Youth Tobacco Use Is at Historic Lows. Adult Smokers Still Need Better Choices.

(Dr. Matthew Holman) - There is a piece of good public health news that deserves more attention: youth tobacco use in the United States has fallen to historically low levels. That progress did not happen by accident. It reflects years of prevention work, stronger age restrictions, public education, and a broad consensus that tobacco and nicotine products should not be used by anyone under the legal age.

That progress is worth saying plainly, especially at a time when public discussion often leaves people with the impression that youth tobacco use is only moving in the wrong direction. The data tell a more encouraging story. But encouraging does not mean solved. Any youth use is unacceptable, and prevention must remain central to how nicotine products are marketed, sold, monitored, and regulated.

The public health challenge now is to protect that hard-won progress while confronting a different, persistent problem: cigarettes. According to the CDC, cigarette smoking remains the leading cause of preventable death in the United States. Millions of adults continue to smoke despite decades of warnings, restrictions, taxes, and cessation campaigns. Complete cessation is always the best choice for health. But for adults who would otherwise continue smoking, access to accurate information about scientifically substantiated smoke-free nicotine alternatives matters.

That is why FDA's recent action on ZYN nicotine pouches is significant. After scientific review, the agency issued modified risk orders for 20 ZYN nicotine pouch products, allowing them to be marketed with a specific FDA-authorized claim: "using ZYN instead of cigarettes puts adults at lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and chronic bronchitis." FDA did not say these products are safe. It did not say people who do not use nicotine should start. It authorized a claim to help adults who smoke better understand relative risk.

That distinction is important. Nicotine products are addictive and not risk-free. They are not substitutes for quitting tobacco and nicotine altogether, and they are not intended as nicotine replacement therapies (e.g., patches, gums, etc.). But science-based policy should recognize meaningful differences in risk between cigarettes and smoke-free nicotine products for adults who switch completely.

The latest youth tobacco data show these goals are not mutually exclusive. According to FDA's analysis of the 2025 National Youth Tobacco Survey, current use of tobacco products, combustible tobacco products, and e-cigarettes declined between 2022 and 2025. FDA also reported that youth use of nicotine pouches remained low and stable, with 1.7 percent of students reporting current nicotine pouch use in 2025, compared with 1.8 percent in 2024.

Those numbers should give policymakers confidence, not complacency. They show that historically low youth tobacco use can coexist with a marketplace that includes FDA-authorized smoke-free alternatives for adults. Keeping youth use low requires continued discipline from regulators, retailers, manufacturers, parents, educators, and public health leaders.

PMI U.S. has been clear that smoke-free nicotine products are for current nicotine consumers who are 21 and older—not youth, not non-users, and not people who are trying to quit nicotine altogether. The company's responsible marketing practices reflect that commitment. Advertising features only individuals aged 35 or older. Branded websites require independent online age verification for visitors 21 and older. PMI U.S. limits its social media presence to platforms that allow age-restricted controls. It does not pay social media influencers to endorse its products and does not engage in product placement in movies or television programs.

Those practices are part of a broader 10-point approach to underage prevention that includes responsible marketing, retail support programs, real-world monitoring, and a call for collective action. The approach includes age-gated website access, monitoring of underage-use data, responsible marketing standards, retail technology advancement, responsible social media policies, FDA regulation, continued innovation for age restriction, support for enforcement against illicit products, responsible retail practices, and support for compliance checks such as mystery shopping by FDA.

No single company, regulator, or public health organization can do this alone. The right framework is practical and evidence-based: keep nicotine products away from anyone under 21, enforce minimum age of purchase laws, address illicit products, maintain clear product standards, and require responsible marketing.

The United States has made extraordinary progress reducing youth tobacco use. That is worth saying plainly, and it is worth protecting. The next step is to bring the same seriousness to the adults who still smoke. A mature tobacco policy should be able to do both: prevent young people from starting and help adults who continue to smoke move to better alternatives. Those goals belong together.

Dr. Matthew R. Holman is the vice president and chief science and regulatory strategy officer for PMI U.S. Holman is the former chief scientist at the FDA's Center for Tobacco Products.