Nicotine Risk and the Implications for Benefit Design

Nicotine use is important to consider in any population health or wellness strategy. It increases member risk and should be factored into benefit design, including the potential for increased member cost share. While there is often debate about whether vaping or nicotine pouches are safer than cigarettes, evidence shows that nicotine itself is harmful regardless of delivery method. Research demonstrates consistent increases in blood pressure, vascular damage, and higher cardiovascular risk across cigarettes, vapes, heated tobacco, and nicotine pouches. No nicotine-delivering product is safe for the heart. Incorporating nicotine use into risk assessment and incentive strategies can help employers better align costs with risk and reinforce healthier behaviors (Münzel et al., 2025).

Münzel, T., Crea, F., Rajagopalan, S., & Lüscher, T. (2025). Nicotine and the cardiovascular system: Unmasking a global public health threat. European Heart Journal, ehaf1010. https://doi.org/10.1093/eurheartj/ehaf1010