services include strengthening multidisciplinary teamwork, increasing institutional resources, expanding behavioral support, and enhancing public awareness about smoking cessation.
Bevin N, Aye PS, Harrison NJ, et al. Drug Alcohol Rev. 2026. PubMed
Summary
Integrating intensive smoking cessation services directly into lung cancer screening programs—combining multi-session behavioural support with medications—produces higher quit rates than brief interventions, particularly when delivered immediately or at the same location as screening. For Aotearoa New Zealand, designing these integrated programs with culturally safe, whānau-centred, and Māori-led approaches is essential to address the disproportionate burden of smoking-related disease and lung cancer among Māori populations.
Rich JL, Segan CJ, Trigg J, et al. Drug Alcohol Rev. 2026. PubMed
Summary
Quitline counsellors in Australia shared their experiences supporting clients with substance use disorders who were trying to quit smoking using nicotine vaping products or combination nicotine replacement therapy. Counsellors identified key success factors including adequate training and organizational support, the importance of continuity of care between residential treatment and community follow-up, and the need to address the complexity of supporting people managing multiple addictions simultaneously. The findings suggest that Quitline services can effectively partner with addiction treatment providers and research teams to deliver evidence-based smoking cessation support for this vulnerable population.
Cessation—Pharmacotherapy(11)
Chellian R, Huisman G, Caglayan L, et al. Front Pharmacol. 2026. PubMed
Summary
Researchers tested how different nicotine receptor-targeting drugs affect impulsive decision-making in rats self-administering nicotine using a Go/No-Go task. Mecamylamine, a nicotine receptor blocker, selectively reduced impulsive responding during the task, while varenicline and nicotine itself produced only general reductions in activity rather than specifically improving impulse control. These findings suggest that blocking nicotine receptors may help reduce the impulsive behavior patterns that contribute to tobacco dependence and relapse.
Edvardsson CE, Emous TA, Witley S, et al. Br J Pharmacol. 2026. PubMed
Summary
Tirzepatide, a dual GIP/GLP-1 receptor agonist medication, reduced nicotine-induced reward behaviours and dopamine release in the brain of male mice across multiple measures, including locomotor stimulation, conditioned place preference, and reinstatement of nicotine-seeking. These findings suggest tirzepatide may have potential as a pharmacological treatment for nicotine dependence by targeting reward pathways associated with nicotine addiction.
Lu D, Chen L, Tang C. Front Med (Lausanne). 2026. PubMed
Summary
A case report documents a patient who developed acute urticaria (hives) after consuming excessive amounts of nicotine-containing smoking cessation lozenges. While the authors suggest a possible link between nicotine overdose and the urticaria symptoms, they acknowledge this association cannot be confirmed from a single case. This report highlights a potential adverse reaction to consider when counseling patients on appropriate use of nicotine replacement therapy products.
Mutlu HH, Erdem F, Mutlu HH. Healthcare (Basel). 2026. PubMed
Summary
In a real-world smoking cessation study of 487 smokers in Turkey, combination therapy with bupropion plus nicotine replacement therapy was more effective than cytisine alone, achieving a 3-month quit rate of 32.2%. However, patient characteristics such as higher education level, prior quit attempts, and longer periods of previous abstinence were stronger predictors of success than the choice of medication, suggesting that individualized behavioral support remains crucial alongside pharmacotherapy in cessation programs.
Jones J, Redding J, Amador E. J Psychopharmacol. 2026. PubMed
Summary
A small pilot study examined whether ketamine, combined with motivational enhancement therapy, could help people quit smoking. All seven participants completed the treatment sessions, which were well-tolerated, and the study found reductions in cigarette consumption and nicotine craving, though withdrawal symptoms and motivation to quit remained stable. These preliminary results suggest ketamine-enhanced psychotherapy warrants further investigation as a potential addition to smoking cessation treatments.
Hu SS, Zhang CF, Lkhagvasuren B, et al. CNS Neurosci Ther. 2026. PubMed
Summary
Nicotine withdrawal increases pain sensitivity (hyperalgesia) by disrupting brain chemicals that regulate pain perception, which can worsen postoperative pain and increase opioid use in people quitting smoking. Nicotine replacement therapy effectively reduces this withdrawal-related pain hypersensitivity and could improve pain management outcomes for smokers undergoing surgery or attempting cessation.
Strandberg L, Fernandes TP, Shoshina II, et al. Braz J Psychiatry. 2026. PubMed
Summary
Researchers compared smoking cessation outcomes between people receiving psilocybin-assisted treatment and standard care, finding that psilocybin was associated with greater reductions in smoking and cravings at early timepoints. However, psilocybin did not significantly improve verified abstinence rates when other factors were accounted for, whereas early reductions in cravings themselves were strongly associated with successful long-term abstinence regardless of treatment type.
Sala Tenna B, Christmass M. J Dual Diagn. 2026. PubMed
Summary
A quality improvement project in a psychiatric inpatient unit demonstrated that staff education about nicotine replacement therapy (NRT) significantly increased the proportion of patients receiving NRT within 24 hours (from 63.6% to 86.7%) and receiving adequate doses (from 14.6% to 70%). Patients who received timely and adequate NRT showed reduced agitation and aggressive behaviors associated with nicotine withdrawal.
Emvalomenos GM, Gu Q, Kim SJ, et al. Nicotine Tob Res. 2026. PubMed
Summary
Researchers used brain imaging to confirm that men and women respond differently to smoking, with men showing more reward-driven dopamine responses in the ventral striatum and women showing more habit- and stress-related responses in the caudate region. When using a nicotine patch, men showed a greater reduction in dopamine activation compared to women, suggesting that nicotine replacement therapy may work differently by sex—a finding that could help explain why nicotine patches are generally less effective for women trying to quit smoking.
Cheng A, Wang M, Gao Y, et al. J Med Econ. 2026. PubMed
Summary
A cost-effectiveness analysis in China compared personalized smoking cessation treatment guided by nicotine metabolite ratio (NMR)—a biomarker that reflects how quickly the body metabolizes nicotine—against standard care. The analysis found that matching fast metabolizers to varenicline and slow metabolizers to bupropion was economically favorable compared to standard care, though health gains were modest (0.003 additional QALYs). The findings suggest potential value in implementing metabolism-informed treatment selection, though researchers recommend further real-world implementation and budget-impact studies before routine adoption.
Jalali S, McBride H, Maser J, et al. Drug Alcohol Depend. 2026. PubMed
Summary
A post-hoc analysis of a cocaine use disorder treatment trial found that clavulanic acid (a β-lactamase inhibitor) was associated with reduced cigarette smoking in participants with low adverse childhood experiences (ACE scores 0-3), but unexpectedly increased smoking in those with high ACE scores (4+). This exploratory finding suggests that clavulanic acid's potential effects on smoking behavior may depend on individuals' trauma history, warranting further research to understand this differential response.
Cessation—Pregnancy(13)
Barrera B, Ahmed F, Brand T, et al. Public Health Rev. 2026. PubMed
Summary
This systematic review of 58 studies examined behavioral and psychosocial smoking cessation interventions for pregnant people, with a focus on approaches tailored to vulnerable populations and involving expectant fathers. Individual counseling proved most effective for maternal smoking cessation, while socioeconomically inclusive interventions showed the strongest results among vulnerable subgroups. Father-directed interventions were highly effective for paternal cessation, though involving fathers did not significantly improve pregnant people's quit rates.
Tatton C, Melendez-Torres GJ. Tob Use Insights. 2026. PubMed
Summary
A systematic review analyzed how smoking cessation interventions for pregnant people were tailored to address health disparities, examining 54 randomized controlled trials. While tailored interventions showed effectiveness for both quitting during pregnancy and staying smoke-free after birth, the analysis could not pinpoint which specific tailored components were most responsible for success, though the framework identified promising approaches including adapted communication, habit-building support, social network involvement, and removal of practical barriers to care.
Allen AM, Baurley J, Linde-Krieger LB, et al. Drug Alcohol Depend Rep. 2026. PubMed
Summary
A prospective study of 46 pregnant and postpartum women who used nicotine examined how reproductive hormones influence craving and use during the perinatal period. Higher oxytocin during pregnancy and greater declines in oxytocin around delivery were associated with increased craving and use, while lower estradiol postpartum was linked to more craving and continued use. These findings suggest that hormonal changes during pregnancy and after birth may be important drivers of nicotine dependence in this population and could inform future intervention strategies.
Porto L, Ordean A, Morin C, et al. J Obstet Gynaecol Can. 2026. PubMed
🍁 Canadian
Summary
This guideline provides evidence-based recommendations for screening and managing nicotine use among pregnant individuals and those planning pregnancy, covering combustible tobacco, e-cigarettes, and smokeless tobacco. Key recommendations include routine screening, behavioural counselling as first-line treatment, cautious use of nicotine replacement therapy or other medications when needed, and continued support postpartum to prevent relapse. Implementation of these recommendations aims to improve cessation rates during pregnancy and reduce adverse maternal and neonatal outcomes.
Gulley T, Hammer D, Jarvill M, et al. Matern Child Health J. 2026. PubMed
Summary
Pregnant women who perceived greater risks from smoking tobacco were significantly less likely to smoke during pregnancy, with each unit increase in perceived risk associated with a 4% lower likelihood of current tobacco use. Maternal-fetal attachment and perceived stress were not found to be predictive factors for smoking status. These findings suggest that healthcare providers may be able to enhance smoking cessation interventions during pregnancy by focusing on patients' personal risk perceptions related to tobacco use.
Sharma E, Powers JM, Maloney S, et al. Nicotine Tob Res. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Among pregnant people who smoked cigarettes before pregnancy, approximately 80% attempted to quit or reduce smoking during pregnancy, with 43.6% successfully quitting. However, menthol cigarette use prior to pregnancy was not associated with differences in quit attempts, successful cessation, or postpartum return to smoking. These findings suggest that smoking cessation interventions for pregnant people should prioritize behavioral and contextual factors rather than focusing on cigarette type alone.
Thimkorn P, Booncharoen C, Chaipitak P, et al. Addict Behav. 2026. PubMed
SR
Summary
A systematic review of 11 randomized controlled trials found that combining nicotine patch and gum, as well as e-cigarette use, significantly improved smoking cessation rates in pregnant women compared to usual care. Nicotine gum was also associated with improved birth outcomes, including higher birthweight and lower preterm birth risk, though the researchers noted that findings are based on a limited number of studies and more high-quality research is needed.
Osibogun O, Jebai R, Li W, et al. Nicotine Tob Res. 2026. PubMed
Summary
Heavy alcohol consumption is strongly associated with e-cigarette, cigarette, and dual tobacco use among females of reproductive age, with pregnancy significantly amplifying these associations. Pregnant females who consume alcohol heavily show substantially higher rates of all tobacco product use compared to non-pregnant females with similar alcohol consumption. Healthcare providers should implement comprehensive substance use screening and integrated cessation interventions for pregnant females and those of reproductive age to reduce compounded risks of adverse maternal and fetal outcomes.
Jones E, Casey A, MacArthur C, et al. Nicotine Tob Res. 2026. PubMed
Summary
Healthcare professionals in England who support pregnant women with mental illness in smoking cessation reported significant barriers, including prioritizing mental health concerns over smoking cessation and doubting whether these women could successfully quit. Key facilitators for improving support included integrating smoking cessation services within maternity and mental health settings, offering flexible appointment timing, and ensuring healthcare providers have adequate training on communicating smoking harms and understanding the relationship between smoking and mental health.
Binder A, Kuitunen-Paul S, Burke M, et al. Nicotine Tob Res. 2026. PubMed
Summary
Health-care professionals (gynecologists, midwives, and social workers) perceive traditional cigarettes as slightly more harmful than e-cigarettes during pregnancy, yet they assess and counsel on e-cigarette use far less frequently than cigarette smoking. Professionals with greater knowledge about tobacco and nicotine products reported higher risk perceptions and more frequent assessment and counseling, suggesting that targeted, profession-specific training programs could improve consistent screening and cessation support for pregnant patients using either tobacco or vaping products.
Igoe H, Emery J, Naughton F, et al. Nicotine Tob Res. 2026. PubMed
Summary
Using data from two UK clinical trials involving 1,409 pregnant women, researchers identified distinct predictors for quit attempts versus successful abstinence. While intention to quit and self-efficacy were key drivers for attempting to quit, the strongest predictors of actual smoking abstinence were reducing cigarette consumption early in pregnancy and having a previous quit attempt lasting more than 6 weeks. These findings suggest that support strategies for pregnant women should emphasize early behavioral changes and leverage past quitting experiences to achieve sustained abstinence.
Barnes LAJ, Longman J, Gersh VL, et al. Nicotine Tob Res. 2026. PubMed
Summary
Australian postpartum women were interviewed about what support they would need to quit smoking or vaping or stay quit, with responses tracked over the first year after birth. Women who had successfully quit identified babies and children as motivators, those who relapsed emphasized the importance of tobacco pricing and regulation, and stress was commonly cited as a barrier among those who never quit or had relapsed. Many women reported uncertainty about what support would help, highlighting a need for more proactive, tailored cessation approaches during the postpartum period.
Bryant J, Hitching R, Clapham M, et al. Nicotine Tob Res. 2026. PubMed
Summary
Among Aboriginal and Torres Strait Islander women in Australia, 56% did not smoke during pregnancy and 13% quit smoking during pregnancy. Key factors associated with smoke-free pregnancies included being older, married or in a de facto relationship, being a private patient, attending more antenatal care visits, and beginning antenatal care earlier—suggesting that targeted interventions focusing on younger and unmarried women, as well as improving early and consistent antenatal care access, could help increase smoking cessation rates in this population.
Cessation—Youth(7)
Hoo Chuin Shen M, Gabriel MM, Wilde N, et al. Arch Dis Child. 2026. PubMed
Summary
This scoping review identified only eight studies of vaping cessation interventions for youth under 18 years delivered in healthcare settings, all from North America. Most interventions combined behavioural support with nicotine replacement therapy and achieved quit rates between 16.7% and 37%, but uptake of cessation support was consistently low and no structured cessation pathways have been tested in routine clinical practice. The review highlights an urgent need for adequately powered trials, evaluation of clinical pathways, and research across different healthcare systems to address this emerging gap in youth vaping cessation care.
Lee H, Lim IJ, Lee H, et al. Subst Use Misuse. 2026. PubMed
Summary
Researchers identified six distinct psychosocial profiles among Korean adolescents, finding that a subgroup characterized by weak negative attitudes toward smoking and low perceived risk had the highest smoking rates (21.4%), despite overall low adolescent smoking prevalence in South Korea. Prevention programs may be more effective when they strengthen comprehension of anti-smoking messages, provide practical family support, and address emotional distress, rather than focusing solely on refusal self-efficacy or peer influence.
Vranken S, Geusens F, Greene K, et al. Health Commun. 2026. PubMed
Summary
A media literacy intervention where adolescents (ages 13-15) designed their own counter-campaigns was tested to change attitudes toward cigarettes and e-cigarettes. The intervention showed promising delayed effects, particularly for e-cigarettes, with improvements in social norms, attitudes, and willingness to use persisting up to 6 months after the program, though effects varied by product type and gender.
Özkol O, Gür K. J Child Adolesc Trauma. 2026. PubMed
Summary
Among adolescent survivors of the 2023 Türkiye earthquakes, those who smoked reported significantly lower perceived social support compared to non-smokers. The study found that stronger family support was particularly associated with better sleep quality and lower rates of insomnia, suggesting that social support may be a protective factor against both smoking and sleep problems in trauma-exposed youth.
Stubbendorff A, Borgfors A, Bolmsjö BB, et al. Acta Psychol (Amst). 2026. PubMed
Summary
Among adolescent girls aged 15-19, daily nicotine use was associated with higher fatigue and lower quality of life, independent of iron deficiency status. Heavy menstrual bleeding and meal skipping also contributed significantly to fatigue. These findings suggest that addressing behavioral and menstrual health factors may be more effective than focusing on iron status alone when managing fatigue in this population.
Simpson VL, Levy T, Esquenazi-Karonika S, et al. Drug Alcohol Depend. 2026. PubMed
Summary
Among U.S. youth who use tobacco, those who also vaped cannabis in the past 30 days were significantly less likely to intend to quit smoking and showed greater signs of nicotine dependence, including more intense cravings and smoking within 30 minutes of waking. These findings suggest that concurrent cannabis vaping may undermine tobacco cessation efforts in young people and should be considered when designing youth smoking cessation programs.
Park JY, Koh SJ. J Subst Use Addict Treat. 2026. PubMed
SR
Summary
A meta-analysis of five randomized controlled trials involving 717 youth and young adults (ages 12–26) found that varenicline was nearly twice as effective as placebo, bupropion, or nicotine patches for achieving smoking abstinence, with safety profiles comparable to alternative treatments. These findings suggest varenicline warrants consideration as a cessation option for young people, including those using e-cigarettes, though further clinical trials in adolescents are needed to confirm effectiveness and safety in younger age groups.
E-cigarettes—Addiction/Dependence(4)
Figueroa W, Ferketich AK, Breitborde N, et al. Drug Alcohol Depend. 2026. PubMed
Summary
Young people aged 14-25 who use e-cigarettes and experience psychological distress (anxiety and depression) were more likely to develop nicotine dependence. The study found that perceived psychological rewards from e-cigarette use—such as feeling calmer, less irritable, or better able to concentrate—partially explained this relationship. These cross-sectional findings suggest that addressing psychological distress may be an important consideration in efforts to reduce nicotine dependence among youth, though further research is needed to establish cause-and-effect relationships.
Cooper M, Peng MQ, Park-Lee E, et al. J Adolesc Health. 2026. PubMed
Summary
Youth who use e-cigarettes containing nicotine salts are significantly more likely to experience nicotine dependence symptoms, including cravings and the urge to use tobacco within 30 minutes of waking, compared to those using non-nicotine salt e-cigarettes. Nicotine salt users also reported more frequent e-cigarette use (20+ days per month). These findings highlight that the formulation of nicotine salts—which produces higher blood nicotine levels—poses a greater addiction risk for adolescent users.
Vilches JR, Guillot CR. Eval Health Prof. 2026. PubMed
Summary
Researchers developed and tested a new 27-item questionnaire called the Multidimensional Vaping Dependence Index (MVDI) to measure vaping dependence across three dimensions: preoccupation with vaping, reinforcement from vaping, and loss of control over vaping use. The tool demonstrated strong validity and reliability in a study of 530 regular adult vapers, and was able to predict vaping frequency, nicotine concentration preferences, and self-perceived addiction better than existing measures.
Maddox SK, Mensah EN, Young LE, et al. Neuropsychopharmacology. 2026. PubMed
Summary
Synthetic cooling agents WS-3 and WS-23, which are emerging substitutes for banned menthol in e-cigarettes, enhance nicotine's addictive properties by increasing dopamine release in the brain's reward center. These cooling agents produce effects comparable to menthol by increasing how readily mice self-administer nicotine and by amplifying dopamine signaling and changes in nicotine receptors in the brain.
E-cigarettes—Cessation(9)
Kasza KA, Mahoney MC, Anesetti-Rothermel A, et al. Tob Prev Cessat. 2026. PubMed
Summary
Among U.S. adults who smoked daily and had no plans to quit, those who adopted daily e-cigarette use were significantly more likely to reduce or stop smoking cigarettes compared to those who did not use e-cigarettes. However, only 2% of the study population took up daily e-cigarette use, suggesting that while e-cigarettes may facilitate smoking reduction among some resistant smokers, uptake of regular e-cigarette use remains limited in this population.
Le TTT, Sverdrup E, Sun R, et al. medRxiv. 2026. PubMed
Summary
Researchers analyzed data from smokers followed over six years to examine whether vaping frequency affected their ability to quit cigarettes. Daily vaping was associated with a 12.5 percentage-point higher likelihood of smoking abstinence compared to non-vaping, while infrequent vaping (1-5 days per month) showed no significant benefit for quitting; the association between vaping and cessation increased with frequency of use.
Nathwani AA, Kundu A, Schwartz R, et al. Tob Induc Dis. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
A smartphone cessation app analysis of 360 vaping users identified past-month vaping frequency as the strongest independent predictor of relapse, with higher frequency associated with increased relapse risk. While other measures like puffs per session and pod depletion time showed some predictive value individually, only past-month vaping frequency remained significant when all usage measures were considered together. These findings suggest that frequency of use should be prioritized as a key assessment metric in vaping cessation interventions and research.
Kaufman A, Gibson L, Mayne RG, et al. Prev Med. 2026. PubMed
Summary
Most U.S. adults (57.4%) are uncertain whether non-cigarette tobacco products can help people quit smoking, while about one-fifth believe they can and one-fifth believe they cannot. People who have ever used e-cigarettes or modified risk tobacco products are significantly more likely to believe these products can aid cessation, highlighting the need for clearer public communication about evidence-based smoking cessation methods.
Coyne R, Zhang M, van der Spek L, et al. Tob Prev Cessat. 2026. PubMed
Summary
A rapid review of 23 studies examining vaping and non-combustible nicotine cessation interventions found that existing programs perform best in demonstrating relevance and effectiveness, but fall short in stakeholder collaboration and long-term sustainability. Users prefer digital, flexible interventions that offer social support and require minimal burden, suggesting that future cessation services should prioritize accessibility and user autonomy while strengthening partnerships across sectors.
Reid G, Nightingale G, Maani N, et al. J Public Health (Oxf). 2026. PubMed
Summary
Researchers developed a new statistical method called the 'Test for Dominance' to identify when a single study has an outsized influence on the results of a systematic review. When applied to a review of e-cigarettes for smoking cessation, they found that one study (Hajek et al.) was driving the overall findings, suggesting the review's conclusions should be interpreted cautiously. The authors recommend this new test be used alongside existing quality checks to strengthen how we evaluate evidence on contested topics like e-cigarette effectiveness.
Moore E, Gillespie D, Simonavičius E, et al. Addiction. 2026. PubMed
Summary
England's Swap to Stop scheme distributed free e-cigarette starter kits alongside behavioural support through local authorities to help people quit smoking. The program achieved a 34.3% four-week quit rate at a product cost of £113 per quit, with regional uptake varying considerably and services successfully targeting socioeconomically disadvantaged groups and people with mental health conditions. Early results suggest the scheme is cost-comparable to other cessation programs, with potential for expansion and improved targeting of priority populations.
Poliakova N, Bouchard R, Haddad S, et al. Addict Behav. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Over half of adolescents who attempted to quit vaping reported experiencing barriers to cessation, with addiction, mood control difficulties, and fear of failure being most common. Females and older teens faced significantly more barriers and were less likely to achieve abstinence, while youth experiencing material deprivation or using other tobacco products also reported higher barrier scores, indicating that tailored cessation support is needed across different adolescent populations.
Aihemaiti A, Xie Y, Su Z, et al. J Addict Med. PubMed
Summary
A systematic review of 7 studies with 1,161 participants examined pharmacological treatments to help people quit e-cigarettes. Varenicline (a prescription medication used for smoking cessation) showed effectiveness for e-cigarette cessation, while nicotine replacement therapy did not demonstrate statistically significant benefits. The researchers concluded that while varenicline is promising, more rigorous studies are needed before firmly recommending these medications for e-cigarette cessation.
E-cigarettes—Co-use(8)
Huh Y, Kim HR, Lee JA, et al. Tob Control. 2026. PubMed
Summary
A large South Korean study of 7.26 million adults found that while heated tobacco products and e-cigarettes were associated with increased combustible cigarette cessation, they were also linked to higher rates of cigarette initiation and relapse, and lower rates of complete tobacco product discontinuation. Users of multiple tobacco products were particularly unlikely to achieve full cessation, with over 70% of dual users of cigarettes and heated tobacco products reverting to exclusive cigarette use.
Hollingworth D, Fozard TE, Kolokotroni KZ. Psychopharmacology (Berl). 2026. PubMed
Summary
This study compared personality traits and decision-making patterns across non-users, cigarette-only smokers, e-cigarette-only users, and dual users (cigarettes and e-cigarettes). Researchers found that vaping is associated with sensation-seeking and poor impulse control around nicotine cues, while smoking is linked to negative emotions driving use; dual users showed a particular vulnerability to immediate rewards (both monetary and cigarette-related) and reduced ability to inhibit responses to nicotine cues, suggesting they may be at higher risk of continued dual use.
Lüthgen M, Burgard A, Truempelmann M, et al. Vasc Med. 2026. PubMed
Summary
Among 444 school-aged adolescents (median age 15 years), those who used both cigarettes and e-cigarettes together had significantly higher diastolic blood pressure compared to peers with infrequent or no nicotine use. This finding suggests that combined exposure to combustible and electronic nicotine products may cause vascular changes earlier in adolescence than previously recognized, highlighting an emerging cardiovascular health concern in youth.
Xu L, Zhang S, Elsaid M, et al. Subst Use Misuse. 2026. PubMed
Summary
Among U.S. adolescents and young adults aged 15-21 who use or are susceptible to cannabis, researchers used a best-worst scaling method to compare preferences for cannabis, alcohol, and nicotine products. Cannabis edibles and alcohol were most preferred while traditional cigarettes were least preferred; however, e-cigarettes and oral nicotine pouches were more favored than cigarettes. The findings highlight both substitution away from combustible tobacco and complementary use patterns with cannabis and alcohol, indicating a need for integrated regulatory approaches addressing multiple substance use.
Brouwer AF, Roberts OK, Jeon J, et al. Am J Prev Med. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Using data from 2021-2024, researchers tracked how U.S. adults transition between cigarettes, e-cigarettes, and dual use. The study found that dual use is becoming more persistent, with fewer people moving away from using both products, while e-cigarette adoption continues to be driven primarily by young adults. These trends suggest the need for targeted public health efforts to address persistent dual use and support smoking cessation, particularly among older adults.
Jo D, Mayorga NA, Smit T, et al. Subst Use Misuse. 2026. PubMed
Summary
Researchers developed and validated a new measurement tool called the Stress Burden of Electronic Cigarette Smoking Scale (SBECSS) to assess stress related to e-cigarette use and quit attempts among adults who use both traditional cigarettes and e-cigarettes. The scale was tested with 400 dual users and showed strong reliability and validity, demonstrating it can effectively measure the psychological burden associated with e-cigarette use and cessation efforts in this population.
Streck J, Regan S, Chang Y, et al. Nicotine Tob Res. 2026. PubMed
Summary
A randomized controlled trial provided standardized e-cigarettes to 41 adults with opioid use disorder who were heavy smokers and not seeking to quit. Over 8 weeks, those receiving e-cigarettes reduced their daily cigarette consumption by more than half (from 15 to 7 cigarettes per day) compared to minimal reduction in the control group, with corresponding decreases in carbon monoxide exposure. Importantly, access to e-cigarettes did not worsen opioid withdrawal symptoms, nicotine dependence, or opioid use disorder stability.
Jo D, Heggeness LF, Jones AA, et al. J Dual Diagn. 2026. PubMed
Summary
Black adults who use both combustible cigarettes and e-cigarettes together (dual use) experience significantly higher rates of anxiety, depression, drug use problems, and hazardous drinking compared to those using cigarettes alone. This research suggests that dual users represent a particularly vulnerable population that may benefit from specialized mental health and substance use support services.
E-cigarettes—Health Effects(29)
Nata'atmadja BS, Fabian P, Lumintang LM. Arch Plast Surg. 2026. PubMed
Summary
This case report describes two instances of pneumothorax (collapsed lung) occurring in patients undergoing rib cartilage grafting for rhinoplasty surgery, with vaping identified as a potential risk factor. While pneumothorax from rib graft harvesting is rare, the authors emphasize that vaping may increase this risk and that clinicians should be aware of this complication and manage it appropriately through observation or chest tube placement.
Kruthika K, Aishwarya MU, Vaishnavi K, et al. Front Dent Med. 2026. PubMed
Summary
A scoping review of 10 studies examined how e-cigarette use affects periodontal (gum and tooth support) health compared to conventional smoking and non-smoking. While conventional cigarette smokers showed the most severe gum damage, e-cigarette users demonstrated intermediate periodontal problems including increased pocket depth, gum recession, and inflammation—suggesting e-cigarettes are not without risk to oral health, though potentially less harmful than traditional cigarettes. The review identifies several biological pathways (oxidative stress, immune dysfunction, impaired healing) through which e-cigarettes may damage periodontal tissues, highlighting the need for further research to better understand these effects.
Almeshari MA, Alrashdi AM, Almutairi AG, et al. Tob Induc Dis. 2026. PubMed
Summary
A systematic review of six studies examining whether long-term e-cigarette use causes airway inflammation found inconsistent results across studies, with a meta-analysis showing no significant difference in the inflammation marker FeNO between e-cigarette users and control groups. The findings highlight substantial variability in how e-cigarettes affect airway inflammation, underscoring the need for rigorous, long-term prospective studies to clarify the respiratory health impacts of sustained e-cigarette use.
Yamaga S, Tanigaki K, Sakanaka A, et al. Toxicol Rep. 2026. PubMed
Summary
Aerosol from heated tobacco products damages the protective barrier of gum tissue by reducing a key protein (CXADR) that maintains cell-to-cell connections. This barrier damage allows harmful bacterial components to penetrate gum tissue more easily, potentially increasing the risk of gum disease. The findings suggest heated tobacco products pose similar periodontal health risks as conventional smoking despite being marketed as alternatives.
Faisal A, Giles A, Jones S, et al. ERJ Open Res. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Young adult e-cigarette users showed significantly reduced exercise capacity, oxygen uptake, and ventilatory efficiency comparable to conventional cigarette smokers, with both groups experiencing impaired vascular function (reduced blood vessel flexibility) and higher symptoms of breathlessness and leg discomfort during exercise compared to never-smokers. Despite similar nicotine exposure between e-cigarette and conventional cigarette users, both demonstrated early cardiovascular and respiratory harms after at least 18 months of use.
Pape T, Pak O, Graalmann T, et al. Respir Res. 2026. PubMed
Summary
Researchers found that nicotine-containing e-cigarette vapor damages the cells lining blood vessels and increases lung fluid accumulation, particularly when combined with bacterial infection markers. A novel drug called PMC-403 showed promise in protecting against this damage in laboratory and lung tissue models, suggesting it could potentially be developed as a treatment for acute lung injury caused by e-cigarette exposure.
Hori A, Taniyama Y, Okazaki H, et al. Sleep Health. 2026. PubMed
Summary
A study of over 12,000 Japanese workers found that exclusive heated tobacco product users and those who used both heated tobacco products and cigarettes experienced longer time to fall asleep and more frequent sleep disturbances compared to never smokers. These findings suggest that heated tobacco products, despite being marketed as less harmful than cigarettes, may have negative effects on sleep quality similar to or potentially greater than combustible cigarettes.
El Khalki L, Wang KW, Woranam K, et al. Am J Respir Cell Mol Biol. 2026. PubMed
Summary
Researchers exposed human lung cells and tissue from organ donors to cinnamon roll-flavored e-cigarette aerosol containing nicotine and found that it damaged mitochondria (the cell's energy centers) and triggered a specific type of cell death called ferroptosis in alveolar cells responsible for lung surfactant production. These findings suggest that vaping disrupts critical lung cell function through mitochondrial injury, which may contribute to vaping-associated lung damage.
Wittmann F, Nebert C, Ruthmeier T, et al. J Cardiovasc Dev Dis. 2026. PubMed
Summary
This narrative review examines the cardiovascular risks associated with electronic cigarette use, challenging the common perception that e-cigarettes are a safe alternative to traditional smoking. Despite industry marketing and initial optimism about their potential for tobacco cessation, accumulating evidence from laboratory and human studies demonstrates that e-cigarettes are associated with cardiovascular diseases, pulmonary conditions, and cancer. The review highlights particular concerns for cardiac surgery patients and identifies gaps in current research on e-cigarette health impacts.
Di Palo MP, Di Spirito F, Giordano F, et al. Dent J (Basel). 2026. PubMed
Summary
This systematic review of 31 studies examined how different smoking products affect gum and dental implant health. Cigarette smoking caused the most damage, followed by waterpipe smoking, while e-cigarettes and heated tobacco products showed intermediate harms—notably, e-cigarettes unexpectedly demonstrated the highest bone loss around teeth despite lower gum inflammation, suggesting these newer products are not risk-free alternatives to traditional cigarettes.
Adebisi YA, Cantone G, Bafail DA, et al. J Epidemiol Popul Health. 2026. PubMed
Summary
A population-based study of over 7,600 English adults found that chronic disease burden varies significantly across different nicotine-use patterns. Adults with current or past cigarette smoking—including exclusive smokers, former smokers, dual users, and former smokers now using e-cigarettes—had substantially higher rates of long-standing conditions compared to never-users. Notably, people currently using e-cigarettes who had never smoked did not show clear evidence of elevated disease burden, though this group was small and estimates were imprecise.
Gulati I, Kosgoda S, Kundu A, et al. Tob Induc Dis. 2026. PubMed
SR 🍁 Canadian 🔓 Open Access
Summary
A systematic review of 16 cross-sectional studies found that people who use e-cigarettes exclusively are 38% more likely to experience poor sleep health compared to never-users, with consistent findings across both adolescents and adults. This association suggests that vaping may negatively impact sleep quality and duration, highlighting a potential health consequence beyond nicotine dependence that warrants further investigation through longitudinal studies.
Solingapuram Sai KK, Brasky TM, Beckerich HJ, et al. Neuropsychopharmacology. 2026. PubMed
Summary
Researchers used PET imaging to compare how nicotine salt and free-base e-cigarettes deposit nicotine in the lungs and brain of adult vapers. Nicotine salts deposited significantly more nicotine deep in the lungs (lower respiratory tract), while free-base nicotine concentrated more in the mouth and throat, though both forms resulted in similar levels of nicotine reaching the brain. These differences in where nicotine deposits in the respiratory system could have important implications for long-term lung health risks from e-cigarette use.
Khanna N, Kwan CS, Klyushnenkova EN, et al. J Am Board Fam Med. 2026. PubMed
Summary
Among 260,149 adult patients screened at a U.S. medical system, ENDS (e-cigarette) use was associated with increased hospital visits for respiratory illnesses, with effects varying by age and race. Young adults (18-44) who used ENDS alone had nearly double the emergency department visits compared to never-users, while older adults (65+) who used ENDS had 2.4 times higher odds of inpatient admission. The increased healthcare utilization was even more pronounced among those using both ENDS and conventional tobacco products.
Guruprasad P, Sivaram P, Putnam J. J Hand Surg Glob Online. 2027. PubMed
Summary
A large retrospective study compared surgical outcomes between adults who used non-tobacco nicotine products (e-cigarettes, nicotine pouches, oral nicotine devices) and those without nicotine dependence before undergoing elective hand surgery. Patients using non-tobacco nicotine products experienced significantly higher rates of wound dehiscence, blood clots/pulmonary embolism, and unspecified surgical site infections at 1, 3, and 6 months after surgery, suggesting that nicotine exposure from any delivery method may impair postoperative healing.
Hamdan AL, Ghzayel L, Sarkis V, et al. Laryngoscope. 2026. PubMed
Summary
E-cigarette smokers experience significantly higher rates of voice fatigue and shortness of breath while talking compared to non-smokers. The study found a moderate correlation between voice fatigue and dry mouth (xerostomia) in e-cigarette users, suggesting that vaping may impact vocal health through its effects on mouth moisture.
Phillips JA, Schwartz AV, Nguyen AD, et al. Mol Immunol. 2026. PubMed
Summary
Researchers used advanced spatial analysis techniques to examine how vaping affects immune cells (macrophages) in the lungs of male and female mice. Vaping caused significant reorganization of these immune cells into distinct regions with different characteristics, and importantly, males and females showed opposite patterns of immune dysfunction—males lost key antigen-fighting abilities while females showed abnormal lipid accumulation—suggesting vaping may damage lung health through sex-specific mechanisms that traditional analysis methods would miss.
Moore ML, Holle AM, Rankin WH, et al. Orthop J Sports Med. 2026. PubMed
Summary
A large study compared surgical complications after rotator cuff repair among nontobacco nicotine users (e.g., vaping products), tobacco smokers, and nonusers. While nontobacco nicotine users had slightly higher rates of one minor complication (adhesion lysis), they experienced significantly fewer serious complications, infections, and readmissions compared to tobacco smokers, and similar outcomes to nonusers for most major medical events.
Sullivan JYC, Huang HX, Heidmann JC, et al. Toxicol Sci. 2026. PubMed
Summary
Researchers compared how cigarette smoke and e-cigarette aerosol affect immune function and blood cell production using laboratory and animal models. Both products suppressed the body's inflammatory response to infection and caused lasting changes to bone marrow stem cells that favored production of myeloid cells (immune cells), potentially increasing risks for infections, heart disease, and blood cancers.
Kimura A, Easwaran M, Kiessling PT, et al. Laryngoscope. 2026. PubMed
Summary
Researchers exposed mice to e-cigarette aerosol after surgical vocal fold injury and found that e-cig exposure blunted normal wound healing responses compared to injury alone, particularly by reducing early inflammation and tissue remodeling markers. Although e-cigarettes are often perceived as safer than conventional cigarettes, these findings suggest that post-operative e-cig use after vocal fold surgery may interfere with essential healing processes needed to restore vocal fold structure and function.
Stevenson M, Wieczorek R, Sticken ET, et al. Mutagenesis. 2026. PubMed
Summary
Researchers compared the toxicological effects of next-generation nicotine products (heated tobacco, herbal products, and e-cigarettes) against conventional cigarette smoke using laboratory cell-based assays. All next-generation products showed reduced biological toxicity compared to cigarettes, with e-cigarettes producing no detectable cell stress responses, while heated tobacco and herbal products showed intermediate effects, suggesting these products may have lower harm potential than conventional smoking.
Alrawashdeh B, Abu Nassar R, Shlash O, et al. Eur Arch Otorhinolaryngol. 2026. PubMed
Summary
A cross-sectional study of 326 medical trainees in Jordan found no significant association between smoking (cigarettes, shisha, or vaping) and self-reported voice handicap, as measured by the Voice Handicap Index-10. The researchers noted that the lack of detected effects may reflect a floor effect in this young, healthy population, and they highlight the need for longitudinal studies with objective voice assessments to better understand early laryngeal impacts of smoking and vaping.
Vu Pham N, Dutta E, Nguyen TH, et al. Ann Epidemiol. 2026. PubMed
Summary
A large U.S. study found that people exposed to non-tobacco nicotine products (such as vaping devices) had more than twice the risk of developing cataracts compared to those without such exposure. Among patients diagnosed with cataracts, those with non-tobacco nicotine product exposure were nearly three times more likely to require cataract surgery within 5 years. These findings suggest that non-tobacco nicotine products may pose previously undocumented risks to eye health and warrant further investigation.
Tsalatsanis A, Johnson J, Abou-Assali O, et al. J Pediatr. 2026. PubMed
Summary
A large study of over 114,000 adolescents and young adults (ages 11-24) found that those who vape have significantly higher rates of heart rhythm abnormalities compared to non-vapers, with approximately twice the risk of developing these conditions. These findings suggest that e-cigarette use may cause harmful effects on the heart's electrical system in young people, pointing to a need for health interventions and ongoing monitoring of vaping's cardiac impacts in this population.
Derefinka A, Słowik J, Ćwirko H, et al. Food Chem Toxicol. 2026. PubMed
Summary
This interpretative review examined heavy metal contamination (including mercury, cadmium, lead, arsenic, nickel, and chromium) across traditional cigarettes, e-cigarettes, snus, and tobacco-free nicotine pouches. While alternative nicotine products may reduce exposure to combustion-related toxicants, users can still be exposed to harmful levels of heavy metals, particularly mercury which has been poorly studied. The findings underscore the need for standardized testing protocols and stronger regulatory oversight to monitor and control heavy metal contamination in all nicotine products.
Ernat JJ. Arthroscopy. 2026. PubMed
Summary
This editorial commentary highlights that while tobacco use is a well-established risk factor for rotator cuff surgery failure, the health impacts of newer nicotine products (such as e-cigarettes) on surgical outcomes remain largely unstudied. As non-tobacco nicotine product use increases, particularly among younger populations, orthopaedic surgeons need better evidence on how these products affect surgery complications and healing.
Florentino SA, Berk AN, Good LM, et al. Arthroscopy. 2026. PubMed
Summary
Among patients undergoing arthroscopic rotator cuff repair, those with nontobacco nicotine dependence (such as e-cigarette use) experienced significantly higher rates of serious perioperative complications within 90 days, including heart attack, stroke, and pneumonia, compared to non-nicotine users. Additionally, nontobacco nicotine users had markedly higher rates of needing repeat surgery within 2 and 5 years, suggesting that nontobacco nicotine products may impair surgical healing and increase postoperative risks.
Sailis AB. Toxicol Mech Methods. 2026. PubMed
Summary
This review examines how e-cigarette aerosols may disrupt multiple body systems involved in metabolism, including mitochondrial function, energy production, circadian rhythms, and brain regions controlling appetite and reward. Evidence from laboratory and animal studies suggests e-cigarette exposure can impair the body's ability to process energy efficiently and regulate blood sugar, potentially increasing metabolic disease risk—effects that extend beyond the lungs to affect whole-body health. However, key gaps remain regarding how these findings translate to real-world human exposure patterns and long-term health outcomes.
Grossmann T, Kirsch A, Gerstenberger C, et al. J Voice. 2026. PubMed
Summary
Researchers exposed human vocal fold cells to smoke extract from IQOS™ heat-not-burn devices under laboratory conditions to understand potential effects on voice health. Short-term exposure did not kill the cells and showed some reduced inflammatory responses at the gene level, but the clinical significance of long-term use remains unknown and requires further research to determine whether IQOS™ is truly less harmful than conventional cigarettes.
E-cigarettes—Products/Marketing(6)
Ciolino LA, Ranieri TL. J Forensic Sci. 2026. PubMed
Summary
Researchers analyzed commercially available synthetic THC vaping products and edibles collected between 2019-2024, developing laboratory methods to identify and quantify seven different THC isomers plus related cannabinoids (THCPs and HHCs). Products showed highly variable and sometimes extreme cannabinoid concentrations, with vaping liquids containing 25-96% THC by weight and individual gummies containing up to 791 mg of combined THC/HHC—far exceeding typical cannabis product potency and raising concerns given reported serious adverse events in both adults and children.
Ignatev A, Kale D, Sun H, et al. Nicotine Tob Res. 2026. PubMed
Summary
UK nicotine pouch retailers market their products primarily through affordability, convenience, and sweet flavours—messaging that may appeal to both adult smokers seeking alternatives and youth with no prior nicotine use. While most websites included addiction warnings, age verification safeguards were inconsistent, and promotional tactics such as student discounts and social media links were commonly used, raising concerns about youth normalization of nicotine use despite these products being potentially less harmful than cigarettes for adults who smoke.
Travis N, Warner KE, Hartmann-Boyce J, et al. Nicotine Tob Res. 2026. PubMed
SR 🍁 Canadian 🔓 Open Access
Summary
This scoping review of 73 new studies examines oral nicotine pouches (ONPs), a rapidly growing nicotine product, finding that their use among youth has slowly increased to 1.8–2.6% prevalence in 2024, while adult use remains low at 0.4–0.8%. ONPs deliver higher nicotine levels than cigarettes, are substantially less toxic, but marketing increasingly uses youth-appealing tactics via social media and online channels; evidence suggests they may reduce smoking in daily smokers but typically result in dual use rather than complete cessation, with long-term health effects remaining unclear.
Le Tu H, Oh JK, Seo HG, et al. J Prev Med Public Health. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
A Korean national survey found that people who use both cigarettes and alternative nicotine products (heated tobacco products or e-cigarettes) perceive these alternatives as significantly less harmful than cigarettes compared to cigarette-only users. Exposure to tobacco advertising was associated with lower perceived harm of these products, highlighting the need for stronger advertising regulation and targeted education to correct misperceptions about the relative risks of alternative nicotine products.
White AM, Eid T, Imran R, et al. Drug Alcohol Depend. 2026. PubMed
Summary
Researchers examined how much menthol a heated tobacco product (IQOS) delivers to the body and whether this affects users' willingness to switch from menthol cigarettes. Among menthol cigarette smokers, IQOS with menthol flavor delivered significantly higher menthol levels than the regular version, and participants were more likely to substitute the menthol IQOS for their own cigarettes. These findings suggest that menthol flavoring plays an important role in how appealing alternative tobacco products are to users, independent of nicotine delivery.
Besaratinia A. Public Health. 2026. PubMed
Summary
Oral nicotine pouches (ONP) are a rapidly emerging tobacco product marketed as "tobacco-free" and promoted to youth as less harmful alternatives, yet evidence on their safety and harm-reduction potential remains minimal or uncertain. The products contain nicotine plus various chemicals including trace amounts of toxic and carcinogenic compounds, and are widely promoted through social media marketing that often contains misinformation and easily circumvents age restrictions. Given the unknown long-term health effects and significant potential for youth addiction, researchers emphasize the urgent need for rigorous research, stricter regulation, and targeted prevention strategies to protect young people from this growing public health threat.
E-cigarettes—Youth/Adolescents(21)
Couch ET, Lieuw K, Castillo CG, et al. J Child Adolesc Subst Use. 2026. PubMed
Summary
Family dynamics significantly shape adolescent e-cigarette and cannabis use, with parents often unintentionally facilitating access or displaying more permissive attitudes toward these products compared to combustible tobacco. Adolescents employ various strategies to conceal their use from family members, including choosing small, odorless devices, suggesting that parental awareness and consistent rule-setting across all tobacco and cannabis products may be important intervention targets.
Hansen J, Neumann C, Hanewinkel R. Pneumologie. 2026. PubMed
Summary
Among 28,554 German adolescents surveyed in 2025/2026, disposable e-cigarettes were the most commonly used nicotine product (8.9% in the past 30 days), with prevalence roughly equal to conventional cigarettes and reusable e-cigarettes. Most notably, 84% of adolescent disposable e-cigarette users reported concurrent use of other nicotine products, with over one-third using at least two additional products simultaneously, indicating that multi-product use rather than single-product use is the dominant pattern among youth users.
Le TTH, Thi BTN, Luu XQ, et al. Tob Induc Dis. 2026. PubMed
Summary
Following Vietnam's January 2025 e-cigarette ban, a survey of 2,462 university students across four major cities found that 17.7% had ever used e-cigarettes and 3.3% were current users. E-cigarette use was significantly associated with male gender, conventional cigarette smoking, peer or family member use, and exposure to advertising, suggesting that despite the ban policy, continued efforts are needed to address youth e-cigarette use through surveillance and targeted interventions.
Li C, Zhang M, Zhao J, et al. Tob Induc Dis. 2026. PubMed
Summary
Among nearly 9,200 vocational college students in China, 2.05% reported current e-cigarette use, with higher rates among males, those with inadequate tobacco knowledge, and students exposed to parental smoking or smoking peers. The findings underscore how family smoking behaviors and social environments significantly influence e-cigarette adoption among young adults in media-related fields, suggesting that interventions should target modifiable factors like tobacco knowledge and address smoking-normalized settings.
Lim KK, Mahjom M, Awaluddin SM, et al. Tob Induc Dis. 2026. PubMed
Summary
Malaysian adolescent tobacco use patterns shifted dramatically between 2017 and 2022, with cigarette smoking dropping sharply from 4.9% to 0.9%, while e-cigarette use increased from 6.3% to 8.4%. Male adolescents, upper secondary students, and those with parents who use tobacco remained at highest risk across all tobacco product categories.
Acosta-Enriquez ME, Mendez-Dominguez NI, Moran-Martinez J, et al. BMJ Open. 2026. PubMed
Summary
A structured educational session on vaping risks, nicotine addiction, and proper e-cigarette disposal significantly improved vaping-related knowledge among Mexican university students, with gains increasing from an average score of 4.82 to 6.53 (out of 8) immediately after the intervention and remaining stable at 6.62 at 3-month follow-up. While the study demonstrates that educational interventions can effectively build vaping knowledge in young adults, the researchers note that future studies are needed to determine whether these knowledge improvements translate into actual changes in vaping initiation, use, or cessation behaviours.
Seif M, Moghaddam S, Kargar Jahromi H, et al. Subst Use Misuse. 2026. PubMed
SR
Summary
A systematic review of 60 studies involving over 92,000 students across the Eastern Mediterranean Region found that electronic nicotine delivery systems (ENDS) use is highly prevalent, with 21% current use and 24% lifetime use among youth. The analysis revealed a significant gender disparity with males using ENDS at nearly double the rate of females (28% vs. 14%), and countries with lower socioeconomic development showed substantially higher ENDS prevalence rates among students.
Kinouani S, Simon M, Tzourio C. Encephale. 2026. PubMed
Summary
This French study examined vaping of non-nicotine substances (particularly THC and CBD) among 206 university student vapers and found the practice to be uncommon, with only 5% reporting cannabinoid vaping. While no significant statistical association was found between past-year THC use and vaping cannabinoids, qualitative interviews with 30 daily vapers revealed that cannabinoid vaping was perceived as appealing mainly to heavy THC consumers, with most participants unaware of or not regularly practicing this behavior.
Anjorin O, Zumah F, Huynh A, et al. Health Promot Pract. 2026. PubMed
Summary
LGBTQ+ college students (ages 18-24) were engaged as co-researchers in a vaping prevention study through a participatory Youth Council approach. Participants valued the research experience and felt the council promoted inclusive outreach, though sustainability required ongoing faculty support, flexible scheduling, and digital engagement strategies.
Cavazos-Rehg PA, Li X, Paraboschi L, et al. J Psychoactive Drugs. 2026. PubMed
Summary
Young adults aged 15-25 who vape frequently show distinct risk perceptions depending on their use patterns: those vaping nicotine only were significantly more likely to perceive vaping as less harmful than smoking and had fewer health concerns, compared to those using nicotine and cannabis together. Despite two-thirds expressing interest in quitting, fewer than 5% had received any treatment, suggesting a substantial gap between motivation to quit and access to interventions tailored to these diverse user groups.
Weiger C, Gratale S, Wackowski O, et al. Health Commun. 2026. PubMed
Summary
A study of 1,366 youth non-users of e-cigarettes tested how humor in anti-vaping PSA ads affected message effectiveness and potential negative outcomes. Ads combining humorous text and imagery performed similarly to non-humorous ads without causing unintended consequences like reactance or anger, suggesting humor can be safely used in anti-vaping campaigns. However, pairing humor with less effective message themes (like flavors or industry manipulation) reduced perceived effectiveness and ad liking compared to non-humorous versions, indicating the need for pilot testing before broader dissemination.
Faleh Alsabil AH, Hamadneh S, Alhalabi MN. Int J Adolesc Med Health. 2026. PubMed
Summary
A survey of 500 university students in Northern Jordan found that 62% were current e-cigarette users, despite 57.4% expressing negative attitudes toward vaping. While nearly 62% of students had doubts about the safety and benefits of e-cigarettes, significant gender-based differences in attitudes were observed. The findings highlight the need for targeted educational programs to address misconceptions about vaping among young adults.
Soto-Martínez ME, Wallace RK, Bush A, et al. Paediatr Respir Rev. 2026. PubMed
Summary
An international pediatric respiratory health organization has issued a call to action for a global ban on e-cigarette sales, citing evidence that approximately 15 million young teenagers worldwide currently use these products and face exposure to toxic substances including carcinogens and synthetic nicotine compounds. E-cigarette use among adolescents is associated with respiratory disease, mental health problems, and significantly increased risk of transitioning to combustible cigarettes, with over one-third of nicotine-using high school students in the US reporting dual use of both products. The organization recommends comprehensive regulatory measures including sales bans, advertising restrictions, increased taxation, and youth-focused cessation services to address the influence of social media promotion, flavored products, and persistent misconceptions about harm.
Yoon H. Nurs Health Sci. 2026. PubMed
Summary
Among Korean adolescents with e-cigarette experience, drug use and violence-related hospitalization were strongly linked to suicidal ideation for both boys and girls. Girls who also smoked cigarettes showed elevated suicidal ideation risk, highlighting the need for gender-specific mental health and suicide prevention approaches tailored to adolescent e-cigarette users.
Lee J, Mattingly DT. Drug Alcohol Depend. 2026. PubMed
Summary
Among US youth aged 12-17, those who perceived their parents as limiting screen time had significantly lower odds of past-month nicotine vaping compared to those with no perceived parental screen time restrictions. The study found that 5.5% of adolescents reported past-month nicotine vaping, and each increase in the level of perceived parental screen time limitation was associated with a 22% reduction in vaping odds, suggesting that parental screen time management may be a protective factor against youth nicotine vaping.
Qadir MA, O'Connell MM, Shrier LA, et al. J Adolesc Health. 2026. PubMed
Summary
Over half of U.S. adolescents and young adults (13-24 years) reported exposure to e-cigarette retail stores during their school commute, with exposure to adult-only vape shops being particularly common among youth under 21. Youth exposed to these retail stores had more than double the odds of current e-cigarette use and significantly higher susceptibility to use compared to those without such exposure, suggesting that proximity of e-cigarette retailers to schools may be driving youth use.
McGuckin B, Patel K, Davenport-Jones L. J Orthod. 2026. PubMed
Summary
Among orthodontic patients in a UK hospital setting, 25% reported trying e-cigarettes and 14.3% were regular users, with most initiating use around age 16 driven by curiosity and social factors rather than prior tobacco use. Despite 82% believing e-cigarettes could affect their braces, only 11% felt knowledgeable about oral health risks, and 92% had never discussed e-cigarette use with their orthodontist—yet three-quarters of users reduced or stopped when given clinical advice.
Dougherty A, Frank A, Hunter A, et al. J Adolesc Health. 2026. PubMed
Summary
A nationwide survey of 622 US youth aged 14-24 found that while only 3% reported personal use of Zyn oral nicotine pouches, 37% reported peer use, with exposure occurring primarily through friends and online sources. Despite recognizing health risks associated with Zyn, youth expressed ambivalence about the product, suggesting that perceived benefits may be influencing uptake among this population. Healthcare providers are positioned to address this emerging product use through screening, education about misconceptions regarding harm reduction claims, and integration of Zyn-specific guidance into cessation counseling.
Bray E, Gentry S, Varley A, et al. Addiction. 2026. PubMed
Summary
Researchers analyzed TikTok videos and educational resources about illicit (unregulated) vapes in the UK to understand how young people encounter information on this topic. TikTok videos about illicit vapes were highly engaging (21 million combined likes) and often depicted law-breaking as acceptable and entertaining, while educational resources were of generally good quality but failed to effectively communicate health risks or appeal to youth audiences.
Burgard A, Lüthgen M, Trümpelmann M, et al. Am J Prev Med. 2026. PubMed
Summary
School*Vape*Science is a participatory, science-based prevention program that engages secondary students (grades 5-12) in conducting their own research on e-cigarette risks through a 6-week elective course and school-wide sessions. When implemented in 3 German schools in 2024, the program was well-received by students (mean enjoyment score of 7.08/10) and demonstrated feasibility within regular school structures, suggesting potential as a scalable model for youth-focused nicotine prevention, though further research is needed to evaluate effects on knowledge, risk perception, and actual e-cigarette use behavior.
Adesiyan R, Omotilewa O, Feizy S, et al. Am J Health Promot. 2026. PubMed
Summary
This cross-sectional study of 4,677 Kentucky middle and high school students found that peer influence is a powerful predictor of youth vaping behavior. Having even one friend who vapes nearly triples the likelihood of vaping initiation, while having five vaping friends increases the odds more than 22-fold, suggesting that peer social networks are critical targets for prevention interventions.
Epidemiology—Disparities(19)
Cho A, East KA, Borland R, et al. Addiction. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Smoking-induced deprivation (continuing to smoke despite lacking money for household essentials) affected 13.6% of adult smokers in Canada, the US, England, and Australia in 2024, remaining higher than 2016 levels despite a slight decline from 2022. The phenomenon disproportionately affects younger adults (18-24 years), those with low income and education, and people with high nicotine dependence, and while it was associated with more quit attempts, smokers experiencing this deprivation were significantly less likely to successfully quit.
Rueden H, Kelley B, Douglas B, et al. Healthcare (Basel). 2026. PubMed
Summary
Among low-income adults motivated to quit smoking, those with low health literacy were older, had lower socioeconomic status, and were more likely to be African American, with greater signs of nicotine dependence (smoking within 5 minutes of waking). Conversely, adults with adequate health literacy were more likely to use electronic vapor products. These findings highlight how health literacy intersects with social determinants of health and tobacco use patterns, suggesting the need for smoking cessation interventions tailored to health literacy levels.
Huang F, Romero Villela PN, Luo Z, et al. medRxiv. 2026. PubMed
Summary
Researchers analyzed genetic and personal characteristics across five different modes of nicotine use (cigarettes, e-cigarettes, cigars, hookah, and smokeless tobacco) in over 300,000 people. The study found that while cigarette, e-cigarette, and smokeless tobacco users share similar genetic risk factors and psychiatric correlates, cigar and hookah users show distinct genetic patterns and are more likely to have sensation-seeking personalities rather than psychiatric conditions, suggesting these products may appeal to different populations with different underlying risk factors.
Collatuzzo G, Siea AC, Mangiaterra S, et al. Cancer Epidemiol. 2026. PubMed
Summary
Researchers estimated how much of the cancer burden across racial and ethnic groups in the US could be attributed to smoking, using smoking data from the 1990s linked to 2022-2023 cancer cases and deaths. Smoking accounted for a disproportionately high burden of cancer in Alaska Native and American Indian populations (26.4% of men's cancer cases, 19.8% of women's), while Asian/Pacific Islander women had the lowest attributable burden at 7.7%. The findings highlight significant disparities in smoking-related cancer risk across ethnic groups, with implications for designing targeted cessation and prevention strategies.
Lawton R, Dowd JB, Skinner J, et al. PNAS Nexus. 2026. PubMed
Summary
Research using national health survey data found that the mortality risk associated with smoking increased by nearly 50% between 1987-1990 and 2012-2013. Rather than being caused by changes in how people smoke or smoking-related health behaviors, this growing gap between smokers and nonsmokers was primarily driven by shifts in who smokes—specifically changes in the age distribution of the smoking population over time.
Kim J, Kwon H. Healthcare (Basel). 2026. PubMed
Summary
Adults with lower health literacy in Korea had modestly higher smoking rates, with a 3.34 percentage point difference in smoking prevalence between those with lower versus higher health literacy scores. The association suggests that accessible and tailored smoking prevention and cessation services may be particularly important for individuals with limited health literacy, though further research is needed to understand whether health literacy influences smoking behaviour or vice versa.
Dickerson F, Origoni A, Katsafanas E, et al. Schizophr Res. 2026. PubMed
Summary
Over a 27-year period (1999–2026), smoking prevalence declined significantly in the general population and among people with bipolar disorder and major depressive disorder, but remained stagnant among individuals with schizophrenia (61.2% prevalence). While daily cigarette consumption decreased across all groups, people with schizophrenia have not benefited from the public health gains in smoking reduction achieved elsewhere, indicating a growing disparity that requires targeted cessation interventions.
Kyei EF, Adekeye OT, Abuga CM, et al. Am J Health Promot. 2026. PubMed
Summary
Among over 28,000 U.S. adults, life dissatisfaction was associated with significantly higher smoking rates, and this relationship varied by marital status and race/ethnicity. Higher education generally protected against smoking, though this protective effect was not consistent across all demographic subgroups, suggesting that smoking prevention strategies should account for both psychological stress factors and how these factors interact differently across populations.
Osborne A, Sesay U, Ali AS. Glob Health Action. 2026. PubMed
Summary
Across 39 African countries, men smoke cigarettes at substantially higher rates than women, with male prevalence exceeding female prevalence in all countries studied. The gap between male and female smoking rates ranged from 3.3 percentage points in Ghana to 36.4 percentage points in Lesotho, suggesting that sex-specific factors—such as social norms, marketing practices, or policy environments—may influence smoking patterns differently for men and women across the region.
Adebisi YA, Alhur AA, Alzain MA, et al. Nicotine Tob Res. 2026. PubMed
Summary
This longitudinal study of over 19,000 UK adults found that people with functional disabilities were significantly more likely to take up exclusive cigarette smoking over a 4-year period, but showed no increased risk for e-cigarette use or dual use. The association was strongest among those reporting multiple functional limitations, suggesting that disability-related disparities in nicotine product uptake are primarily driven by combustible tobacco rather than e-cigarettes.
Ganz O, Gonsalves NJ, Tomaino M, et al. Psychol Sex Orientat Gend Divers. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
This research examined how different ways of asking survey questions about sexual orientation and gender identity (SOGI) affect estimates of cigarette relighting behaviors among smokers. The study found that the order and wording of SOGI questions significantly changed reported relighting rates in a convenience sample, suggesting that survey measurement choices can substantially influence estimates of health behaviors in sexual and gender minority populations—an important consideration for public health surveillance and research.
Zhang D, Dong J, Ruan C, et al. Nicotine Tob Res. 2026. PubMed
Summary
Between 1990 and 2021, China achieved faster declines in age-standardized smoking-related death rates than the global average, yet the absolute number of smoking-related deaths increased by 57.5% to reach 2.30 million annually—accounting for over one-third of global smoking deaths. Males experienced a burden nearly 10 times higher than females, with cancer (rather than cardiovascular disease) emerging as the leading smoking-attributable disease in China, indicating that sustained, targeted tobacco control efforts are needed, particularly among older males.
Schmidt AM, Brown EM, Nonnemaker J, et al. Nicotine Tob Res. 2026. PubMed
Summary
Adults experiencing frequent mental distress (FMD) showed significantly higher rates of nicotine use across multiple products, including cigarettes, e-cigarettes, and blunts, compared to those without FMD. Sexual and gender minorities, young adults, and people with disabilities were identified as groups with elevated mental distress and higher nicotine use risk. Notably, among current cigarette smokers, those with FMD were more likely to have attempted quitting in the past year, suggesting both increased vulnerability to tobacco use and potential motivation for cessation among this population.
Kou J, Ren J, Min A, et al. Tob Induc Dis. 2026. PubMed
Summary
Smoking-attributable low-back pain caused 8.67 million disability-adjusted life years globally in 2021, with the absolute burden increasing 29.6% since 1990 due to population growth and aging, despite significant declines in age-standardized rates. However, progress is highly unequal: high-income countries like Denmark experienced rapid improvements while developing nations such as Afghanistan saw worsening burdens, highlighting critical gaps in tobacco control implementation across regions and socioeconomic groups.
Guan A, Wang X, Chen X. Tob Control. 2026. PubMed
Summary
This global study examined how WHO MPOWER tobacco control policies affect inequalities in smoking-related respiratory cancers (lung, laryngeal, and nasopharyngeal cancers) across countries from 1990 to 2021. Countries with stronger MPOWER policies—particularly monitoring, protection, and enforcement measures—showed narrower gaps in cancer burden between populations, though disparities by sex and region persisted. Projections to 2050 suggest continued decline in smoking-related cancer burden, especially among women, with tailored policy implementation potentially accelerating progress.
Li S, Xu Z, Morgan B, et al. EClinicalMedicine. 2026. PubMed
Summary
This global analysis of tobacco-related disease burden from 1990 to 2023 found that males consistently experience higher disease burden from smoking, secondhand smoke, and chewing tobacco compared to females, though the magnitude of these sex disparities varies by region, age group, and type of tobacco exposure. Population growth and aging were the primary drivers of increasing disease burden in both sexes, while changes in tobacco exposure patterns differed between males and females across the three tobacco risks. Sex disparities in tobacco-attributable disease are projected to persist through 2050, suggesting the need for sex-specific approaches in tobacco control strategies.
Thasineku OC, Gurung YB, Pandit S. Public Health Chall. 2026. PubMed
Summary
A national survey of over 19,000 Nepali adults found smoking prevalence of 3.8% among women and 28.0% among men, with significant disparities by geographic region, ethnicity, education level, age, and occupational status. Key risk factors differed between genders: women smokers were more likely to be from Karnali province, have no formal education, be aged 35-49, and use alcohol; men smokers were more likely to be from Koshi province, engaged in non-agricultural work, aged 20-34, and alcohol users. These findings suggest that effective tobacco control strategies in Nepal must address underlying structural and sociocultural inequities rather than rely on individual-level interventions alone.
Alhabdan S, Alashjaai A, Adebisi YA. Intern Emerg Med. 2026. PubMed
Summary
Among Scottish adults with COPD, e-cigarette use was present in nearly 12% of the population and was significantly more common among younger adults, current and former smokers, and those experiencing socioeconomic deprivation. This concentration of e-cigarette use among already-vulnerable populations with COPD raises questions about whether e-cigarettes are being used as a harm reduction tool or represent a form of dual use, particularly among younger and more disadvantaged groups.
Moore JR, Castro Y, Guerra ZC, et al. Addict Behav. 2026. PubMed
Summary
Researchers validated a Spanish-language version of the Nicotine Dependence Syndrome Scale (NDSS) among Mexican-origin smokers in the U.S., addressing the lack of validated multidimensional dependence measures in Spanish. The final 16-item scale with five factors (later combined into four factors) demonstrated good psychometric properties and can be used to better understand the factors influencing smoking and cessation among Hispanic populations, where physical dependence indicators alone are weaker predictors of quitting success.
Epidemiology—Prevalence(10)
Odani S, Tabuchi T. Lancet Reg Health West Pac. 2026. PubMed
Summary
Heated tobacco product (HTP) use in Japan increased dramatically from 0.1% to 14.9% between 2015 and 2025, with a shift in growth patterns around 2018 from rapid expansion to more gradual but sustained increase. The growth after 2018 was driven by multiple factors including uptake from former non-users, continued switching from cigarettes to HTPs, and high persistence rates among existing HTP users, rather than primarily by cigarette substitution alone.
Fatokun BS, Oluyemi SO, Mba OJ, et al. Health Sci Rep. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Despite global declines in smoking rates, Africa's tobacco user population is projected to grow from 57 million in 2015 to 67 million by 2025 due to rapid population growth and weak regulatory frameworks, significantly increasing cardiovascular disease burden across the region. While interventions like public awareness campaigns, graphic warning labels, and progressive taxation show promise, their inconsistent enforcement limits effectiveness. Stronger policy enforcement and multi-sectoral collaboration targeting vulnerable populations are needed to reverse these trends and reduce projected health and economic costs.
Luo H, Zhang L, Zhang Z, et al. Tob Induc Dis. 2026. PubMed
Summary
Among 1,736 diabetic patients in Chongqing, China, 25.6% were current smokers, 16.0% were former smokers, and 58.4% never smoked. Smoking cessation was more likely among patients with comorbid chronic conditions, those living in smoke-free homes, and those with greater knowledge of smoking's link to diabetes and more positive attitudes toward quitting, though over half of current smokers cited nicotine addiction and withdrawal discomfort as barriers to cessation.
Mizuno S, Inoura S, Matsumoto T, et al. PCN Rep. 2026. PubMed
Summary
Between 2017 and 2025, overall tobacco use in Japan declined from 24.3% to 21.0%, driven largely by a substantial decrease in cigarette smoking (from 20.7% to 12.3%). However, this reduction was partially offset by a significant increase in heated tobacco product (HTP) use (from 5.3% to 11.7%), with concurrent cigarette and HTP use becoming an increasingly common pattern. E-cigarette use remained minimal throughout the period, suggesting a product substitution trend toward HTPs rather than a comprehensive shift away from tobacco.
Seaman Jones EL, Cordova J, Mahoney M, et al. Prev Med Rep. 2026. PubMed
Summary
Current e-cigarette use among U.S. adults increased from 2.33% in 2018-2019 to 3.13% in 2022-2023, with notable increases among Black non-Hispanic and Hispanic adults. A concerning trend emerged showing that the proportion of e-cigarette users with no prior cigarette smoking history nearly quadrupled among young adults aged 18-24 (from 25.11% to 67.63%), suggesting e-cigarettes may be initiating rather than replacing conventional smoking in this population.
Peña S, Palet D, Salazar-Fernández C, et al. Drug Alcohol Rev. 2026. PubMed
Summary
During COVID-19 lockdowns in two Chilean university communities, regional lockdown measures were associated with increases in weekly alcohol consumption (15.6 grams) and daily cigarette smoking (0.3 cigarettes) compared to regions without lockdown restrictions. However, heavy episodic drinking patterns did not change significantly during the study period from July 2020 to April 2021.
Cranford HM, de Wilde L, Gallalee S, et al. Sci Total Environ. 2026. PubMed
Summary
Wastewater surveillance detected nicotine (a key tobacco use indicator) in 100% of samples collected across the U.S. Virgin Islands from October 2023 to December 2024, with significantly higher nicotine consumption in the St. Thomas/St. John District compared to St. Croix, particularly during low tourism seasons. These findings suggest substantial and geographically variable tobacco and nicotine product use across the islands, highlighting the need for district-specific public health interventions.
Bonacquisti M, Russo L, Gualano MR, et al. J Public Health (Oxf). 2026. PubMed
Summary
Smoking prevalence in Italy declined overall from 1993 to 2024, with steeper reductions among men than women, but a concerning reversal occurred between 2020 and 2024 with smoking rates increasing. Alongside this uptick in traditional cigarettes, use of alternative nicotine products has shifted dramatically, with e-cigarette use dropping 40% while heated tobacco products and hand-rolled cigarettes surged by over 180%, suggesting smokers are switching to less-regulated alternatives.
Posse CM, Lira J, Míguez MC. Addict Behav. 2026. PubMed
Summary
A systematic review of 45 studies published between 2015-2025 examined electronic cigarette use among women across different continents, countries, and age groups. The Americas had the highest prevalence rate at 28.8%, with young adults showing the highest usage at 6.2% in the past 30 days, and women overall using e-cigarettes at lower rates than men. These findings can help inform targeted prevention and treatment strategies in regions and populations with higher e-cigarette use among women.
Dorfman SF, Tran ANS. Mil Med. 2026. PubMed
Summary
A survey of US Military Academy cadets (ages 17-22) tracked nicotine use from arrival through graduation over four years, finding approximately a threefold increase in nicotine use prevalence during their time at the academy. Product preferences shifted toward smokeless options, particularly nicotine pouches, suggesting that the military academy environment may be associated with increased adoption of nicotine use among this young adult population.
Health Effects—Cancer(28)
Nguyen OTD, Fotopoulos I, Tsamardinos I, et al. ERJ Open Res. 2026. PubMed
Summary
Norwegian researchers followed over 80,000 ever-smokers across 11 population-based studies and found that the median time between smoking debut and lung cancer diagnosis is 53.3 years, considerably longer than the commonly cited 40-year lag. Women and current smokers developed lung cancer approximately 5-7 years sooner than men and former smokers, respectively, which has important implications for lung cancer screening programs and healthcare resource planning.
Ishak P, Shu KK, Yeoh I, et al. Eur J Surg Oncol. 2026. PubMed
Summary
A study of 134 patients undergoing surgery for advanced rectal cancer found that current smoking was an independent risk factor for both major surgical complications and the need for reoperation within 30 days, with smokers showing 3-5 times higher odds of adverse outcomes. Former smoking also independently predicted major complications. These findings suggest that smoking status should be considered in preoperative risk assessment for patients undergoing complex rectal cancer surgery.
Padmanabhan S, Khan-Garrard M, Gupta B, et al. Tob Prev Cessat. 2026. PubMed
Summary
This narrative review synthesizes evidence on how nicotine acts as a tumor promoter in gastrointestinal cancers across multiple organ systems, including the mouth, esophagus, stomach, pancreas, colon, and liver. Although nicotine itself is not a direct carcinogen, it activates cellular pathways that promote cancer development by increasing cell growth, reducing cell death, promoting blood vessel formation, and triggering inflammation—effects that vary by tissue type and interact with other tobacco-related carcinogens. The findings underscore that nicotine's role in cancer risk extends beyond addiction and highlights the importance of reducing nicotine exposure through all tobacco and nicotine delivery products.
Fan X, Li DL, Hodge AM, et al. Int J Cancer. 2026. PubMed
Summary
Researchers validated six DNA methylation-based smoking predictors using blood samples from over 2,800 middle-aged and older Australians and found they were highly reliable and accurate at estimating smoking exposure. These epigenetic biomarkers were strongly associated with lung and urothelial cancer risk, performing better than self-reported smoking data alone and showing potential as tools for identifying individuals at higher cancer risk based on their smoking history.
Kim S, Kim TS, Shin DW, et al. Cancers (Basel). 2026. PubMed
Summary
A large Korean cohort study of 4.5 million people found that exclusive cigarette smoking increased colorectal cancer risk by 29% compared to never smokers, with the highest risk observed in the rectum. Notably, switching from cigarettes to non-combustible nicotine products or using both together showed different risk patterns depending on cancer location, with rectal cancer risk remaining elevated even after switching to non-combustible products, suggesting these products may not eliminate smoking-related cancer risks.
Sobhanparast S, Herischi A, Amiri-Sadeghan A, et al. Monaldi Arch Chest Dis. 2026. PubMed
Summary
Researchers examined whether light smoking (1-4 cigarettes per day) was associated with two biomarkers of cellular damage and cancer risk in men with and without asthma. Among men with asthma, light smoking was linked to higher levels of a cancer-related protein (CEA) and shorter telomeres (a marker of cellular aging) in primary analyses, though these associations were not consistent across all analytical approaches and did not prove causation.
Azar D, Kabbani D, Abdel Karim C, et al. Front Genet. 2026. PubMed
Summary
Researchers exposed lung cancer cells to smoke extracts from cigarettes and waterpipes over 12 weeks to study how chronic tobacco smoke affects cancer development. Waterpipe smoke shortened telomeres (protective caps on DNA) while cigarette smoke increased telomerase activity (an enzyme involved in cell immortalization), and both smoke types triggered changes associated with cancer cell migration and progression in lung, breast, and colon cancer cells. These findings suggest a biological mechanism linking tobacco smoke exposure to increased cancer risk through disruption of cellular aging processes.
Lee CH, Yang YY, Chuang KH, et al. Biomaterials. 2026. PubMed
Summary
Researchers developed antibody-based therapies that target α9-nAChR, a receptor activated by nicotine that drives triple-negative breast cancer progression. In laboratory and animal models, these engineered antibodies successfully blocked nicotine-enhanced tumor growth and improved chemotherapy effectiveness, while showing a favorable safety profile in primate testing. This represents a potential new therapeutic approach for breast cancer patients with a history of nicotine or smoking exposure.
Rolf E, Niedermaier B, Allgäuer M, et al. Respiration. 2026. PubMed
Summary
Among 507 patients with stage I lung adenocarcinoma, never-smokers (19% of the cohort) differed significantly from smokers in tumor characteristics and demographics. Never-smokers were predominantly female (76% vs. 46%) and had more favorable tumor grades and growth patterns (lepidic-predominant tumors nearly twice as common), yet smoking status independently predicted worse recurrence-free survival outcomes.
Deng J, Yang B, Wu Z, et al. Tob Induc Dis. 2026. PubMed
Summary
Smoking caused an estimated 2,379 deaths and 50,850 DALYs from bladder and kidney cancer combined in Latin America and the Caribbean in 2023, with age-standardized rates declining overall from 1990 to 2023. However, absolute numbers of deaths and disability-adjusted life years are projected to increase through 2050 due to population aging, with particular concern in the Caribbean region where burden is rising. These findings underscore the need for strengthened tobacco control efforts and enhanced health system capacity to manage the growing cancer burden in the region.
Nam SY, Jo J, Kim SK. Dig Dis. 2026. PubMed
Summary
This large population-based study of 4.5 million adults found a U-shaped relationship between physical activity and digestive cancer risk, where both sedentary behavior and very high-frequency physical activity (6-7 days per week) were associated with elevated cancer risks compared to light activity. The associations were stronger in men and never-smokers, with sedentary behavior linked to higher risks of gastric, liver, gallbladder, and colorectal cancers, though the overall effect sizes were modest.
Choi YJ, Kim CY, Kim EY, et al. J Cancer. 2026. PubMed
Summary
Researchers compared lung tumor immune cells from current smokers versus never-smokers and found that smokers had more specialized immune helper cells (Tfh cells) that produce CXCL13, which recruits B cells and supports the formation of organized lymphoid structures within tumors. These smoking-associated immune changes may explain why smokers sometimes respond better to certain cancer immunotherapies, and the CXCL13-producing cells and supporting fibroblasts could serve as new biomarkers or treatment targets for lung cancer.
Kopa-Stojak PN, Pawliczak R. Toxicol Mech Methods. 2026. PubMed
SR
Summary
This systematic review examined whether alternative tobacco and nicotine products (such as e-cigarettes and snus) affect how well cancer patients respond to chemotherapy. The review found limited evidence overall, with some studies suggesting snus use may reduce survival rates, but inconsistent findings for e-cigarettes—initial concerns about e-cigarette-induced drug resistance were not confirmed in follow-up studies. The authors conclude that more rigorous prospective studies and cancer patient registries are needed before drawing firm conclusions about the safety of using these products during cancer treatment.
Jia X, Wang X, Han X, et al. Dig Dis. 2026. PubMed
Summary
Gastric cancer deaths attributable to smoking decreased significantly in Japan (73.48%) but increased in China (26%) between 1992 and 2021, despite similar declines in age-standardized mortality rates in both countries. The divergence was primarily driven by differences in period effects, with Japan experiencing rapid improvements in mortality rates while China saw increases, suggesting that China could benefit from adopting Japan's gastric cancer screening strategies and strengthening tobacco control policies, particularly targeting males and older birth cohorts.
Shin JW, Nguyen TM, Jee SH. Tob Induc Dis. 2026. PubMed
Summary
A 14-year study of over 20,000 Korean men found that higher levels of systemic inflammatory markers in the blood were associated with increased lung cancer risk, particularly among current smokers. The strongest associations were observed in men who smoked 30 or more cigarettes daily and those with concurrent smoking and alcohol use, suggesting that inflammatory markers may help identify individuals at highest risk for smoking-related lung cancer.
Feagin C, Geisinger ML, Litz M. Compend Contin Educ Dent. 2026. PubMed
Summary
Oral nicotine pouches (ONPs) are increasingly popular products, especially among younger users, but evidence suggests they carry health risks despite lower toxicant exposure than combustible tobacco. The review documents local mucosal irritation, tissue changes, potential impacts on gum health and oral bacteria, and possible carcinogenic effects, while noting that long-term health impacts remain unclear due to limited evidence and varying product compositions. Dental professionals are urged to screen for oral lesions associated with ONP use and counsel patients about potential risks.
Choi C, Labriola M, Henderson N, et al. Prostate Cancer Prostatic Dis. 2026. PubMed
Summary
Active smoking in men with prostate cancer was associated with significantly worse overall survival compared to never or former smokers, even after accounting for disease characteristics. The study also found that current smokers were more likely to have specific genetic alterations in their tumors (SPOP, FGFR1, and ARID1A genes), suggesting smoking may promote more aggressive disease biology in metastatic prostate cancer.
Abe Y, Mizuguchi M, Ikushima K, et al. Ann Plast Surg. 2026. PubMed
Summary
Cumulative smoking exposure, measured by the Brinkman index, was identified as an independent predictor of severe surgical complications and total flap failure in head and neck cancer patients undergoing free tissue reconstruction. Among 183 patients in this standardized surgical program, those with higher cumulative smoking history had significantly increased odds of major complications and complete tissue necrosis, suggesting that smoking-related vascular damage may impair surgical healing even under optimized reconstructive conditions.
Sharma JR, Singh V, Kandhari K, et al. Biochim Biophys Acta Rev Cancer. 2026. PubMed
Summary
Cigarette smoke promotes the development of cancer stem cells—a particularly dangerous subpopulation of cancer cells that can self-renew, resist treatment, and spread to distant sites—through activation of multiple biological pathways and remodeling of the tumor microenvironment. This mechanism helps explain why smokers experience poorer cancer outcomes even with advanced targeted and immune therapies, and identifies potential therapeutic vulnerabilities that could be exploited to overcome treatment resistance in smoking-related cancers.
Liu X, Jiang Q, Xie B, et al. Antioxid Redox Signal. 2026. PubMed
Summary
This review examines how nicotine from tobacco products and secondhand smoke promotes stomach cancer by triggering a cascade of cellular changes involving reactive oxygen species (ROS) and multiple interconnected signaling pathways. The authors propose that nicotine doesn't simply damage cells but actively reprograms stomach cells through organized redox signaling that drives tumor growth, spread, and resistance to treatment. The findings suggest targeting these ROS-dependent pathways could enable new prevention and treatment strategies for nicotine-associated gastric cancer.
Wallace C, Razavi-Shearer D, Hall S, et al. J Viral Hepat. 2026. PubMed
Summary
This meta-analysis of 126 studies compared cancer risks across different causes, finding that viral hepatitis infections (HBV, HCV, and HDV) carry substantially higher risks for liver cancer than smoking carries for lung cancer. While alcohol use and metabolic dysfunction-associated fatty liver disease (MASLD) also increase liver cancer risk, they do so at lower levels than viral hepatitis, highlighting the need for better surveillance and management of viral hepatitis to prevent liver cancer globally.
Dhilipkannah P, Jiang F. Lung Cancer. 2026. PubMed
Summary
Researchers found that never-smokers with lung cancer have elevated levels of specific bacteria (Selenomonas, Streptococcus, and Veillonella) and inflammatory markers in their blood, similar to smokers with lung cancer. This suggests that respiratory microbial imbalance and associated inflammation may contribute to lung cancer development independent of smoking history, pointing to a potential biological mechanism underlying the rising incidence of lung cancer in never-smokers.
Gemine RE, Davies GR, Lewis KE. Clin Lung Cancer. 2026. PubMed
Summary
In a UK study of 720 patients newly diagnosed with small-cell lung cancer (SCLC), quitting smoking showed a positive trend toward improved 2-year survival, particularly in patients with limited-stage disease (median survival of 503 days for quitters vs. 431 days for those who continued smoking). However, the overall difference in survival between never, former, and current smokers was not statistically significant, and the benefit of quitting in the limited-stage group approached but did not reach statistical significance, suggesting that larger studies and longer follow-up are needed to confirm these findings.
Mol Oncol. 2026. PubMed
Summary
This article, originally published in 2022, has been retracted due to image duplication and insufficient raw data documentation. The research had examined how NNK, a toxic chemical found in tobacco smoke, may increase pancreatic cancer cell resistance to chemotherapy through specific cellular mechanisms. The retraction means the findings are considered unreliable and should not be cited as evidence.
Poorolajal J. Public Health. 2026. PubMed
Summary
Researchers developed a new measurement tool called the Exponential Cigarette-Pack-Year Index (ECPYI) to better assess lung cancer risk from smoking by accounting for the fact that how long someone smokes matters more than how much they smoke per day. Unlike the traditional pack-year metric, ECPYI revealed that smoking patterns with the same total exposure can carry very different lung cancer risks depending on duration, providing a more accurate way to evaluate individual smoking-related health hazards in public health practice.
Jiang Q, Zhang Z, Zhou J, et al. Food Chem Toxicol. 2026. PubMed
SR
Summary
This systematic review identifies how nicotine activates multiple molecular signaling pathways that suppress the p53 tumor suppressor protein across lung, gastric, liver, and cervical cancers, promoting cancer development and progression. The research reveals that nicotine's cancer-promoting effects work differently depending on whether p53 is normal or mutated, raising concerns about the carcinogenic potential of nicotine itself—not just other tobacco smoke components—and alternative nicotine delivery systems. These findings provide a biological foundation for understanding smoking-related cancer mechanisms and support the need for prevention and early intervention strategies.
Bakhsh A, Abdullah S, Farghal DM, et al. Int Urol Nephrol. 2026. PubMed
Summary
A large analysis of survey data from 2020-2022 found that conventional cigarette smoking was strongly associated with increased risk of both bladder and prostate cancers, with smokers having nearly 4 times higher odds of bladder cancer and 1.4 times higher odds of prostate cancer. Electronic cigarette use showed an inverse association with bladder cancer in adjusted analyses, but this finding was not significant for prostate cancer, and the authors emphasize that the long-term health effects of e-cigarettes remain unclear and require further investigation.
Auriol C, Raynal P, Préaubert A, et al. J Health Psychol. 2026. PubMed
Summary
Researchers compared how community members and healthcare professionals view smoking and drinking in the context of cancer diagnosis, using 72 different scenarios involving colorectal and lung cancers. The study found that drinking was perceived as more acceptable than smoking, though stigma around smoking decreased at advanced cancer stages, and healthcare professionals showed slightly more compassionate attitudes than the general public. These findings highlight the need for interventions that reduce stigma and promote non-judgmental care in oncology settings.
Health Effects—Cardiovascular(28)
Chen X, Yang X, Li Z, et al. J Inflamm Res. 2026. PubMed
Summary
Cigarette smoke damages blood vessel lining cells through three main mechanisms: oxidative stress (harmful chemical reactions), inflammatory responses, and cell death. This damage occurs through specific molecular pathways (NF-κB, nitric oxide, and MAPK signaling) and represents the initial step in atherosclerosis development, explaining why smoking is a major risk factor for heart disease and stroke.
Lee ARYB, Li H, Chua KY, et al. Front Aging. 2026. PubMed
Summary
Among Chinese men in Singapore followed over 20 years, those who continued smoking had significantly higher odds of developing physical frailty in late life compared to never smokers. The good news is that quitting smoking for at least 10 years, or before age 60, substantially reduced frailty risk to levels similar to those who never smoked, suggesting it is never too late to benefit from cessation.
Zhu X, Chen Y, Meng W, et al. Adv Sci (Weinh). 2026. PubMed
Summary
Cigarette tar triggers endothelial cells to release extracellular vesicles containing a protein called TDP43, which promotes atherosclerosis development by activating harmful inflammatory responses in immune cells. In mouse models and laboratory studies, blocking either the vesicles themselves or TDP43 reduced atherosclerotic plaque formation, while retinoic acid showed potential as a protective compound against smoking-related cardiovascular damage.
Loffredo L. Antioxidants (Basel). 2026. PubMed
Summary
This research examined how different tobacco products—conventional cigarettes, heated tobacco products, e-cigarettes, and waterpipes—may cause cardiovascular harm through a common biological mechanism involving oxidative stress. The findings suggest that despite differences in how these products are used, they share a similar pathway that damages the cardiovascular system and increases risk for heart attack and stroke.
Matsumura K, Tabuchi T, Imano H, et al. Hypertens Res. 2026. PubMed
Summary
A Japanese cohort study of nearly 31,000 adults found that current heated tobacco product (HTP) users had a 23% higher risk of developing hypertension compared to never-smokers, similar to but slightly lower than the risk for cigarette smokers. While the study demonstrates an association between HTP use and incident hypertension, it cannot establish whether HTPs directly cause this cardiovascular effect.
Sultan SR, Alzahrani A. Tomography. 2026. PubMed
Summary
Researchers used ultrasound imaging to measure stiffness in carotid artery plaques among smokers and non-smokers, finding that smokers had significantly stiffer plaques. This finding suggests that smoking changes the composition of arterial plaques in ways that can now be detected and measured non-invasively, potentially providing a new tool to assess smoking-related cardiovascular damage.
Wang J, He J, Li Y, et al. Tob Induc Dis. 2026. PubMed
Summary
This study of over 12,900 U.S. adults found that smoking accelerates biological aging, with current smokers showing biological ages about 1.5 years older than never smokers, and each additional cigarette per day adding roughly 0.08 years of biological age acceleration. The accelerated aging from smoking appears to be partially driven by increased inflammation and oxidative stress in the body, suggesting that smoking's harmful effects operate through these biological pathways.
Liu Y, Yuan H, Huang C, et al. Tob Induc Dis. 2026. PubMed
Summary
Researchers used genetic analysis to identify specific proteins in the blood that explain how smoking increases the risk of intracranial aneurysms (weakened blood vessels in the brain) and their rupture. Six proteins were identified as key mediators in the pathway from smoking to aneurysmal stroke, with CD74 and YAP1 emerging as the most important candidates that could be targeted for future prevention and risk assessment strategies in smokers.
Tinworth AC, Yao P, Iona A, et al. Nat Cardiovasc Res. 2026. PubMed
Summary
Researchers identified ASGR1, a specific protein in the blood, as a potential biological mechanism linking smoking to heart disease. Using genetic analyses, they found that smoking exposure increases ASGR1 levels, which in turn increases the risk of ischemic heart disease and may account for about 6% of smoking's harmful cardiovascular effects. This finding could help explain how smoking damages the heart at a molecular level and may inform future prevention or treatment strategies.
Rodrigues DVS, Rogers RT, Chait J, et al. J Endovasc Ther. 2026. PubMed
Summary
A retrospective study of 676 patients undergoing complex aortic aneurysm repair found that active smokers (21% of the cohort) did not experience worse short-term surgical outcomes compared to former or never smokers, despite having higher rates of lung disease and peripheral artery disease. The findings suggest that active smoking status alone should not delay or prevent this type of vascular surgery in otherwise optimized patients, though smoking cessation remains strongly encouraged.
Lee KY, Lee SR, Choi J, et al. J Korean Med Sci. 2026. PubMed
Summary
Among over 1.3 million Korean patients with diabetes, current smokers had a 20% higher risk of developing atrial fibrillation compared to never smokers. Importantly, patients who quit smoking showed significantly reduced risk, with those who quit early in their diabetes course (within 5 years of diagnosis) reaching risk levels comparable to never smokers, suggesting that smoking cessation provides substantial cardiovascular benefits even in this high-risk population.
Gou W, Yang L, Chen S, et al. PLoS One. 2026. PubMed
Summary
Researchers used advanced sequencing technology to examine how cigarette smoke affects human aortic smooth muscle cells at the molecular level. High concentrations of cigarette smoke extract triggered widespread changes in gene expression patterns, including activation of cell death pathways and suppression of protective cellular functions, suggesting that smoking damages blood vessels through coordinated disruption of multiple regulatory mechanisms.
Song JS, Kim MS. PLoS One. 2026. PubMed
Summary
A large population-based study of over 22,000 Koreans found that current smokers had significantly thicker choroidal tissue in the eye (a layer of blood vessels behind the retina) compared to never and former smokers. This structural change in choroidal thickness associated with smoking may have implications for eye health and vascular function, and adds to evidence that smoking affects blood vessel structure throughout the body.
Moon SH, Kim MH, Joo JY, et al. Maturitas. 2026. PubMed
Summary
A large Korean study of over 1.3 million people found that smokers who quit had progressively lower risk of ischemic stroke as their time smoke-free increased. People who had quit for 2-3 years already had stroke risk levels similar to those who never smoked, with the greatest risk reduction observed among those abstinent for 6-7 years, demonstrating substantial cardiovascular benefits from sustained smoking cessation.
Liang Y, Li A, Ren L, et al. Tob Induc Dis. 2026. PubMed
Summary
Among older adults in the US Health and Retirement Study, those who quit smoking had lower risk of developing frailty (a state of physical vulnerability) compared to current smokers, with benefits increasing over time after quitting. However, individuals who gained more than 10 kg after quitting had nearly twice the risk of developing frailty compared to those with minimal weight gain, suggesting that while smoking cessation remains essential for healthy aging, substantial post-cessation weight gain may warrant targeted monitoring and intervention.
Kim Y, Kang H. Geroscience. 2026. PubMed
Summary
This study examined whether smoking-induced biological aging can be reversed after quitting by analyzing DNA methylation patterns in nearly 1,900 US adults aged 50-84. Former smokers who had quit for 20 or more years showed substantial improvements in biological aging markers, approaching the levels of never smokers, with the greatest improvements occurring during the first decade after cessation. These findings provide biological evidence that sustained smoking cessation can reverse smoking-related aging at the cellular level, supporting long-term health benefits of quitting.
Akagi Y, Arakawa K, Sakima A, et al. Hypertens Res. 2026. PubMed
Summary
A systematic review of four studies with 104 current smokers found that smoking periods were associated with significantly higher diastolic blood pressure and heart rate compared to abstinence periods (ranging from 1 day to 1 week), while systolic blood pressure showed no significant difference. These findings demonstrate measurable cardiovascular stress during active smoking and provide evidence supporting the cardiovascular benefits of smoking cessation.
Park CH, Shin Y, Park W, et al. Eur J Appl Physiol. 2026. PubMed
Summary
Physically active smokers who smoked cigarettes immediately after high-intensity interval exercise experienced delayed recovery of heart rate and heart rate variability, reduced blood vessel function, and prolonged low oxygen levels compared to those who did not smoke or used sham smoking. These findings suggest that smoking shortly after intense exercise significantly impairs cardiovascular recovery and function, even in people who regularly exercise.
Olsson M, Tønnesen H, Hedberg J, et al. J Intern Med. 2026. PubMed
Summary
Snus and nicotine pouches are associated with increased cardiovascular disease mortality, particularly fatal heart attacks and heart failure, with nicotine itself identified as the primary driver of risk rather than tobacco-specific toxins. While nicotine pouches deliver comparable or higher nicotine levels than conventional snus, there is insufficient long-term cardiovascular outcome data for these newer products. The evidence suggests that cardiovascular risk may follow nicotine exposure regardless of product type, highlighting the need for public health guidance and regulatory decisions informed by further research.
Sebastian SA, Bimal T, Hart H, et al. Eur J Prev Cardiol. 2026. PubMed
Summary
A meta-analysis of 16 imaging studies involving over 250,000 participants found that cigarette smokers have significantly higher amounts of coronary plaque compared to never-smokers, with smokers showing a higher proportion of non-calcified (soft) plaque. This finding is important because standard coronary artery calcium scoring may underestimate cardiovascular risk in smokers, as soft plaque is less visible on calcium scans yet can still rupture and cause heart attacks.
Hassanpour H, Nasiri L, Mojtahed M, et al. Int J Cardiol Cardiovasc Risk Prev. 2026. PubMed
Summary
This meta-analysis of 55 studies examined how smoking affects heart-related inflammatory markers in the blood. Smoking was found to significantly elevate eight key biomarkers indicating inflammation and heart damage, with current smokers showing the most severe effects, males more affected than females, and some markers remaining elevated even after quitting. These findings provide biological evidence for how smoking increases cardiovascular disease risk and support the critical importance of cessation programs.
Widłak P, Mieczkowski J, Tomasik B, et al. Public Health. 2026. PubMed
Summary
The MULTIPREVENT study is following 3,000 former and current smokers (aged 50-79 with 30+ pack-year histories) to evaluate whether low-dose chest CT scans combined with blood tests, functional assessments, and genetic profiling can effectively predict the risk of multiple smoking-related diseases including lung cancer, heart disease, COPD, osteoporosis, and diabetes. Using artificial intelligence to integrate imaging, biomarker, genetic, and clinical data, researchers aim to develop data-driven prevention strategies that could reduce disease burden among tobacco-exposed populations.
Almohammed H, Alrashidi L, Thalib HI, et al. Cardiovasc Endocrinol Metab. 2026. PubMed
Summary
A Saudi Arabian hospital study of 336 stroke patients found that diabetes independently increased the risk of mortality following stroke, while smoking was present in about one-fifth of patients but was not significantly associated with death outcomes. Older age and non-Saudi nationality were also independent risk factors for mortality, with an overall mortality rate of 4.2% in this cohort where ischemic stroke was the predominant type.
Hamad CD, Wiener J, Shahamatdar S, et al. N Am Spine Soc J. 2026. PubMed
Summary
A large retrospective study of 144,488 spine surgery patients found that those with documented cannabis-related diagnoses had higher rates of serious postoperative complications including heart attacks, kidney injury, depression, and opioid use disorder, particularly when combined with nicotine use. Rather than reducing opioid needs as commonly believed, problematic cannabis use appeared to identify patients at greater perioperative risk, suggesting the need for routine preoperative screening and counseling before elective spine procedures.
Hou X, Jiang X, Meng X, et al. Food Chem Toxicol. 2026. PubMed
Summary
Nicotine exposure in mice caused pulmonary hypertension and increased blood vessel reactivity in the lungs through a cellular mechanism involving a protein called Cx43, which suppressed potassium channels (Kv1.2 and Kv2.1) needed for normal blood vessel relaxation. Mice with reduced Cx43 levels were protected from these harmful effects, suggesting this protein could be a potential therapeutic target for nicotine-related pulmonary vascular disease.
Henríquez-Beltrán M, Gracia-Lavedan E, Sánchez-Cucó A, et al. Arch Bronconeumol. 2026. PubMed
Summary
A 4-year Spanish cohort study of 1,623 middle-aged adults found that the development of airflow obstruction (a sign of lung disease) was strongly associated with faster progression of atherosclerosis (plaque buildup in arteries), even after accounting for smoking status and other risk factors. Importantly, the rate of general lung function decline alone did not predict atherosclerosis progression, suggesting that airflow obstruction itself—rather than gradual lung decline—is the key respiratory marker linked to cardiovascular disease risk.
Hu H, Nakagawa T, Honda T, et al. Am J Prev Med. 2026. PubMed
Summary
A large cohort study of Japanese workers followed from 2018–2025 found that exclusive heated tobacco product (HTP) use was associated with a 61% increased risk of developing type 2 diabetes compared to never smoking, similar to the risk from cigarette smoking alone. The study provides no evidence that switching to HTPs reduces diabetes risk compared to continued cigarette smoking, though longer follow-up is needed to determine whether HTPs carry independent metabolic harms or reflect residual effects from prior smoking.
Woodie BR, Aggarwal P, Rivin GM, et al. Dermatol Surg. 2026. PubMed
Summary
A large study of nearly 930,000 patients undergoing dermatologic surgery found that nicotine use, obesity, vitamin D deficiency, and poorly controlled diabetes or hypertension significantly increased the risk of postoperative complications within 30 days. The findings suggest that addressing these modifiable risk factors before and after surgery could help improve surgical outcomes and reduce patient morbidity.
Health Effects—Mental Health(14)
Vanderkam P, Solinas M, Ingrand I, et al. J Psychiatr Res. 2026. PubMed
Summary
Among adults attempting to quit smoking, those with childhood ADHD symptoms and higher impulsivity levels were significantly more likely to have poor smoking reduction outcomes at 12 months. Depression was also associated with lower smoking reduction success. The findings suggest that screening for and managing ADHD and impulsivity early in smoking cessation treatment could improve quit rates.
White AM, Richie DL, Kendrick PT, et al. Addict Neurosci. 2026. PubMed
Summary
Researchers examined how nicotine affects immune signaling in the brain's reward center (nucleus accumbens) in female rats. Chronic nicotine use suppressed inflammatory markers in the brain but increased a distress signal (fractalkine), suggesting nicotine disrupts the brain's immune balance without causing cell death. These findings point to potential new therapeutic targets for reducing nicotine's harmful effects specifically in women.
Sloan AF, Alexander JD, Ellingson JM, et al. J Psychopathol Clin Sci. 2026. PubMed
Summary
A longitudinal study of 3,836 twins examined whether nicotine use in adolescence increases the risk of psychosis-like symptoms in adulthood. While adolescent nicotine use was associated with higher psychoticism in adults, this relationship was largely explained by shared family factors and continued nicotine use into adulthood rather than a direct causal effect of teenage smoking. Current nicotine use in adults showed cross-sectional associations with psychoticism symptoms, suggesting potential short-term effects that warrant further investigation.
Glastad SH, Klungsøyr O, Aminoff SR, et al. Front Psychiatry. 2026. PubMed
Summary
Researchers tracked mood, sleep, and nicotine and alcohol use patterns in 40 people with bipolar disorder during their first treatment phase using a smartphone app over approximately 18 weeks. Contrary to previous research suggesting bipolar II disorder involves more mood instability than bipolar I, this study found similar levels of mood fluctuations, sleep variability, and substance use patterns between the two subtypes, suggesting that bipolar disorder subtype alone may not fully explain differences in mood and behavioral instability.
Zaur AJ, Sidhu NK, Jin JJ, et al. Addict Behav. 2026. PubMed
Summary
This study examined how childhood maltreatment affects stress responses in daily smokers during a laboratory stress task. Smokers with greater exposure to childhood maltreatment showed sustained elevations in negative affect during stress, suggesting that early trauma may intensify emotional vulnerability in cigarette users. These findings point to the importance of considering trauma history when developing smoking cessation interventions, particularly those targeting stress management.
Palamar A, Rahman Y, Buzzi B, et al. Neuropharmacology. 2026. PubMed
Summary
Researchers used a mouse model expressing HIV-1 Tat protein to investigate how HIV infection may affect nicotine dependence, a concern given high smoking rates among people living with HIV. Long-term Tat expression significantly worsened nicotine withdrawal symptoms, including both physical signs (like somatic symptoms lasting a week after cessation) and mood-related effects (like anhedonia), while paradoxically reducing nicotine intake and preference at higher concentrations. These findings suggest that HIV-related factors may intensify the difficulty of quitting smoking in this population by amplifying withdrawal discomfort.
Lotufo-Denucci B, Isnardo-Fernandes J, Matos GO, et al. Physiol Behav. 2026. PubMed
Summary
Researchers exposed adolescent and young adult mice to nicotine and monitored behavioral changes and stress hormones during and after exposure. Both age groups showed increased anxiety-like behavior during early withdrawal, though responses to nicotine differed by age in some measures, suggesting that vulnerability to nicotine's neurobiological effects may extend into adulthood. The findings highlight potential mental health impacts of nicotine exposure during critical developmental periods, though the relationship between behavioral and hormonal stress responses warrants further investigation.
Shibin C F, Antony S, A U S, et al. J Dual Diagn. 2026. PubMed
Summary
Nicotine use among people with schizophrenia is significantly higher than the general population and is sustained by interconnected psychological, social, and systemic factors rather than biology alone. Key psychosocial drivers include stress regulation, cognitive enhancement, loneliness, social exclusion, stigma, peer influence, and limited institutional support for cessation. Addressing nicotine dependence in this population requires integrated interventions combining psychoeducation, family support, social rehabilitation, and policy reforms to improve both cessation outcomes and functional recovery.
Fitzke RE, Raudales AM, Ferguson JJ, et al. Subst Use Misuse. 2026. PubMed
Summary
Among women currently experiencing intimate partner violence, the relationship between cigarette smoking and stress levels (measured by hair cortisol) depends on their ability to regulate emotions. Women with low to moderate emotion dysregulation showed lower stress levels when smoking more cigarettes, suggesting smoking may provide temporary stress relief for this group. However, this stress-relieving effect was not observed in women with high emotion dysregulation, indicating that smoking cessation interventions for women in violent relationships should address emotion regulation skills and offer alternative coping strategies.
Lee HS, Lee W, Lee S. Public Health Rep. 2026. PubMed
Summary
This study examined whether nicotine dependence, measured using the Heavy Smoking Index (HSI), could help identify Korean adults at higher risk for suicidal thoughts and behaviors. Smokers had significantly higher odds of suicidal ideation and suicide planning compared to nonsmokers, and among current smokers, greater nicotine dependence was associated with increased suicide risk in a dose-response pattern. The findings suggest that assessing nicotine dependence levels could be a useful screening tool for suicide prevention and supports integrating smoking cessation programs into suicide prevention strategies.
Jo D, Farahmand Y, Friedman K, et al. J Dual Diagn. 2026. PubMed
Summary
Among adults with both IBS and smoking habits, risky opioid use was strongly linked to worse IBS symptoms, poorer quality of life, increased anxiety and depression, and greater barriers to quitting smoking. Alcohol use was specifically associated with higher anxiety and depression, while cannabis use showed a relationship with anxiety only. These findings suggest that screening for and addressing substance use patterns should be integrated into smoking cessation and IBS management programs.
Nohor N, Hassan MM, Maruf MFI, et al. Public Health Chall. 2026. PubMed
Summary
A study of 487 Bangladeshi university students found a strong inverse relationship between daily cigarette consumption and health-related quality of life, with heavy smokers (≥6 cigarettes/day) reporting significantly worse overall quality of life compared to non-smokers and lighter smokers. The decline in quality of life increased progressively with smoking intensity, suggesting that even light smoking (1-3 cigarettes/day) is associated with meaningful reductions in health-related quality of life among young adults.
Kim H, Na H, Lee H, et al. J Affect Disord. 2026. PubMed
Summary
Among over 52,000 South Korean adolescents, smoking, alcohol use, and smartphone overdependence were all significantly associated with increased risk of suicidal ideation, planning, and attempts, with stronger associations observed at higher levels of each behavior. For example, adolescents smoking 20+ cigarettes daily had over 4 times higher odds of suicidal planning and attempts compared to non-smokers. These findings suggest that addressing multiple addictive behaviors should be integrated into youth suicide prevention strategies.
Ter Meulen WG, Draisma S, Hoogendoorn AW, et al. J Affect Disord. 2026. PubMed
Summary
Among people with depression, smoking risk decreased over 6 years for those who achieved remission or had recurring episodes, but remained unchanged for those with persistent, repeated depression. People with the most chronic depression patterns were nearly 4 times more likely to maintain repeated smoking cycles compared to those with better remission outcomes, suggesting that incomplete depression recovery may be a significant barrier to smoking cessation.
Health Effects—Pregnancy/Perinatal(20)
Fielder S, Barnes C, Ormesher L, et al. PLoS One. 2026. PubMed
Summary
A comprehensive review of 64 studies (34 animal, 30 human) examining vaping during pregnancy found significant gaps in current evidence. While animal studies suggest potential biological risks across multiple systems including cardiovascular, respiratory, and neurodevelopmental effects, human studies remain largely observational and rely on self-reported exposure without biochemical validation, limiting the ability to draw firm conclusions about actual health risks to pregnant people and infants. Future research needs prospective designs with objective exposure measurement and assessment of maternal physiological outcomes to better understand vaping's effects during pregnancy.
Borrego-Soto G, Riddington IM, Maier E, et al. PNAS Nexus. 2026. PubMed
Summary
Researchers using zebrafish models found that nicotine's toxic effects on fetal facial and jaw development come not from nicotine itself, but from how the body breaks it down into metabolites, particularly a compound called 4HPBA. When pregnant individuals are exposed to both nicotine and alcohol, alcohol interferes with nicotine metabolism but paradoxically worsens the birth defects caused by nicotine metabolites, highlighting complex drug interactions during pregnancy.
Bülbül R, Kerget B, Evren Dilmaç A, et al. Medicina (Kaunas). 2026. PubMed
Summary
Pregnant women who smoked cigarettes during their second trimester showed significantly reduced lung function, weaker respiratory muscles, lower exercise capacity, and compromised oxygen delivery to skeletal muscles compared to non-smoking pregnant women. The findings demonstrate that maternal smoking during pregnancy affects multiple physiological systems beyond the lungs, with smoking intensity (pack-years) being a key predictor of muscle oxygenation impairment, underscoring the importance of smoking cessation counseling early in pregnancy.
Skowron K, Godziszewski F, Putyrska A, et al. Int J Mol Sci. 2026. PubMed
Summary
This scoping review examined how maternal stress, psychiatric medications, and smoking during pregnancy affect the biochemical composition of amniotic fluid and fetal development. The analysis of 30 studies found that maternal smoking interferes with metabolic pathways in amniotic fluid related to oxidative stress, while chronic stress and anxiety elevate stress hormones that may influence long-term fetal health outcomes through metabolic programming mechanisms.
Xie S, Liu L, Zhang B, et al. Tob Induc Dis. 2026. PubMed
Summary
Using genetic analysis methods to reduce bias, researchers found that maternal smoking during pregnancy significantly increases the risk of non-alcoholic fatty liver disease (NAFLD) in offspring, with those exposed having nearly twice the risk compared to unexposed individuals. The study did not find a clear association between the age someone starts smoking and NAFLD risk. These findings suggest that prenatal smoking exposure may have lasting metabolic effects on liver health in the next generation.
Liu B, He E, Li N, et al. Hypertension. 2026. PubMed
Summary
Prenatal nicotine exposure from maternal smoking or e-cigarette use programs male offspring to develop high blood pressure susceptibility in adulthood through a molecular mechanism involving abnormal RNA modifications that disrupt nitric oxide production in blood vessels. The study identified a potential drug target (FTO protein) that when blocked with an experimental inhibitor reversed the vascular dysfunction caused by prenatal nicotine exposure in animal models and human cells.
Yang K, Song X, Zhai P, et al. Tob Induc Dis. 2026. PubMed
Summary
Researchers used advanced molecular analysis to identify five key genes (CTNNB1, TINAGL1, RAD50, FGF2, and VIM) that appear to be critical in how nicotine from tobacco causes miscarriage. Two of these genes, RAD50 and FGF2, showed a causal relationship with pregnancy loss. These findings could lead to new biomarkers for early detection of tobacco-related pregnancy complications and potential targets for intervention.
Du Y, Liang S, Bian M, et al. Brain Res Bull. 2026. PubMed
Summary
Prenatal nicotine exposure disrupts development of respiratory control centers in the brainstem of newborn rats by triggering neuronal death and immune cell activation through dysregulated cellular signaling pathways. Blocking the PI3K/AKT signaling pathway partially reversed these harmful effects, suggesting this mechanism plays a key role in how fetal nicotine exposure impairs respiratory system development and may increase breathing problems after birth.
Liu Y, Deng J, Zhang Y. Tob Induc Dis. 2026. PubMed
Summary
Adolescents whose mothers smoked during pregnancy were significantly more likely to experience anxiety and poor mental health compared to those without prenatal smoke exposure, with nearly twice as many days of anxiety symptoms and poor mental health reported. The study found that severe anxiety and severe poor mental health outcomes were three times more common among adolescents exposed to maternal smoking during pregnancy. While these cross-sectional findings suggest a meaningful association, the study design cannot establish causality, and further longitudinal research is needed to confirm the relationship and understand the underlying mechanisms.
Kunno J, Pimviriyakul P, Luangwilai T, et al. Tob Induc Dis. 2026. PubMed
Summary
Pregnant women exposed to secondhand smoke in their homes had elevated nicotine metabolites in their urine and breast milk, which were directly linked to reduced infant birth weight and length. Specific household smoking behaviors, such as smoking in living rooms and bedrooms, were associated with higher nicotine exposure levels in mothers. These findings demonstrate a measurable biological pathway through which prenatal secondhand smoke exposure can negatively affect infant growth outcomes.
Korhonen K, Holopainen LS, Gissler M, et al. Clin Epidemiol. 2026. PubMed
Summary
A large Finnish study of nearly 800,000 full-term births found that mothers who continued smoking during pregnancy had a 43% higher risk of neonatal intensive care unit admission and a 22% higher risk of antibiotic treatment in their newborns compared to non-smoking mothers. Continued smoking was associated with increased rates of bacterial infections and low blood sugar in newborns, and also increased the risk of stillbirth by 49%, while quitting smoking in early pregnancy showed more modest but still elevated risks.
Dave H, Maru S, Sr KJ. Birth Defects Res. 2026. PubMed
Summary
This comprehensive review synthesizes evidence across multiple scientific disciplines to demonstrate that nicotine exposure during pregnancy initiates a cascade of harmful effects beginning with placental dysfunction and fetal oxygen deprivation, which then contribute to adverse birth outcomes, increased sudden infant death syndrome risk, and long-term neurobehavioral problems including cognitive and psychiatric vulnerabilities. The review identifies that nicotine disrupts critical developmental processes in the fetal brain through effects on nicotinic acetylcholine receptor signaling, with emerging evidence also pointing to epigenetic changes and sex-specific vulnerabilities that may extend across generations. These findings highlight specific developmental windows and molecular targets that could inform more effective prevention strategies and public health interventions to reduce prenatal nicotine exposure from tobacco, e-cigarettes, and secondhand smoke.
Simes L, Salguero S, Alonso R, et al. Matern Child Health J. 2026. PubMed
Summary
During COVID-19 lockdowns, pregnant women showed higher rates of prenatal smoking (6.1% vs. 1.2%) and their fetuses had reduced head growth compared to the same period in 2019. The combination of lockdown exposure and prenatal smoking was particularly associated with smaller fetal head circumference, suggesting that public health emergencies may increase smoking in pregnancy with potential effects on fetal development, and highlighting the need for targeted smoking cessation support during such periods.
Erato Garza G, Pereira DP, Corey A, et al. R I Med J (2013). 2026. PubMed
Summary
Maternal smoking during pregnancy is associated with altered fetal and neonatal neurobehavior, including decreased fetal heart rate variability and movement, as well as increased excitability, irritability, and stress signs in newborns. These behavioral changes resemble abstinence symptoms seen with other prenatal substance exposures, suggesting nicotine may affect fetal nervous system development and neonatal adaptation.
Weller E, Aarsman SR, Teague S, et al. Drug Alcohol Depend. 2026. PubMed
Summary
Maternal smoking before and during pregnancy was strongly associated with adverse infant outcomes including low birth weight, prematurity, small-for-gestational age, and admission to intensive or special care nurseries. The risks were particularly elevated when mothers smoked during pregnancy (odds ratios ranging from 2.2 to 3.8 times higher), and smoking cessation support prior to conception and in early pregnancy could help reduce these harms to infants.
Tu J, Jian J, Li Y, et al. Biol Reprod. 2026. PubMed
Summary
Prenatal exposure to e-cigarette aerosol causes lasting changes to heart protein composition in newborn rats, with different effects in males versus females. Male offspring developed impaired heart function and severe damage during heart attacks in adulthood, while females maintained normal baseline heart function but became more vulnerable to stress-induced heart injury. These findings suggest that e-cigarette use during pregnancy may program sex-specific cardiac vulnerabilities in developing fetuses that manifest as cardiovascular disease risk later in life.
Johnstone S, Schenkel A, Canazzi S, et al. Nicotine Tob Res. 2026. PubMed
Summary
This systematic review of 22 studies examined birth outcomes in pregnancies exposed to electronic nicotine delivery systems (ENDS/vaping) compared to non-exposure, nicotine replacement therapy, and cigarette smoking. ENDS exposure was associated with increased odds of preterm birth and lower birthweight compared to no exposure, with risks similar to cigarette smoking, though findings had low to moderate confidence levels. The review highlights that pregnant people using ENDS should be supported to quit, and that alternative smoking cessation approaches need further investigation for use during pregnancy.
Zhu L, Munch IC, Lee SS, et al. Acta Ophthalmol. 2026. PubMed
Summary
A meta-analysis of three birth cohorts (two Danish and one Australian) found that prenatal smoking exposure was associated with measurable deficits in retinal nerve fibre layer thickness in children, with reductions ranging from 8-10% depending on the eye region examined. These structural changes in the retina suggest that maternal smoking during pregnancy may have lasting adverse effects on children's eye development and visual health.
Sayad E, Faghani M, Keshavarz P, et al. Clin Exp Reprod Med. 2026. PubMed
Summary
Nicotine exposure damages female reproductive organs (ovaries and uterus) in animal models, but co-treatment with quercetin, a plant-derived antioxidant compound, significantly reduced this damage by lowering oxidative stress markers and restoring hormone levels and reproductive tissue health. These findings suggest quercetin may have protective potential against smoking-related reproductive harm, though human clinical studies would be needed to determine applicability to women of reproductive age.
Le AD, Zhang CA, Chen AL, et al. Nicotine Tob Res. 2026. PubMed
Summary
A prospective cohort study of 6,136 females and 1,688 male partners examined whether nicotine vaping before conception was associated with miscarriage risk. The study found no meaningful increase in miscarriage rates among females or male partners who vaped before pregnancy, regardless of concurrent cigarette smoking history.
Health Effects—Respiratory(35)
Pan M, Zou Y, Lv Y, et al. Curr Res Toxicol. 2026. PubMed
Summary
Mice exposed to cigarette smoke combined with PFOS or PFOA (common drinking water contaminants) developed more severe lung damage and airway inflammation compared to smoke exposure alone, with impaired lung function. The enhanced injury appeared to result from increased inflammatory signaling pathways in the lungs, suggesting that drinking water contamination with these per- and polyfluoroalkyl substances may worsen cigarette smoke-related respiratory disease.
Tu Q, Zhang X, Zou Y, et al. Front Public Health. 2026. PubMed
Summary
This UK study of over 270,000 people found that both active and secondhand smoke exposure were associated with increased mortality risk, particularly among those with idiopathic pulmonary fibrosis (IPF), a serious lung disease. Notably, maternal smoking during pregnancy showed a stronger combined effect with IPF on respiratory mortality than would be expected from either exposure alone, suggesting early-life smoke exposure may have particular consequences for individuals who develop IPF later in life.
Şahin T, Nik-Eezammuddeen NB. Tob Induc Dis. 2026. PubMed
Summary
A cross-sectional study of 484 participants found that current smokers experienced more rapid progression of periodontitis (Grade C disease) compared to non-smokers (40.4% vs 11.5%), with longer smoking duration and higher pack-year exposure strongly associated with increased disease severity. Smokers also demonstrated higher plaque accumulation and paradoxically lower bleeding on probing, suggesting smoking may mask typical inflammatory signs of periodontal disease while accelerating underlying tissue damage.
Massara L, Kervoaze G, Ollivier A, et al. Rev Mal Respir. 2026. PubMed
Summary
A genetic variation in the nicotinic receptor gene (rs16969968) increases susceptibility to cigarette smoke-induced lung inflammation and COPD development, independent of how much a person smokes. This discovery suggests that some individuals are genetically predisposed to severe respiratory damage from smoking and highlights the need for personalized prevention strategies that consider genetic risk factors alongside environmental and clinical factors.
Fatemikia H, Ziaian B, Ketabchi F. Respir Physiol Neurobiol. 2026. PubMed
Summary
Researchers tested whether nicotine could reduce lung injury in rats with acute respiratory distress syndrome (ARDS), a severe lung condition. Nicotine improved lung function and reduced inflammation markers, and this protective effect appeared to involve a cellular pathway called PPAR-γ, suggesting that nicotine's anti-inflammatory actions in the lungs may work through multiple interconnected mechanisms.
Ghio AJ, Pennington ER, Pulczinski JC, et al. Pathogens. 2026. PubMed
Summary
Cigarette smoke and particle exposures (air pollution, biomass burning, silica) reduce iron availability in the respiratory tract, creating conditions that favor Mycobacterium tuberculosis infection and replication. The bacterium has multiple pathways to acquire iron in iron-deficient environments, giving it a competitive advantage. This biological mechanism helps explain the well-documented association between smoking and other particle exposures with increased tuberculosis infection rates.
Zaarour RF, Azakir B, Mahmood AS, et al. PLoS One. 2026. PubMed
Summary
Waterpipe smoke exposure activates protective autophagy (a cellular self-cleaning process) in lung epithelial cells, allowing them to survive initial damage rather than die. However, this adaptive survival mechanism occurs alongside DNA damage, inflammation, and upregulation of cancer stem cell markers, suggesting that waterpipe smoking may initiate early cellular changes that could lead to lung cancer development.
Miyamoto A, Uemasu K, Li X, et al. Biochem Biophys Res Commun. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers identified USP19, a protein that helps cells manage stress from cigarette smoke exposure, as a protective factor against lung injury and COPD development. When USP19 levels were reduced or absent, lung cells were more susceptible to damage from cigarette smoke, suggesting that this protein plays an important role in protecting lung epithelial cells from the harmful effects of smoking.
He L, Wang J, Rao Y, et al. Tob Induc Dis. 2026. PubMed
Summary
This study examined how smoking and heavy drinking affect the sense of smell in US adults aged 40 and older, using both self-reported and objective testing measures. Chronic smokers and heavy drinkers, especially those with both habits, had significantly higher rates of olfactory dysfunction compared to non-smokers and non-drinkers. The findings suggest that smoking and heavy alcohol use are modifiable risk factors that may impair the ability to smell, highlighting another potential health benefit of smoking cessation.
Caminati M, Charriot J, Bansal AT, et al. Am J Respir Crit Care Med. 2026. PubMed
Summary
A large European study of 3,876 adults with severe asthma found that biologic medications were equally effective at improving symptom control, reducing exacerbations, and improving quality of life regardless of smoking status—including current smokers, ex-smokers, and never-smokers. Despite this evidence of equal effectiveness, nearly 30% of European countries surveyed reported opposition to prescribing biologics to current smokers, suggesting that smoking status-based treatment restrictions may be unjustified and could be denying effective therapy to patients with severe asthma.
Zeng KHH, Puzdrakiewicz TL, King SA, et al. Am Surg. 2026. PubMed
Summary
Among older adults hospitalized with rib fractures from ground-level falls, people with a history of smoking experienced longer hospital stays and higher death rates after discharge compared to never-smokers. Although smokers had fewer documented acute lung complications during hospitalization, smoking appeared to be a marker of broader health vulnerabilities—including multiple chronic conditions, substance use, and social factors—that negatively affected recovery and survival after discharge.
Pardakhty S, Najafipour H, Jafari E, et al. Naunyn Schmiedebergs Arch Pharmacol. 2026. PubMed
Summary
Researchers tested whether inhaled myrtenol, a natural plant compound, could protect rat lungs from damage caused by cigarette smoke exposure over 4 weeks. Myrtenol treatment significantly reduced lung inflammation, oxidative stress, and tissue damage markers, with protective effects comparable to the corticosteroid budesonide, suggesting it may have potential as a therapeutic agent for smoking-related lung diseases.
Shi BY, Hu XD, Liu YC, et al. Tob Induc Dis. 2026. PubMed
Summary
Researchers identified a molecular pathway explaining how cigarette smoke damages lung cells and contributes to COPD development. The study found that chemicals in cigarette smoke activate a receptor called AhR, which triggers a cascade of harmful events: increased oxidative stress (cellular damage from reactive molecules), impaired cellular cleanup processes, and premature cell aging. Blocking this AhR pathway with an experimental antagonist reversed these harmful effects, suggesting it could be a potential therapeutic target for smoke-related lung disease.
Li Z, Li D, Huang Y, et al. Tob Induc Dis. 2026. PubMed
Summary
Using computer modeling and molecular simulations, researchers identified how nicotine and coal tar from cigarettes may trigger sarcopenic obesity—a condition in older adults involving muscle loss and excess fat accumulation. The study found that nicotine binds to five key proteins involved in inflammation and metabolism, potentially disrupting muscle and fat regulation through several cellular pathways. These findings suggest specific biological mechanisms by which tobacco exposure contributes to this metabolic syndrome in aging populations.
Ma Z, Hu S, Lv Z, et al. Molecules. 2026. PubMed
Summary
Formononetin, a naturally occurring compound found in plants, reduced lung damage caused by cigarette smoke exposure in mice by lowering inflammation and oxidative stress. The protective effect appeared to work through multiple pathways, including changes to gut bacteria composition and metabolism, suggesting that dietary-botanical approaches targeting both the lungs and gut microbiota may offer potential strategies for preventing smoke-related respiratory disease.
Liu P, Wang Y, Lv H, et al. Int Immunopharmacol. 2026. PubMed
Summary
Cigarette smoke exposure causes olfactory impairment (loss of smell) in chronic rhinosinusitis with nasal polyps, and this damage is significantly worsened in mice lacking the TET2 gene. The mechanism involves nicotine triggering a cell death process called ferroptosis in the brain's olfactory bulb by reducing protective proteins, leading to increased neuroinflammation and nerve cell damage that impairs smell function.
Fernández-Fernández S, Hernansanz AN, Ortiz C, et al. Respir Med. 2026. PubMed
Summary
Among individuals with asthma or chronic obstructive pulmonary disease in Spain, about one in five continued to smoke despite their diagnosis. Current smokers with these respiratory conditions faced significantly higher all-cause mortality risk compared to those who had quit smoking, with asthma patients showing a 70% increased risk and COPD patients showing a 34% increased risk. Smoking cessation interventions should prioritize high-risk groups including younger individuals, those with lower education levels, sedentary people, and women with asthma.
Kilic B, Akel Bilgic H, Unal BK, et al. Int J Pharm. 2026. PubMed
Summary
Researchers investigated whether PEGylated curcumin, a modified form of the natural compound curcumin with improved solubility, could protect nasal cells from oxidative damage caused by cigarette smoke exposure. Both curcumin and its modified form reduced harmful gene expression changes in nasal epithelial cells exposed to cigarette smoke, with the PEGylated version showing stronger effects on reducing DNA methylation. The researchers then developed a dissolving microneedle patch to deliver this compound directly into the nasal cavity, demonstrating a promising new approach for treating smoke-related respiratory damage.
Coleman SRM, Gaalema DE, Ismail R, et al. J Cardiopulm Rehabil Prev. 2026. PubMed
Summary
A large study of over 41,000 COPD patients in pulmonary rehabilitation programs found that current smokers (14% of participants) attended fewer sessions than former or never smokers, yet achieved similar improvements in walking distance, anxiety, and shortness of breath. However, current smokers showed less improvement in depression symptoms and had higher depression levels at program completion, suggesting that smoking status alone should not disqualify patients from pulmonary rehabilitation programs.
Rasat A, Gunen Yilmaz S. Med Princ Pract. 2026. PubMed
Summary
Researchers examined whether smoking is associated with tonsilloliths (calcified deposits in the throat) using imaging scans of 416 patients. While smoking was not linked to the overall presence, size, or number of tonsilloliths, smokers who had tonsilloliths were more likely to have them on one side only or in the back of the throat compared to non-smokers. Age was found to be a stronger predictor of tonsillolith formation than smoking status.
de Oliveira AB, Barbosa F, Belin AC, et al. Biol Trace Elem Res. 2026. PubMed
Summary
Cadmium (Cd), a toxic metal found in tobacco smoke, was associated with increased odds of migraine in a large Brazilian cohort study, with stronger effects observed in men. Participants with the highest serum cadmium levels had 51% higher odds of migraine compared to those in the middle range, though this association weakened when looking only at definite migraine cases. The findings suggest that cadmium exposure from smoking may contribute to migraine risk, though the relationship requires further investigation.
Alrabadi B, Alghzawi Y, Alshakhshir AE, et al. Neurol Sci. 2026. PubMed
SR
Summary
A systematic review of 18 studies examined whether smoking worsens disability outcomes in people with multiple sclerosis (MS). While smoking did not show statistically significant effects on standard disability measures, there were trends suggesting associations with poorer quality of life, increased fatigue, respiratory symptoms, and slower recovery from MS relapses, though evidence remained inconsistent across studies.
Kozaki A, Inoue R, Watanabe N, et al. Jpn J Ophthalmol. 2026. PubMed
Summary
A Japanese retrospective study of over 12,000 individuals found that current smokers were significantly more likely to develop thyroid eye disease (TED) compared to non-smokers, with stronger effects observed in males. Among patients with TED, current smokers were also more likely to experience diplopia (double vision), a complication that was particularly pronounced in female patients. These findings suggest that smoking cessation counseling should be integrated into the management of patients with thyroid disease.
Alrabadi B, Matar H, Bandak N, et al. Mult Scler Relat Disord. 2026. PubMed
SR
Summary
A meta-analysis of 10 studies found that smoking does not increase the risk of developing NMOSD or MOGAD, but smokers who do develop these autoimmune neurological conditions experience significantly poorer recovery after disease relapses compared to non-smokers. The negative impact of smoking on recovery was particularly pronounced in MOGAD patients, suggesting that smoking cessation counseling should be integrated into the management of these conditions to help reduce disability progression.
Zhou Y, Xu Q, Wang Y, et al. Mol Immunol. 2026. PubMed
Summary
Researchers identified CXCL3, a protein produced by airway cells in response to cigarette smoke, as a key driver of neutrophil extracellular trap (NET) formation—a process that contributes to lung inflammation and damage in COPD. When CXCL3 was reduced in mouse models of cigarette smoke exposure, NET formation, airway inflammation, and emphysema were all significantly reduced. These findings suggest that blocking CXCL3 could represent a new therapeutic approach to slow COPD progression in smokers.
Zhyvylo I, Sood N, Pugashetti JV, et al. Pulm Circ. 2026. PubMed
Summary
A study of 226 patients with interstitial lung diseases found that smokers had significantly shorter survival rates and worse lung function (measured by carbon monoxide diffusing capacity) compared to non-smokers, particularly among those with idiopathic pulmonary fibrosis complicated by pulmonary hypertension. Researchers identified three genes (BBS1, BARD1, and SMURF1) that showed promise as potential biomarkers for measuring disease severity in smoking patients with this condition, suggesting molecular pathways through which smoking worsens pulmonary outcomes.
Yoshioka Y, Tanabe N, Oshima Y, et al. Respir Investig. 2026. PubMed
Summary
Researchers identified a condition called respiratory sarcopenia—a combination of weak respiratory muscles and low muscle mass—in 12% of elderly smokers in their study cohort, with 79% having COPD. People with respiratory sarcopenia showed significantly worse exercise capacity and physical function compared to smokers without the condition, suggesting it may be an important clinical marker for identifying smokers at risk of functional decline who could benefit from early intervention.
Wang J, Wei M, Song X, et al. Adv Sci (Weinh). 2026. PubMed
Summary
Researchers identified a cellular pathway (GEM/SIRT3) that drives premature aging of alveolar macrophages—immune cells in the lungs—in response to cigarette smoke exposure. This smoke-induced cellular aging impairs the macrophages' ability to fight infection and triggers harmful inflammatory responses. The findings suggest this pathway could serve as a biomarker for smoking-related lung damage and a potential target for new therapeutic interventions to prevent smoking-related lung disease.
Heimbach NS, Ding J, Eidelman DH, et al. Transl Res. 2026. PubMed
SR 🍁 Canadian 🔓 Open Access
Summary
Researchers analyzed lung cell data from never smokers, active smokers, and former smokers to understand why former smokers remain at higher risk for lung disease even after quitting. While smoking cessation reversed some smoking-related damage in certain lung cells, it failed to fully restore normal function in others and even triggered new molecular problems in some cell types, explaining why former smokers' lungs don't completely recover.
Jian T, Huang J, Zhang F, et al. Naunyn Schmiedebergs Arch Pharmacol. 2026. PubMed
Summary
This laboratory study examined how luteolin, a plant-derived compound, could reduce cigarette smoke-induced damage in mice with COPD-like disease. Treatment with luteolin decreased lung inflammation and altered the balance of bacteria in both the lungs and gut, along with changes in amino acid metabolism, suggesting potential mechanisms for protecting against smoke-induced lung disease.
Zhang X, Ye D, Xiong Z, et al. Free Radic Biol Med. 2026. PubMed
Summary
Researchers identified that cigarette smoke reduces levels of a chloride channel protein (ClC-3) in the airways, which normally protects against oxidative damage and inflammation. When ClC-3 is deficient, cells lose their ability to clear damaged components through a cellular cleanup process called autophagy, leading to increased cell death, inflammation, and chronic bronchitis. Restoring ClC-3 function may offer a new therapeutic approach to prevent cigarette smoke-induced lung damage.
Revel MP, Goo JM, Vliegenthart R, et al. Chest. 2026. PubMed
Summary
Low-dose CT lung cancer screening detects not only lung nodules but also several smoking-related conditions including emphysema, coronary artery calcium, interstitial lung abnormalities, osteoporosis, and sarcopenia. This review examines the prevalence and clinical significance of these additional findings, particularly in patients with COPD, and explores how screening protocols could integrate detection of these comorbidities to improve overall health outcomes for smokers undergoing lung cancer screening.
Ceylan S, Tanyeri Toker G, Erkan D, et al. Acta Otolaryngol. 2026. PubMed
Summary
Researchers compared auditory brain responses between young adult smokers and non-smokers with normal hearing thresholds, using specialized testing that detects subtle central auditory changes. Smokers showed delayed and reduced cortical auditory responses compared to non-smokers, suggesting that smoking damages the brain's auditory processing centers even before conventional hearing loss is detectable. These findings indicate that cigarette smoking causes early subclinical changes in auditory function that could be identified through sensitive neurophysiological testing.
Tian X, Zhang W, You Z, et al. Free Radic Biol Med. 2026. PubMed
Summary
Researchers identified a new cellular mechanism explaining how cigarette smoke damages airway cells in COPD through a process called ferroptosis (a type of cell death). The study found that a protein called Rab26, which is reduced in smokers' lungs, normally protects cells by preventing damage to mitochondria; when Rab26 is depleted, cigarette smoke triggers a chain reaction that leads to excessive cell death and airway inflammation. Restoring Rab26 levels or blocking specific signaling pathways could offer new therapeutic approaches to slow COPD progression.
Zoulakis M, Ambjörn M, Jaiswal R, et al. J Bone Miner Res. 2026. PubMed
Summary
Among older Swedish women, current smokers had significantly higher risk of fractures—particularly hip fractures—compared to never smokers, with risks decreasing substantially within 5–10 years of quitting. The increased fracture risk was partly explained by smoking's effects on physical function (walking speed) and bone density, suggesting that smoking cessation could provide meaningful skeletal benefits in aging populations.
Indigenous—Tobacco(3)
Booth K, Bryant J, Roberts-Barker K, et al. BMJ Open. 2026. PubMed
Summary
This national study will evaluate whether the Which Way? Quit Pack—a mailed cessation programme containing nicotine replacement therapy, counselling, and online support tailored for Aboriginal and Torres Strait Islander people—is effective and cost-effective when delivered at scale. Researchers will follow 2,000 Indigenous participants who smoke or vape for up to 12 months to measure quit rates and identify which groups benefit most from the intervention, while ensuring the study is governed by and responsive to Indigenous communities.
Soares ÉN, Dos Santos Costa AC, de Jesus Ferrolho G, et al. J Environ Sci Public Health. 2026. PubMed
Summary
This article examines the historical and contemporary use of tobacco by indigenous and Afro-descendant populations in Brazil for treating various diseases, with a focus on nicotine's potential neuroprotective properties for Parkinson's disease (PD). The authors note that PD prevalence is lower in indigenous Brazilian populations compared to White populations, and explore whether traditional tobacco use practices may offer insights into novel therapeutic applications of nicotine for modern medicine, while acknowledging the lack of rigorous clinical trials supporting these potential benefits.
Maidment S, Ridgeway TL, Booth K, et al. Nicotine Tob Res. 2026. PubMed
Summary
Researchers partnered with Aboriginal and Torres Strait Islander women and communities to develop the Which Way? Women's Group-based Smoking and Vaping Cessation Program specifically designed for pregnant women and the perinatal period. The program integrates 60 behavior change techniques across 15 domains that were identified through both Indigenous knowledge and peer-reviewed literature, prioritizing strategies like natural consequences, social support, and goal-setting that are meaningful to Indigenous communities. The program's effectiveness will be tested in an upcoming implementation trial, and the transparent development process demonstrates a model for centering Indigenous self-determination in tobacco control interventions.
Policy—Endgame(3)
Davies NP, Langley T, Murray RL, et al. Addiction. 2026. PubMed
Summary
A modelling study projected that England's proposed smoke-free generation policy—which would ban tobacco sales to anyone born on or after January 1, 2009—would reduce smoking in pregnancy and prevent adverse birth outcomes including stillbirths, premature births, and low birthweight infants. The policy was estimated to be cost-effective and potentially cost-saving for the health system while generating substantial health gains for mothers and children over 15 years.
Wolf JM, Denlinger-Apte RL, Donny EC, et al. Nicotine Tob Res. 2026. PubMed
Summary
Researchers used advanced statistical methods to analyze how very low nicotine content (VLNC) cigarettes affect smoking abstinence, particularly among menthol and non-menthol cigarette smokers. When alternative nicotine products were available, VLNC cigarettes increased the likelihood of abstinence by 11-18 percentage points for menthol smokers and 8-10 percentage points for non-menthol smokers. These findings support VLNC cigarette regulation as a potential endgame strategy to reduce smoking, especially using statistical approaches that can improve precision in smaller subpopulations.
Schwarzschild MA, Macklin EA, Morain SR, et al. J Parkinsons Dis. 2026. PubMed
Summary
The UK's new generational smoking ban prohibits tobacco sales to people born after 2008, which is expected to dramatically reduce smoking-related diseases like cancer and cardiovascular disease. However, research shows that smokers have approximately half the risk of developing Parkinson's disease compared to non-smokers, suggesting this policy may inadvertently increase Parkinson's incidence while providing a valuable opportunity to study tobacco's neuroprotective mechanisms and develop safe alternatives.
Policy—Marketing/Advertising(5)
Salamanca MV, Galeano MIB, Builes JCC, et al. J Prev (2022). 2026. PubMed
SR
Summary
This systematic review of 12 studies examined how electronic cigarette advertising influences young people's attitudes and intentions to use ENDS products. The research found that e-cigarette ads use emotional persuasion tactics—such as messaging about freedom and social belonging—to create positive feelings and reduce perceived risk, ultimately increasing youth interest in trying these products. The review highlights that current prevention efforts need stronger counter-advertising strategies and stricter regulations on how e-cigarette products are marketed to young audiences.
Xiong L, Thrasher JF, Vidaña-Pérez D, et al. Addict Behav. 2026. PubMed
Summary
A two-week randomized trial tested whether cigarette pack inserts with rotating messages about quitting benefits increased smokers' thinking about cessation and their likelihood of skipping cigarettes. The inserts gradually boosted both cognitive engagement with quitting benefits and cigarette forgoing over the first week, but these effects weakened in the second week, suggesting that varied communication approaches beyond pack inserts may be needed to sustain the impact of health warning labels on smoking behavior.
Strickland JC, Naudé GP, Gelino BW, et al. J Exp Anal Behav. 2026. PubMed
Summary
A laboratory study with 31 young adult smokers examined how greenwashing advertising (marketing cigarettes as eco-friendly or natural) affects smoking behavior and perceived health risk. Participants preferred and smoked more cigarettes from brands advertised with greenwashing tactics compared to identical cigarettes with standard advertising, suggesting that environmental or natural health claims may increase cigarette appeal and should be considered in tobacco marketing regulations.
Weng X, Deng Y, Xia Y, et al. J Gambl Stud. 2026. PubMed
Summary
Cigarette card games popular among Chinese children contain gambling-like features (rare card rewards, chance-based mechanics) that may normalize tobacco use and gambling behaviors. Parents often facilitate participation by viewing these games as healthy alternatives to screen time, unaware they are exposing children to both gambling-like reward systems and tobacco imagery, highlighting a gap between parental perceptions and actual public health risks.
Martino SC, Dunbar MS, Setodji CM, et al. Health Psychol. 2026. PubMed
Summary
A simulated retail store experiment with 433 young adult smokers (ages 21-34) found that fully plain cigarette packaging reduced the likelihood of purchase compared to standard branded packaging, while partially plain packaging had no effect. Neither full nor partial plain packaging changed smokers' motivation to quit, suggesting that complete standardization of package appearance may be an effective regulatory approach to reduce cigarette purchasing in this age group.
Policy—Regulation(13)
Ahsan A, Rahim FK, Widyahening IS, et al. Asian Pac J Cancer Prev. 2026. PubMed
Summary
A survey of over 700 Indonesian respondents found that two-thirds were unaware of their country's single-stick cigarette sales ban, with particularly low awareness among older adults and active smokers who opposed the policy. Higher education and urban residence were associated with greater support for the ban, while knowledge and positive attitudes toward the regulation were the strongest predictors of believing it would improve public health—suggesting that public awareness campaigns are critical to the policy's effectiveness.
Xu SS, Quah ACK, Fong GT. Tob Control. 2026. PubMed
🍁 Canadian
Summary
China manufactures over 90% of the world's e-cigarettes, with Chinese companies using a fast-moving consumer goods model that enables rapid product changes, extensive flavour variations, and quick adaptation to regulations. Current regulatory approaches designed for traditional cigarettes have failed to address the speed and complexity of this industry, and domestic Chinese regulations in 2022 appear to have accelerated global expansion rather than slow it. Effective tobacco control responses require coordinated, supply-side approaches that strengthen oversight of manufacturing, distribution, and cross-border trade rather than relying on regulations that assume e-cigarettes behave like conventional cigarettes.
Carroll DM, Hatsukami DK, Wackowski OA, et al. Health Aff Sch. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
A commentary argues for implementing a federal nicotine cap in cigarettes and combusted tobacco products as part of the 'Make America Healthy Again' initiative, citing FDA projections that reducing nicotine to non-addictive levels could prevent 4.3 million smoking-related deaths by 2100 and save $1.1 trillion in healthcare costs. The authors recommend pairing a nicotine cap with increased funding for smoking cessation services and public education about the relative risks of different nicotine/tobacco products to maximize health benefits.
Alba C. JMIR Infodemiology. 2026. PubMed
Summary
Researchers analyzed social media conversations about vaping and e-cigarettes on X (formerly Twitter) in Singapore during a period of comprehensive e-cigarette prohibition. The analysis identified 18 distinct discussion topics, with most conversations being neutral in tone and primarily focused on regulatory policy, illegal sales and smuggling, and health concerns rather than promotional content. These findings can help public health authorities understand public discourse patterns and tailor communication strategies around vaping control measures.
East K, Cheeseman H, Taylor EV. medRxiv. 2026. PubMed
Summary
A randomized experiment in Great Britain found that cigarettes without filters were significantly less appealing to both the general population and current smokers compared to filtered cigarettes, with smokers being 6-7 times less likely to choose an unfiltered cigarette. Removing filters also increased perceptions that cigarettes are extremely harmful to health among the general population, suggesting that cigarette filter regulation or prohibition could reduce cigarette appeal and correct misperceptions of reduced harm while addressing environmental pollution.
Noël A, Kathuria H, Penz E, et al. Ann Am Thorac Soc. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
This article reviews vaping use patterns and regulatory approaches across North and South America, noting that teenagers and young adults have the highest rates of ENDS use and that dual use with combustible tobacco is increasingly common. Evidence suggests that strong anti-tobacco messaging in North America and product bans (as implemented in Brazil and Mexico) have been associated with reduced vaping rates. The authors highlight the need for improved surveillance data, longitudinal research on health impacts, and coordinated regulatory strategies across the Americas to address this growing public health threat.
Abbadi A, Alnaimat T, Al Nahar J, et al. Tob Control. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers examined how 189 countries define tobacco and nicotine-containing products in their national laws, finding significant gaps and inconsistencies in regulatory definitions. While 89% of countries defined tobacco products, only 30% fully aligned with the WHO Framework Convention's definition, and just 10% defined nicotine-containing products broadly—creating potential loopholes that could allow the tobacco industry to circumvent regulations through new or undefined products.
Zhao Y, Qian C, Guo W, et al. Int J Drug Policy. 2026. PubMed
Summary
China's 2022 e-cigarette regulations restricting flavours and online sales had limited public health impact, as users continued to access products through illicit channels and many perceived newly regulated products as safer due to labeling. While reduced flavour options were associated with higher quit rates, expanded informal purchasing access and increased consumption among continuing users undermined the regulations' intended effects.
Chung-Hall J, Fong GT, Meng G, et al. Nicotine Tob Res. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
This international study tracked menthol cigarette use across 25 countries from 2005-2023, comparing four countries with menthol bans (Canada, UK, Netherlands, Spain) to 21 without bans. Menthol cigarette market share declined significantly in all ban countries after implementation, while it increased in several non-ban countries, suggesting that menthol bans are an effective regulatory strategy for reducing menthol cigarette consumption.
Farsalinos K. Harm Reduct J. 2026. PubMed
Summary
This opinion/analysis article examines the regulatory inconsistency between cannabis liberalization and nicotine product restriction, arguing that current policies lack scientific justification. The authors contend that harm-reduction arguments used to support cannabis legalization are systematically ignored for non-combustible nicotine products, despite toxicological evidence suggesting nicotine's primary harms stem from combustion rather than the substance itself, and call for regulators to apply consistent, risk-proportionate standards across all psychoactive substances.
Ndaona S, Adebisi YA, Ngoma C. Int J Drug Policy. 2026. PubMed
Summary
This comparative analysis examined how eleven low- and middle-income countries govern electronic nicotine delivery systems (ENDS), finding three distinct regulatory approaches: prohibitionist (India, Brazil, Mexico, Vietnam), transitional (Bangladesh, Pakistan, South Africa), and differentiated/permissive (Philippines, Indonesia, Egypt, Kenya). All countries implemented explicit ENDS-specific legal treatment, but regulatory stability, institutional oversight, and excise tax structures varied considerably, suggesting that factors beyond economic capacity—such as which government agency holds regulatory authority—significantly shape ENDS governance in these settings.
Jairoun AA, Al-Hemyari SS, Shahwan M, et al. Medicine (Baltimore). 2026. PubMed
Summary
A bibliometric analysis of 984 scientific publications from 2004-2024 mapped global research trends on e-cigarette regulation and compliance, revealing that research has increasingly shifted from general tobacco control toward specific topics including youth vaping, flavor regulation, and regulatory compliance. The United States, United Kingdom, and Canada led research activity, with institutions like the University of Waterloo and King's College London as major contributors. While this analysis cannot assess whether regulations are effective, it demonstrates how the scientific evidence base has evolved and identifies emerging policy areas that require further investigation to inform regulatory decision-making.
Lee SH, Han DH. Am J Public Health. 2026. PubMed
Summary
Statewide e-cigarette flavor bans were associated with a slower rate of increase in adult e-cigarette use between 2018-2023 compared to states without such bans. While overall e-cigarette use among US adults still increased during this period, the ban appeared to have a moderating effect, particularly among adults aged 25 to 44 years, suggesting that flavor restrictions may be an effective policy tool for limiting growth in adult vaping.
Policy—Smoke-free Environments(3)
Azagba S, Roy B, Ebling T, et al. Addict Behav. 2026. PubMed
Summary
When states ended laws that prevented local jurisdictions from creating their own smoke-free protections, adult smoking rates decreased across all types of venues studied (workplaces, restaurants, and bars). The reductions were most pronounced among younger adults (18-24 years) and those with less than high school education, suggesting that local smoke-free policies may be particularly effective for reducing smoking in vulnerable populations.
Lai G, Gartner CE, Morphett K. Tob Control. 2026. PubMed
Summary
Australian news media coverage of smoking and secondhand smoke drift in homes (2015-2024) predominantly framed the issue as a rights-based conflict between individual smokers and non-smokers rather than a public health protection matter. While most articles supported policy action to address smoke-drift in multi-unit housing, the emphasis on competing individual rights may undermine support for comprehensive residential smoke-free policies.
Cook S, Woude CAV, Xie Y, et al. Am J Prev Med. 2026. PubMed
Summary
This study examined how Tobacco 21 laws work together with smoke-free workplace and hospitality laws to reduce adolescent smoking. The findings show that counties with both comprehensive Tobacco 21 coverage and smoke-free laws had lower rates of smoking initiation among 10th graders and lower past 30-day smoking rates among 12th graders, suggesting that layering these complementary policies is more effective than implementing them separately.
Policy—Taxation/Pricing(2)
Saenz-de-Miera B, Reynales-Shigematsu LM, Mendez Gomez-Humaran I, et al. Tob Control. 2026. PubMed
Summary
A follow-up study in 11 Mexican cities found that illicit cigarettes more than doubled from 8.5% in 2017 to 20.4% in 2023 among cities with comparable data, with substantial variation across cities (ranging from <1% to 43.4%). The findings suggest that factors beyond taxation alone drive illicit trade, and Mexico should adopt a comprehensive strategy including ratification of the Protocol to Eliminate Illicit Trade in Tobacco Products to address this growing problem.
Gligorić D, Borović Z, Vidović N, et al. Nicotine Tob Res. 2026. PubMed
Summary
Research on cigarette affordability in Bosnia and Herzegovina (2010–2023) found that price increases must outpace income growth to effectively reduce smoking, with consumers showing a price elasticity of -0.965 and income elasticity of 0.752. To achieve a 10% reduction in cigarette consumption given current income growth rates, excise taxes would need to increase by approximately 34–41%, with the specific amount depending on the analytical model used. The findings underscore the importance of regularly indexing tobacco excise taxes to both inflation and income growth to sustain reductions in consumption.
Protection—Secondhand/Thirdhand Smoke(1)
Vadibeler S, Mustafa K, Dondo TB, et al. Arch Dis Child. 2026. PubMed
Summary
A 10-year study of over 41,000 paediatric intensive care admissions in England found that children living in neighbourhoods with higher cigarette smoke exposure had a 30% increased risk of requiring critical care for respiratory illness. The research also identified significant health inequities, with children of Asian and Black ethnicity and those from economically deprived areas facing substantially higher admission rates and mortality, suggesting that community-level tobacco control measures could meaningfully improve child respiratory health outcomes.
Other / Uncategorized(41)
Bisht A, Shuki, Singh M, et al. Front Public Health. 2026. PubMed
Summary
This narrative review examines heated tobacco products (HTPs) as potential alternatives to combustible cigarettes by evaluating evidence across four levels: product emissions, human exposure biomarkers, individual disease risk indicators, and population health impact. While HTPs may reduce exposure to some combustion-related toxicants compared to conventional cigarettes, they are not risk-free, and their actual public health benefit depends on patterns of use, user populations, and regulatory environments. The review emphasizes that reduced emissions alone cannot establish reduced disease or mortality, and calls for further longitudinal studies to guide evidence-based harm reduction and tobacco control policies.
Zhao S, Li Y, Si H, et al. Front Microbiol. 2026. PubMed
Summary
This is a correction notice for a previously published article about the microbial processes involved in developing aroma compounds during the air-curing of cigar tobacco leaves. The correction updates information from the original 2026 research article but does not present new research findings. This technical article on tobacco product manufacturing processes does not directly address public health interventions, disease prevention, or tobacco control policy.
Andrade G, Benlahcene A, Mohamed E, et al. Front Psychol. 2026. PubMed
Summary
Researchers developed and validated a new measurement tool called the Attitudes Toward Hookah Smoking Scale (ATHS-MENA) specifically designed to assess hookah smoking attitudes in the Middle East and North Africa region, taking into account the cultural significance of hookah in these communities. The scale identified four key attitude dimensions: hookah engagement/dependency, social/cultural acceptance, health awareness/avoidance, and risk minimization, and demonstrated strong reliability and validity when tested with participants in the UAE. This culturally sensitive instrument can be used by public health researchers and practitioners to better understand and address hookah use in MENA populations.
Wright A, Liu S, Wright AP. medRxiv. 2026. PubMed
Summary
Researchers compared a structured-judgment model against four large language models for automatically extracting smoking history information from clinical notes to help identify patients eligible for lung cancer screening. All systems achieved high accuracy (94-100%), but the structured-judgment model was fastest and cheapest, while newer cost-efficient large language models offered better accuracy on complex cases at lower cost, suggesting that real-time clinical decision support tools using these technologies are now practical.
Adiwidjaja J, Boddy AV, McLachlan AJ. Clin Pharmacokinet. 2026. PubMed
Summary
Researchers developed a computer model to predict how the cancer drug pomalidomide behaves differently in people's bodies based on various factors including smoking status. The model successfully predicted how cigarette smoking increases the breakdown of pomalidomide through liver enzymes, as well as other factors affecting drug levels such as disease severity, ethnicity, liver function, food intake, and interactions with other medications.
Silva NFD, Oliveira MVS, Ferreira GIP, et al. Behav Processes. 2026. PubMed
Summary
Cigarette butts discarded on beaches release toxic chemicals that harm marine copepods (tiny organisms important to coastal food webs), causing developmental delays, reduced reproduction, and altered swimming and light-avoidance behaviours at relatively low concentrations. Newly discarded butts (Type I) were most toxic, and effects occurred at concentrations equivalent to 1.5–2.8 cigarette butts per litre of seawater. These findings suggest that cigarette butt pollution in coastal environments may disrupt marine ecosystems by affecting organisms critical to ocean food chains.
Bhamare A, Mane A, Telvekar P, et al. J Appl Toxicol. 2026. PubMed
Summary
Cigarette butts are a major source of pollution in aquatic environments, with an estimated 4.5 trillion discarded annually worldwide. These butts release numerous toxic chemicals including nicotine, heavy metals, and polycyclic aromatic hydrocarbons, as well as microplastic fibres, which harm aquatic organisms ranging from fish to plankton and can accumulate through food webs. The review identifies source-reduction strategies, improved waste management, and extended producer responsibility as key mitigation approaches, while emphasizing the need for more long-term ecological studies to fully understand the risks.
Le WB, Shi JS, Liu F, et al. Ren Fail. 2026. PubMed
Summary
Among 9,560 Chinese patients with IgA nephropathy (a kidney disease), current or former smokers had significantly higher rates of kidney failure and rapid kidney function decline compared to non-smokers, with smoking increasing the risk of kidney failure by 27% and a 50% decline in kidney function by 20% after accounting for other health factors. This finding suggests that smoking exposure accelerates progression of this type of kidney disease, particularly in men, though the study's generalizability may be limited by the small number of women smokers in the cohort.
Barrett ST, Raimondi AT, Finkner AP, et al. Prev Med. 2026. PubMed
Summary
This preclinical study examined how nicotine affects the reinforcing value of sucrose, alcohol, and sweetened alcohol in male and female rats. Nicotine enhanced alcohol's appeal in both sexes and selectively boosted sucrose preference in females, with the latter effect potentially equalizing sex differences in sweetened-alcohol consumption. The findings suggest that concurrent nicotine and alcohol use—particularly sweetened alcohol beverages—may increase heavy drinking risk, especially among women.
Li Q, Xu L, Zhu M, et al. Metabolites. 2026. PubMed
Summary
Researchers used advanced imaging and molecular analysis techniques to map how nicotine and its breakdown products distribute across different brain regions and the kidneys after acute exposure in rats. The study found that nicotine accumulates in specific anatomical locations and triggers region-specific changes in brain chemistry, dopamine activity, and metabolism—particularly in the striatum and hippocampus—revealing that nicotine's effects on the body are highly compartmentalized rather than uniform.
Intskirveli I, Lazar R, Hidalgo D, et al. Front Aging Neurosci. 2026. PubMed
Summary
Researchers investigated how aging affects inhibitory brain cells in the auditory cortex of mice and whether nicotine exposure could reverse age-related declines. Chronic nicotine exposure administered to older mice restored levels of certain inhibitory interneuron markers (parvalbumin and VIP) to those seen in young adults, primarily by increasing the expression of these marker proteins rather than generating new cells. These findings suggest nicotine may have potential therapeutic applications for treating age-related hearing and auditory processing problems, though further research would be needed to determine applicability in humans.
Zhang H, Yin Y, Yang Y, et al. Probiotics Antimicrob Proteins. 2026. PubMed
Summary
Researchers evaluated Bacillus amyloliquefaciens JDF-1, a bacterium isolated from healthy tobacco leaves, as a potential biocontrol agent against Aspergillus flavus mould and aflatoxin contamination during cigar tobacco fermentation. Under controlled fermentation conditions, JDF-1 substantially reduced visible mould growth and aflatoxin accumulation compared to untreated tobacco, though further validation and pilot-scale testing are needed before practical application.
Nongdren L, Vanapalli KR. Waste Manag Res. 2026. PubMed
Summary
A survey of 808 residents in Aizawl, India examined attitudes and behaviors related to cigarette butt littering in a city with very high smoking prevalence. The strongest predictor of littering behavior was the misconception that cigarette butts are biodegradable (18.8 times more likely to litter), with littering also driven by lack of disposal infrastructure and desensitization to litter. Policy recommendations include targeted education about cigarette butt non-biodegradability, strategic placement of fire-proof waste receptacles in high-littering areas, and waste valorization programs.
Kapaothong Y, Pimviriyakul P. Arch Biochem Biophys. 2026. PubMed
Summary
Researchers studied how a bacterial enzyme (nicotine dehydrogenase) breaks down nicotine by examining the specific amino acids and chemical interactions involved in this process using computational modeling and lab experiments. The findings show that certain amino acids help position the nicotine molecule correctly within the enzyme's active site to facilitate its degradation, rather than directly catalyzing the chemical reaction itself, which could inform future efforts to engineer this enzyme for biotechnological applications.
Hotta T, Hamaguchi M, Okimoto T. Respir Investig. 2026. PubMed
Summary
Among people with abnormal findings on lung cancer screening CT scans, current smokers were more than twice as likely to skip diagnostic follow-up appointments compared to former smokers. This finding highlights that smoking status is a strong predictor of whether people will complete necessary follow-up care after screening, suggesting that targeted interventions to improve adherence among active smokers could enhance the effectiveness of CT screening programs.
Alshahrani NZ, Shukri AK, Alqahtani AS, et al. Respir Med. 2026. PubMed
Summary
Physicians in Saudi Arabia showed moderate awareness and knowledge of tobacco harm reduction (THR) strategies and nicotine pouches, with 61.5% willing to recommend them to patients. Willingness to recommend THR was strongest among physicians who were aware of locally available nicotine pouch products, believed there was sufficient evidence supporting THR, had higher self-perceived knowledge, and held more positive attitudes toward these strategies.
Thomas R, Rucker R, Gray N, et al. J Test Eval. 2026. PubMed
Summary
This white paper examines the technical challenges involved in accurately measuring toxic metals in aerosols produced by cannabis vaping devices. Researchers identified significant obstacles in developing reliable collection and analysis methods, including contamination from collection materials and equipment resistance issues. The work highlights both solved problems and remaining gaps that must be addressed before establishing standardized, efficient testing procedures for metal content in vaping aerosols.
Aydoğan Y, Cantürk İ. J Voice. 2026. PubMed
Summary
Researchers tested whether a complex voice analysis model (using 208 acoustic variables) could be simplified into 16 interpretable acoustic domains while maintaining its ability to identify smokers versus nonsmokers from sustained voice recordings. The simplified 16-domain model performed nearly as well as the original complex model (AUC 0.753 vs 0.769) and identified spectral centroid, formant structure, and harmonicity/noise as the most important acoustic features for smoking status discrimination, though no single feature was essential on its own.
Liu Y, Yu H, Zhang J, et al. Front Immunol. 2026. PubMed
Summary
Researchers used advanced single-cell analysis to compare how nicotine, diosmetin (a plant compound), their combination, and galantamine affect microglial cells (immune cells in the brain) when exposed to inflammatory triggers. The nicotine and diosmetin combination showed promise by reducing inflammatory responses while maintaining cell function and increasing production of brain-protective factors, suggesting a potential approach to help manage neuroinflammation associated with neurodegenerative diseases.
Wang G, Ni Z, Zhang J, et al. Free Radic Biol Med. 2026. PubMed
Summary
Researchers investigated how nicotine may protect against Parkinson's disease by examining its effects on ceramide (a fat-like substance) and mitochondrial health in both mouse models and brain cell cultures. Nicotine treatment improved motor function, preserved dopamine-producing nerve fibers, and reduced harmful ceramide buildup while restoring mitochondrial function and reducing cell death, suggesting a potential neuroprotective mechanism involving nicotine receptors in the brain.
Tomko PM, Curran H, Patterson JG, et al. Nicotine Tob Res. 2026. PubMed
Summary
This qualitative study examined how 44 adults use oral nicotine pouches (ONPs), including 16 never-smokers and 28 former smokers or smokeless tobacco users. Users employed diverse consumption strategies, including varying lip placement, moving pouches around the mouth or keeping them stationary, using multiple pouches simultaneously, and stacking consecutive pouches to titrate nicotine delivery. These findings suggest that ONP use patterns are highly variable among established users, which has important implications for understanding addiction potential, toxicity exposure, and overall health effects.
Ji A, Xu W, Xiong H, et al. Tob Induc Dis. 2026. PubMed
🍁 Canadian 🔓 Open Access
Summary
Researchers identified shared genetic factors between smoking dependence and Crohn's disease by analyzing genetic data from large studies, finding a moderate positive genetic correlation between the two conditions. Three specific genetic regions and four key genes were identified as contributing to susceptibility to both conditions, with evidence pointing to shared immune and inflammatory pathways, particularly involving T-helper 17 cells and inflammatory response mechanisms. These findings suggest that some individuals may have inherited genetic predispositions that increase their risk for both smoking dependence and Crohn's disease through common biological pathways.
Jawzal KH, Mosa AA. Biol Trace Elem Res. 2026. PubMed
Summary
Researchers measured heavy metals and trace elements in blood samples from 60 male smokers before wet cupping therapy (a traditional practice), in the cupping blood itself, and again 9-10 days later. The cupping blood contained distinctly higher levels of cadmium, copper, iron, nickel, and lead, but these metals decreased significantly in regular blood samples by the follow-up period. Self-reported cigarette consumption was associated with higher levels of certain metals (nickel, copper, cadmium) and lower zinc levels, suggesting a link between smoking intensity and metal accumulation in the body.
Holguín Galvis S, Martín-García P, Catalá-López F. Rev Esp Salud Publica. 2026. PubMed
SR
Summary
This overview synthesized six systematic reviews containing 143 studies on the economic costs of tobacco use globally. The research found that tobacco-related diseases cost up to US$1.44 trillion worldwide annually (2012), with most estimates focusing on direct healthcare costs at the national level. However, the reviews identified significant methodological inconsistencies across studies, limiting the ability to compare results and highlighting the need for standardized approaches to measuring tobacco's economic burden.
Liang LX, Zhu MJ, Zhao L. J Microbiol Biotechnol. 2026. PubMed
Summary
Researchers fermented cigar tobacco using a Bacillus subtilis bacterium to improve the sensory qualities of heat-not-burn (HnB) tobacco products. The fermentation process reduced protein content while increasing free amino acids and sugars, and produced a more favorable aroma profile with higher levels of esters, aldehydes, and phenols, resulting in improved overall sensory scores in HnB cigarettes made from the fermented tobacco.
Gercek ABK, Karabulut GN, Guncu MB. J Esthet Restor Dent. 2026. PubMed
Summary
Researchers tested how cigarette smoke, tea, and coffee stain dental zirconia (a tooth-colored ceramic material) when finished with different surface treatments. Cigarette smoke caused the most discoloration and surface damage overall, particularly when zirconia was treated with a micro-layering glaze, while tea and coffee caused less damage with this treatment compared to polishing or conventional glazing alone.
Helli H, Jones WB, Fontoura BM, et al. Appl Spectrosc. 2026. PubMed
Summary
Researchers developed and tested a new analytical method called Calibration by Proxy to measure 12 different metals and metalloids in pipe tobacco samples, including toxic elements like cadmium, lead, and arsenic. The method is efficient and accurate, requiring analysis of only two solutions while detecting metals at very low concentrations (parts per billion range), with measured levels in pipe tobacco ranging from 0.04 to 700 mg per kilogram. This technique could be useful for regulatory monitoring of heavy metal contamination in tobacco products.
Ngobese SP, Ayo-Yusuf OA, Egbe CO. Tob Use Insights. 2026. PubMed
Summary
A qualitative study in South Africa explored why adults use smokeless tobacco, how they use it, and what harms they experience, finding that traditional users (healers and initiates) use it for spiritual and healing purposes while non-traditional users cite stress relief, perceived health benefits, and affordability. Although participants reported experiencing health, social, and financial harms, some traditional users believed their use was protected from harm through spiritual or ancestral authority, suggesting that cultural beliefs may influence how people perceive tobacco risks. Public health interventions need to address both the documented health risks of smokeless tobacco and the deep cultural meanings attached to its use, particularly by engaging traditional healers and communities.
Feng X, Hou H, Wang C, et al. Biol Psychiatry Cogn Neurosci Neuroimaging. 2026. PubMed
SR
Summary
A brain imaging meta-analysis of 102 studies examined how smoking cues activate neural regions associated with stress threat and reward anticipation in smokers' brains. The analysis found that smoking cues, threat processing, and reward anticipation activate distinct brain regions rather than overlapping ones, though these regions are functionally connected through neural networks. These findings suggest that smokers may experience a shift from stress-driven reward-seeking to cue-triggered craving, pointing to potential brain targets for interventions to prevent relapse triggered by stress.
Ihara D, Kato Y, Tabuchi A. Drug Discov Ther. 2026. PubMed
Summary
Researchers investigated how nicotine affects the brain's response to kainate, a substance that activates certain neural receptors, by examining changes in four immediate early genes across different brain regions in mice. Nicotine pretreatment selectively reduced kainate-induced expression of Arc and junB genes specifically in the cerebral cortex, while having no effect on c-fos and egr1 genes, suggesting that nicotine's effects on gene expression are both brain-region and gene-specific.
Ahmad M, Ullah U, Ateeq M, et al. J Environ Manage. 2026. PubMed
Summary
Researchers evaluated 14 cigar tobacco varieties for their ability to grow in salty soil conditions, identifying QX200 as highly salt-tolerant and QX103 as salt-sensitive based on plant growth measurements and cellular responses. The salt-tolerant variety maintained better plant health under stress through stronger antioxidant defenses and better regulation of salt ions in cells. These findings could inform breeding programs to develop tobacco cultivars that can be sustainably grown in saline environments.
Tang Q, He Z, Wang S, et al. Appl Environ Microbiol. 2026. PubMed
Summary
Researchers identified how two regulatory proteins (NdpR and NdpR2) work together in a bacterial species to control the breakdown of nicotine, with one protein directly controlling the activity of the other through a cascade mechanism. The study found that an intermediate chemical produced during nicotine degradation acts as a signal to fine-tune this regulatory system, allowing bacteria to efficiently respond to changes in their environment. The findings have potential applications in synthetic biology and could inform strategies for using microorganisms in environmental remediation of tobacco-related pollutants.
Xie K, He M, Wang J, et al. J Hazard Mater. 2026. PubMed
Summary
Researchers discovered that nicotine spontaneously breaks down through radical-mediated oxidation at the air-water interface of aerosols under normal humid conditions, such as those found in the respiratory tract. Using specialized analytical techniques, they identified the oxidation products and the chemical mechanisms involved, and found that certain substances like salt and benzoic acid can inhibit this breakdown process. This finding clarifies how nicotine degrades in the lungs and reveals a broader mechanism for how organic compounds transform when suspended in airborne water droplets.
Kaneko T, Kabasawa K, Kitamura K, et al. Ann Geriatr Med Res. 2026. PubMed
Summary
Heavy smoking (≥20 cigarettes/day) was associated with nearly twice the odds of sarcopenia (age-related muscle loss) in middle-aged and older adults, with even stronger associations observed among those who also consumed alcohol. The relationship between smoking levels and sarcopenia suggests that smoking may contribute to muscle wasting in aging populations, though the study design does not establish direct causality.
Zhang H, Hong B. Trends Biochem Sci. 2026. PubMed
Summary
Researchers identified how tobacco plants produce nicotine through the discovery of previously unknown enzymes and intermediate compounds involved in the biosynthetic pathway. The study found that nicotine-producing enzymes assemble together in plant cell vacuoles in a way that efficiently channels substrates from one enzyme to the next, similar to an assembly line, which allows plants to accumulate higher levels of nicotine. This fundamental research on the plant biology of nicotine production may inform future strategies for reducing nicotine content in tobacco products.
Hof D, Bing T, Brown GG, et al. Aquat Toxicol. 2026. PubMed
Summary
This article examines methods for detecting water pollution from various human sources, which is unrelated to tobacco research. The study evaluates laboratory and field-based testing approaches to identify contamination in surface waters and sediments, finding that laboratory tests were more sensitive than field tests and that wastewater treatment plant discharge was a significant pollution source.
Feng H, Guo M, Guan J, et al. J Sci Food Agric. 2026. PubMed
Summary
This research examined how volatile aromatic compounds change during low-temperature smoking of sea bass using advanced chemical analysis techniques. The study found that the final aroma profile results from both natural lipid breakdown in the fish and smoke-derived compounds from wood decomposition, with the balance shifting during smoking and maturation. These findings could help optimize flavor quality and process control in commercial smoked fish production.
Lenich AK, Litz A, Reindl LM, et al. Arch Toxicol. 2026. PubMed
Summary
Different tobacco products have distinct effects on liver enzymes that metabolize medications, with cigarettes and cigars causing the strongest induction of CYP1A1 enzymes, while e-cigarettes show a different pattern affecting CYP3A4 and CYP2B6 more prominently. Current clinical practice of recording smoking status as simply "Yes" or "No" fails to capture these important differences that could affect how patients metabolize medications. The research recommends collecting detailed information about specific tobacco product use in clinical studies to better predict drug interactions and improve treatment outcomes.
Haneberg E, Harkin W, Singh H, et al. Arthroscopy. 2026. PubMed
Summary
A study of shoulder surgery patients found that smokers were significantly more likely to develop postoperative shoulder stiffness requiring additional surgery compared to non-smokers (21% vs 5%). Smoking was identified as one of four major risk factors for this complication, alongside diabetes, workers' compensation status, and traumatic tear type, suggesting that patients with these characteristics may need modified surgical approaches or closer postoperative monitoring.
Das N, Maiti B, De K, et al. Mar Pollut Bull. 2026. PubMed
Summary
Researchers assessed cigarette butt pollution and heavy metal contamination across eight beaches in Goa, India, finding an average density of 3.15 cigarette butts per square meter with severe pollution levels at all sites. While heavy metal concentrations in the butts were generally in safe-to-moderate ranges, the study highlights cigarette butts as a persistent environmental hazard in coastal areas, requiring coordinated tobacco control, waste management interventions, public education, and enforcement of anti-littering regulations.
Kasakewitch JP, Eguchi M, Perim V, et al. J Laparoendosc Adv Surg Tech A. 2026. PubMed
Summary
Researchers evaluated whether artificial intelligence language models (ChatGPT, Microsoft Copilot, and Google Gemini) could effectively search medical literature on smoking's effects on hernia repair surgery. While AI tools quickly generated citations, they performed poorly overall: only 37.5% of references were valid, 54.2% were fabricated, and the tools missed nearly 80% of studies identified in previous systematic reviews. The findings highlight that AI language models cannot yet reliably replace human expertise in conducting comprehensive literature searches for medical research.
News Articles 15

Recent tobacco and vaping coverage from news sources.

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Ontario Tobacco Research Unit
Current Abstracts is a monthly research digest produced by OTRU  ·  otru.org
Automated literature search via PubMed  ·  AI-assisted categorization and summarization  ·  News coverage via Google News, matched to articles with AI assistance  ·  Editorial review recommended before publication.

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