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Smoking-related disease causes nearly one in five premature deaths in the United States (CDC). Half of those who continue to smoke will die from a smoking-related illness — about 480,000 Americans each year, and more than 1,300 every day (CDC).
It is widely understood that the best option for adult smokers to reduce the risks to their health from combustible cigarettes is to quit tobacco and nicotine products altogether. However, for those adults who continue to use nicotine, switching to a noncombustible alternative can significantly reduce their exposure to harmful constituents in smoke and their risk of smoking-related disease.
In March 2023, Juul Labs published a white paper titled “The Real-World Impact of ENDS for Adult Smokers: Tobacco Harm Reduction Through Real-World Data and Evidence.” This white paper offered evidence on the harms of smoking cigarettes and the demonstrable public health benefits of Americans who smoke switching to smokefree alternatives.
Given the rapidly growing body of science, our second edition in May 2025 is updated to include recent science that continues to demonstrate these benefits. In this second edition paper, Juul Labs has again reviewed and compiled the latest science and evidence reinforcing the real-world impact of ENDS products for adult smokers based on four key lines of evidence:
