Nicotine

STOCKHOLM--(BUSINESS WIRE)--Giving mice a chemically induced epileptic condition and then adding nicotine does not prove that nicotine causes or worsens seizures, according to Haypp Group's recently published criticism of a laboratory study on nicotine pouches. The animal experiment used kainic acid, a well-known compound that is deliberately used to trigger seizures in mice. Before seizures were induced, researchers exposed them to nicotine pouches or cannabidiol (CBD), reporting changes in seizure severity and brain-related biomarkers. But a scientific comment published in Nicotine & Tobacco Research argues the findings are overstated and risk misleading the public if taken out of context. Kainic acid itself causes strong inflammation and significant changes in brain activity, indicating that the animals are already in a highly abnormal neurological state. That makes it extremely difficult to determine what is driving any observed effects: the seizure-inducing chemical, nicotine, or their interaction. Without proper control groups, such as animals exposed to nicotine alone or CBD alone, it is not possible to separate out the specific role of each substance. The problem is not unique to nicotine. Caffeine, for example, has been shown in animal seizure models to sometimes appear to worsen seizure activity, depending on dose and experimental conditions, even though that does not translate into evidence of harm in humans from drinking caffeine-containing drinks like coffee. Dr. Lindsay Reese, Senior Content Manager, External Affairs at the Haypp Group (parent company of Nicokick.com and Northerner.com), who authored the critique, argues that this is a broader issue in preclinical neuroscience: when experiments are built on already destabilized biological systems, almost any compound can appear to shift outcomes in either direction. The concern, she says, is what happens next—when complex, highly technical findings are simplified outside the laboratory. According to the comment, the nicotine study suffers from unclear dosing methods, a lack of verification of actual nicotine exposure in animals, and insufficient experimental controls to support strong conclusions about nicotine pouch harm. This is yet another example of how poorly designed or poorly interpreted animal studies can be used to generate alarmist narratives in the media, even when the underlying science does not justify the claims. The result is a cycle in which uncertain laboratory findings are transformed into confident-sounding headlines that often leave the public with a distorted view of risk far removed from the actual evidence base. ABOUT NICOTINE & TOBACCO RESEARCH Nicotine & Tobacco Research is the official journal of the Society for Research on Nicotine and Tobacco and is published by Oxford University Press. The journal provides a forum for empirical findings, critical reviews, and scholarly debate on all aspects of nicotine and tobacco research. About Haypp Group Haypp Group is leading the global shift from smoking to oral nicotine products. With roots in the pioneering smoke-free alternative markets of Scandinavia, Haypp uses its regulatory expertise and e-commerce leadership to bring compelling value to over 1.1 million consumers. Operating through eleven distinct e-commerce brands, the Group is active across six countries in Europe and the USA. Haypp Group's e-commerce sites in the U.S. are: Nicokick.com and Northerner.com. DISCLOSURE The author declares their competing interests and affiliations in the published Letter to the Editor. The commentary does not present new experimental data.

Receiving a cancer diagnosis sometimes makes people think there is no point in quitting smoking, or that quitting will be too stressful to attempt during or after difficult cancer treatment. In reality, quitting is linked to better survival and fewer side effects, and although quitting can is difficult, it’s never too late to make a change. New research from the University of Chicago Medicine indicates that a simple opt-out, technology-based outreach program is an effective and efficient way for cancer centers to make smoking cessation a routine part of patient care. Through the No Smoker Left Behind program, healthcare professionals identify cancer patients who smoke and use an opt-out approach to repeatedly offer a menu of free or low-cost treatment and support options for quitting. According to the new analysis, more than half of eligible cancer patients responded to automated outreach, and of those who chose treatment, most selected a combination of counseling and medication, which is considered the “gold standard” for smoking cessation. “Adults who have cancer and who smoke have worse outcomes across the board: poorer treatment response and higher likelihood of complications, relapse, and secondary cancers,” said senior author Andrea King, PhD , director of UChicago Medicine’s Courage to Quit and No Smoker Left Behind programs. “Tobacco cessation for cancer patients should be a medical priority right alongside treatments like chemotherapy.” A place for smoking cessation in cancer care Despite the statistics about the adverse effects of continued tobacco use after a cancer diagnosis, the authors said smoking has too often remained an afterthought in oncology. “There’s a tendency to assume that smoking cessation is something that falls outside the realm of cancer care,” said first author Michael Wakeman, an MD candidate at the University of Chicago Pritzker School of Medicine. “And when we talked to healthcare professionals across multiple cancer centers, we repeatedly heard that people don’t feel like they have time to add tobacco cessation programs to their routine practice.” The Cancer Moonshot-funded Cancer Center Cessation Initiative (C3I) was created in 2017 to change that by providing support for National Cancer Institute-designated cancer centers integrating tobacco treatment into routine care. The UChicago Medicine Comprehensive Cancer Center was one of just 22 cancer centers across the country to receive the first wave of funding to develop and sustain smoking cessation programs. A persistent, efficient intervention that retains patient agency No Smoker Left Behind was UChicago’s C3I result: an “opt-out” program that uses technology instead of relying on already overburdened clinicians to initiate the conversation. The system uses the electronic health record to identify adult cancer patients who currently smoke. After an outpatient visit, those patients are automatically contacted for up to six months through text messages, emails, and short, interactive phone calls with pre-recorded messages from King. The opt-out model means that every eligible patient is invited to participate rather than having to reach out for help on their own, and the contact messages are designed to be warm and welcoming. This strategy helps lower barriers to participation and avoids making patients feel singled out or shamed, and makes the program sustainable from a labor and cost perspective since the initial enrollment doesn’t need to be triggered by additional actions from a healthcare team member. “I’m old school: I would love to meet with every patient and have a warm, 30-minute conversation. But I know I’d only reach a fraction of patients that way, and there are financial constraints at the institutional level,” King said. “But we can’t let excuses get in the way of providing state-of-the-art care and offering all patients a range of options. Technology is the way to do that.” Patients who engage with the No Smoker Left Behind communications answer a few questions about their smoking behaviors and can then choose from a menu of treatment options, including: Individual virtual counseling from a dedicated UChicago Medicine specialist Group-based virtual counseling through the Courage to Quit program FDA-approved medications that can aid cessation The Illinois Tobacco Quitline , which offers free phone-based counseling and nicotine replacement patches A free intensive text-messaging program sponsored by SmokeFree.gov and the National Cancer Institute Patients can select counseling, medications, both, or decline altogether, and they are offered these options multiple times over the course of 180 days. Patients who don’t quit within six months or who don’t respond to the first set of outreach attempts can be invited again after another outpatient visit. King said that both the repeated contact and the offering of multiple options are deliberate. “We had many people re-enroll over and over again. It’s about finding a moment when someone’s ready to receive the information and support,” she said. “Providing options lets patients retain agency, which should be made a standard of care.” High referral rates, relatively low cost During the study period (2019–2024), No Smoker Left Behind contacted 3,706 eligible cancer patients who smoked. Nearly half were Black, and almost two-thirds were publicly insured — groups that often face greater tobacco-related harms and have less access to community resources and other cessation support. More than half of those contacted responded to at least one message from the program, and about one in four of all eligible patients went on to receive referrals to cessation treatment. Over 70% of those who selected treatment chose to combine medication and counseling, which is considered the “gold standard” treatment plan for smoking cessation. The researchers calculated that the program costs are lower than the estimated cost of cancer treatments failing because patients continue to smoke, which has been estimated at more than $10,000 per patient in some analyses. ‘Quitting smoking is cancer care’ “We want patients and their loved ones to know that it's never too late to make a change when it comes to smoking,” Wakeman said. “Millions have quit — it’s okay that for some people it takes longer or requires more support. We recognize that it’s a journey: if you're not ready to quit yet, we talk about reducing to get to the point of quitting. There’s a lot of flexibility.” In the future, the researchers hope to expand the program to hospitalized patients and eventually to people with other serious conditions linked to smoking, such as chronic obstructive pulmonary disease (COPD) , cardiovascular disease, and diabetes. With the current paper and ongoing efforts, they hope to shift how patients and healthcare professionals alike think about smoking in the context of cancer. “Quitting smoking is cancer care,” King said. “If we could start changing our thinking about that, it would be so important. It's all about support, not blame.” “ No Smoker Left Behind: Evaluation of a Population-Based, Opt-Out Smoking Cessation Program for Cancer Patients Who Smoke ” was published in the Journal of Clinical Oncology in May 2026. Co-authors are Michael Wakeman, Yasmin Asvat, Raymond A. Ruiz, Emma I. Brett, Vincent Talbot, Jasmin Tiro and Andrea C. King. 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