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.

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.

As the landscape of e-cigarette use continues to evolve in the US, research has been mounting on the potential health harms. Previous studies have shown that e-cigarette use contributes to heart and lung disease. Now, a recent case control study conducted in Ohio shows a potential link between dual use – smoking both cigarettes and vaping – and an increased risk of lung cancer. The bottom line: those who smoke and vape have increased lung cancer risk.