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Scale of health risk 8,9 *Cigarettes & alternative tobacco and nicotine products mostly owned and manufactured by tobacco companies 22,23,24.25 Alternative tobacco and nicotine products: What you need to know Whilst alternative tobacco and nicotine products could be a step in the right direction, most have not been specifically developed to aid quitting: Average weekly nicotine consumption amongst vapers is 2X that of an average smoker 34-36 70% of alternative tobacco and nicotine product users still smoke 37 Alternative tobacco and nicotine products are not licensed medicines No clear dosing regimen and inconsistent dose delivery No tapering guidance Often flavoured for purposes of enjoyment May contain harmful ingredients Long-term health risks largely unknown Alternative tobacco and nicotine products in adolescents Studies , show that nicotine binds to more receptors in the brains of teenagers than in adults

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Public Health 128(2):161166 Huang Y (2016) Understanding Chinas belt & road initiative: motivation, framework and assessment