We have all seen it creeping into social media feeds and popular media: the idea of nicotine as a “wellness” and productivity tool. This unexpected rebrand has relied on podcasters and influencers promoting nicotine pouches, patches, and even drinks as part of a “biohacking” lifestyle—promising sharper focus, improved energy, and enhanced performance.

Rachael Joyner’s journey from learner to Duke clinician showcases the transformational impact of the Duke-UNC Tobacco Treatment Specialist Training Program.

In the last year, the U.S. Food and Drug Administration began publicly acknowledging harm reduction as a legitimate principle within its regulatory framework. Through its Premarket Tobacco Product Application process, companies can gain authorization to sell their products in the U.S. An important distinction here is that these products are not recognized by the FDA as being safe or approved for treatment of tobacco use disorder.