PMI U.S. exec to discuss ‘the forgotten smoker’ in Miami tobacco harm reduction talk

A top executive at Phillip Morris International U.S. is speaking Wednesday at the 8th Annual Next Generation Nicotine Delivery USA conference in Miami.

The speech is expected to tackle solutions for those who continue to smoke despite health advice and access to less harmful options.

Erin Warren, head of U.S. regulatory and public policy at Philip Morris International’s U.S. businesses (PMI U.S.), calls them “the forgotten smokers,” and her talk reflects that with its title: “The Forgotten Smoker: New U.S. Polling, Persistent Misinformation, and Policy Levers to Reduce Cigarette Harm.”

Warren is set to discuss how evidence-based policy and clearer public understanding can help address the needs of the millions of American adults who still smoke cigarettes.

In Florida, there are about 2 million residents who still spark up, making up nearly 11% of the state’s population.

Warren spoke to Florida Politics ahead of Wednesday’s speech to shine a light on the issue, why it persists, and how it might change.

“Smoking remains disproportionately common,” she explained, noting that people who live in rural communities, those who work in blue-collar jobs, and those earning lower incomes are often the ones who continue turning to combustible cigarettes.

That’s despite more and more Americans either ditching the habit altogether, or turning to less harmful nicotine delivery such as pouches and heat-not-burn tobacco.

“Individuals may not know that they have ability to use other products,” Warren said.

In communities where smoking is still prevalent, Warren explained that information — and sometimes stigma — is keeping smokers from turning to alternatives. Even doctors sometimes push complete cessation, believing that harm reduction nicotine products are still carcinogens.

While Warren was quick to agree that quitting nicotine use altogether should be the ultimate goal, and is the only way to avoid all risk, she reminded that cessation programs and products, such as nicotine gums or patches, are only about 10% effective.

But turning to alternative products offers smokers a chance to switch to products that are less harmful than cigarettes, even if it’s not quite as good as kicking the habit.

“The FDA (Food and Drug Administration) itself has for a while now acknowledged that there is a continuum of risk,” Warren said.

Cigarettes are at the top, “because cigarettes have combustion.”

When a smoker lights up, “you get all sorts of harmful chemicals that are byproducts that an individual is then inhaling,” Warren said. But at the bottom of that continuum are nicotine pouches — those taken orally — and heat-not-burn products, which heat tobacco, but don’t create combustion.

“When these products are more available you see an entire shift,” Warren said.

Her session in Miami this week follows a newly released white paper from PMI U.S., for which Warren’s talk is named. “The Forgotten Smoker” found that despite significant progress in lowering the smoking rate across the U.S., about 25 million Americans still light up. For Warren and PMI U.S., that’s a big public health issue, and should be treated as such.

The white paper hits with something policymakers often understand best: money.

The Centers for Disease Control and Prevention estimates smoking costs Americans more than $600 billion a year in health care-related expenses and lost productivity. While that’s not even accounting for the actual out-of-pocket cost of smoking, it’s a number derived from the fact that nearly half a million Americans die prematurely each year from smoking-related illnesses.

Yet smoking has in recent years been treated as a problem that has already been solved, with the white paper finding as far back as 2014 that perceptions of smoking as a public health issue had fallen 19 percentage points over just one decade, from 72% in 2004, to just 53%.

By 2017, the report said smoking ranked last among all tested health concerns in Pew Research Center surveys. Now, Pew doesn’t even list smoking among the health issues it asks Americans to rate.

“This is a call to action to the entire community,” Warren said of her Miami talk. To her, reminding people — whether it’s a neighbor or a lawmaker — that smoking still presents a huge health risk and, more broadly, a significant public health risk. By enhancing understanding, more people might push for regulatory frameworks and overall communication strategies that adopt harm reduction strategies as part of the eradication goal.

She praised Florida lawmakers for their work on the issue. The state has a program through Tobacco Free Florida that provides smoking cessation tools to qualifying Floridians for free, including nicotine patches, gum and lozenges. But the program still has not embraced tobacco alternatives.

“I just truly believe that smoke-free products could make the impact even bigger with additional choices,” Warren said.

Warren is a regulatory and public policy executive with expertise in tobacco harm reduction, life sciences, regulatory strategy and stakeholder engagement.

Throughout her career, Warren has held senior legal and policy leadership roles across the tobacco, nicotine and cannabis sectors, helping shape regulatory strategy, guide product innovation and navigate complex legislative and agency engagement.

Prior to her work with PMI U.S., Warren led initiatives focused on youth access prevention, product integrity and regulatory compliance, and served as an advisor during high-profile enforcement actions and public health debates.