At a Miami conference focused on nicotine delivery, a senior executive from Philip Morris International’s U.S. operations is drawing attention to a persistent public health issue: the population of adults who continue to smoke despite available alternatives. Her remarks frame the problem as one of both perception and policy, suggesting that clearer information and regulatory adjustments could shift behavior among these smokers.
The speaker identifies a set of smokers she calls the forgotten smoker, people for whom quitting or switching has proved difficult. She argues that addressing their needs requires a mix of evidence-based policy, better public education and broader availability of less risky nicotine options.
Who are the forgotten smokers?
According to the executive, smoking is now concentrated among particular demographic groups: residents of rural areas, workers in blue-collar trades and adults with lower incomes. These patterns persist even as overall smoking prevalence declines and more consumers choose alternatives such as nicotine pouches and heat-not-burn products. The executive emphasized that social context and access to information play major roles in whether a smoker considers less harmful choices.
Barriers: stigma, misinformation and limited awareness
She pointed to a trifecta of obstacles keeping people on combustible cigarettes: stigma attached to seeking alternatives, widespread misinformation about relative risks, and simple lack of awareness that other options exist. Even some health professionals, she noted, may mistakenly equate all nicotine products with the harms of smoking, which discourages patients from trying harm reduction approaches.
Harm reduction as a public health strategy
The executive did not deny that the best health outcome is complete nicotine cessation. She acknowledged that quitting entirely is the only route to eliminate all risk. At the same time, she highlighted research and regulatory language that describe a continuum of risk, where different nicotine products carry different levels of harm. That framework places combustible cigarettes at the highest risk because of combustion and the toxic byproducts it creates, while oral nicotine pouches and heat-not-burn products occupy lower positions on the spectrum.
Effectiveness and realistic goals
Quitting aids such as nicotine gum or patches are acknowledged as valuable, but the executive pointed out their limited long-term success rates. By contrast, switching smokers to less harmful alternatives may reduce risk at the population level even when complete cessation proves elusive. The discussion framed this shift as a pragmatic complement to cessation services rather than a replacement.
Evidence, economics and policy levers
Complementing her conference remarks, a white paper from the company’s U.S. arm maps the scale of the problem: tens of millions of Americans still smoke. The document emphasizes the economic toll of smoking, referencing public health cost estimates in the hundreds of billions annually tied to medical care and lost productivity. Those figures serve as a policy argument: reducing smoking through targeted strategies could yield broad societal savings.
Policy recommendations in the executive’s presentation included clearer public messaging about risk differences, support for regulatory frameworks that enable wider access to lower-risk products, and integration of harm reduction into existing cessation programs. She asked policymakers, health advocates and communities to treat persistent smoking as an unresolved public health challenge rather than a solved problem.
State-level efforts and remaining gaps
The executive praised Florida’s Tobacco Free Florida program for offering free cessation tools like patches, gum and lozenges. Still, she argued the program could reach more people if it incorporated additional product options that may be less harmful than combustible cigarettes. Her message emphasized choice and expanded pathways for smokers who have not succeeded with conventional cessation approaches.
Professional background and framing
She spoke from a background in regulatory strategy, public policy and stakeholder engagement across tobacco, nicotine and adjacent sectors. Her career has included leadership roles addressing product integrity, youth access prevention and compliance, often in high-profile regulatory settings. That experience informed her presentation, which combined industry perspective with public health arguments to press for nuanced policy responses.
Overall, the talk presented at the Miami event urged a shift in how regulators, clinicians and communities approach those who continue to smoke: move beyond binary messages of quit-or-fail, reduce misinformation, and consider a wider range of tools so millions of adult smokers have realistic alternatives that lower harm.
