Re: Disregarding the impact of nicotine on the developing brain when evaluating costs and benefits of noncombustible nicotine products

This Letter to the Editor is in response to a letter from Ms. Flannery, titled, “Disregarding the impact of nicotine on the developing brain when evaluating costs and benefits of noncombustible nicotine products”. In our response, we address some concerns raised by Ms. Flannery, and reiterate our position in our original article. In particular, we underline the importance of a rational public health calculus that weighs beneficial and harmful consequences of policies related to noncombustible nicotine product (NNP) use. We further emphasize the need to correct misperceptions about relative risk of different products to encourage smokers to switch to NNPs. Lastly, we are explicit about our assertion that no use of any nicotine-containing products is the only way to avoid harm at any age, but that we must view this issue pragmatically for the benefit of public health.