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New guidance says doctors should include nicotine vapes in smoking-cessation conversations

• A new JAMA paper says nicotine e-cigarettes should be part of conversations about quitting cigarettes.

• Researchers reviewed existing evidence on e-cigarettes and smoking cessation and developed guidance for clinicians.

• The authors say e-cigarettes can be less harmful than cigarettes and more effective for quitting than FDA-approved nicotine replacement therapies.

For people trying to quit smoking, there are plenty of options to consider from nicotine patches and gum to prescription medications. Now, a group of tobacco researchers says nicotine e-cigarettes deserve a more prominent place in those conversations.

A new special communication published in JAMA recommends that clinicians discuss nicotine e-cigarettes alongside other evidence-based treatments for adults who currently smoke cigarettes. The authors say existing evidence indicates that e-cigarettes with nicotine are less harmful than traditional cigarettes and have been more effective for smoking cessation than FDA-approved nicotine replacement therapies.

The recommendation doesn't mean e-cigarettes are risk-free. Instead, the authors argue that conversations about quitting should give smokers a clearer picture of the potential benefits and risks of each available treatment.

Cigarette smoking causes about 30% of all cancer deaths in the United States and most people want to quit but struggle to do so, researcher Eleanor Leavens, Ph.D., said in a news release. Adding clear guidance on ecigarettes gives clinicians a practical tool that can help people move away from combustible tobacco and toward better health.

How researchers developed the guidance

This wasn't a clinical trial in which smokers were assigned to different treatments. Instead, the paper was developed by a working group within the Treatment Research Network of the international Society for Research on Nicotine and Tobacco.

The researchers' goal was to summarize the existing evidence surrounding nicotine e-cigarettes and smoking cessation and use that evidence to develop practical recommendations for clinicians. They focused on two areas: how doctors can discuss e-cigarettes as part of shared decision-making about smoking-cessation treatments and how e-cigarettes can be used in practice to help people quit.

The group also addressed what it describes as misconceptions about the risks of e-cigarettes and offered questions clinicians can use when talking with patients about their options.

What this means for smokers

The paper's main recommendation is straightforward: Doctors should include nicotine e-cigarettes when discussing evidence-based ways to quit smoking.

The authors point to evidence that nicotine e-cigarettes can help people stop smoking and say they can reduce the harms associated with cigarette smoking when used as a quitting tool. At the same time, the guidance is intended for adults who currently smoke cigarettes not as a recommendation for people who don't smoke to start vaping.

For consumers who are trying to quit, the takeaway is that e-cigarettes may be worth discussing with a healthcare professional alongside other smoking-cessation options. The authors emphasize patient-centered conversations, meaning the choice of treatment should take into account the individual smoker's circumstances, preferences, and needs.

This work is about correcting misperceptions that act as barriers to evidence-based care for smokers and expanding the tools clinicians can use to support smoking cessation among their patients, Dr. Leavens said. There is no single approach that will help all smokers quit, but by providing patients with a menu of options and engaging in a risk-benefit conversation, providers will ensure patients have a better chance of quitting for good and improving their overall health.

From fake deals to convincing security alerts, scammers are looking for ways to turn holiday shopping into a costly mistake

• Watch for fake retail websites, steep discounts, and unusual payment requests that can signal a Labor Day shopping scam.

• Be skeptical of urgent texts and account security alerts, especially those asking you to click a link, share sensitive information, or provide a verification code.

• Shop directly through retailers websites or apps and use protected payment methods, such as credit cards, to reduce your risk of losing money.

Labor Day weekend can be a great time to score a deal, but shoppers arent the only ones paying attention.

As consumers browse sales, respond to promotional messages, and place online orders, scammers are looking for opportunities to steal money or personal information. Fake websites, too-good-to-be-true offers, phishing texts, and even convincing account security alerts can make it difficult to tell a legitimate shopping message from a scam.

To help consumers shop more safely this Labor Day, ConsumerAffairs spoke with Ira Bondar-Mucci, Fraud Expert at Veriff, about the biggest shoppers should know about, the red flags that can give them away, and what consumers can do to protect themselves.

The most common

How can consumers spot these amid the sales? Bondar-Mucci broke it all down.

Urgent, steep discounts associated with limited time sale periods like Labor Day give bad actors a cover to deploy fraud at scale, she said. Fraudsters often deploy lookalike retail websites of name brands that lure shoppers in with steep markdowns, typically about 70-90% off their standard pricing.

Some things to look out for:

• A misspelled web domain

• A slightly altered URL (extra words, hyphens, or an unusual ending like .shop or .top in place of the brands real address).

• Poor website design

• Broken links

• Limited contact information

• Pressure to act immediately

One caution: dont treat the padlock icon or https as proof a site is safe fraudsters routinely obtain valid certificates, so a secure connection is not the same as a trustworthy seller, Bondar-Mucci said.

She also suggests being vigilant at checkout. Watch for the flow breaking away from the site you started on. Fraudulent checkout flows may pressure shoppers to pay with an unusual payment method like cryptocurrency, gift card, or wire transfer that offers limited consumer protection and makes money recovery difficult, she said.

More check-out red flags: unexpected changes at the time of purchase additional charges, changes to the merchant's name, requests to re-enter payment information through a separate pop-up or link, or a missing verification step where your bank would normally prompt you.

Promo texts can hide fraud

In addition to retail websites and checkout, Bondar-Mucci wants consumers to be aware of the potential for fraud in promo texts or account security prompts. The biggest thing to keep in mind here: scammers love to exploit urgency.

Texts containing threats urging immediate action to prevent an account being locked, requests to verify an account with sensitive information, or confirmations of a credit card through an unprompted link should be considered suspicious, she said. Legitimate companies should not ask for your password or to complete a one-time authentication code through an unsolicited message. If anyone ever asks you to read back a code that was just texted to you, that is the attack full stop.

She also warns about texts that include exclusive flash sales or too-good-to-be-true promotions like free gifts or steep discounts. These often prompt consumers to pay a shipping fee or submit information through a link are another common fraud tactic.

One caution Id add: the old advice to watch for spelling and grammar mistakes is no longer reliable, Bondar-Mucci said. Generative AI has made scam messages clean and well written, so a polished, error-free text is not evidence its genuine focus instead on the sender, whether the links real destination matches the brand, and any pressure to act before you can think.

Go directly to the retailer

With plenty of sales to take advantage of for Labor Day, consumers shouldnt be afraid to shop. Instead, Bondar-Mucci says vigilance is key, and sometimes taking a few extra steps can save you an expensive headache later.

I recommend consumers buy directly from a brand website or app rather than clicking on social media ads, emails, or text messages, she said. Be skeptical of deals that seem too good to be true, because they usually are. Promotions offering 70-90% discounts on name brands can signal a fraudulent website, so compare prices with established retailers before purchasing.

I also recommend using payment methods like credit cards that have strong dispute protections when shopping online sales. Alternative forms of payment like cryptocurrency, wire transfers, or gift cards are ideal for fraudsters, and being prompted to complete a transaction with one of these methods is cause for suspicion.

Some more habits that can go a long way to protect against scammers:

• Turn on multi-factor authentication an authenticator app or passkey is far stronger than an SMS code.

• Use a unique password per retailer through a password manager.

• Consider a virtual or one-time card number so no single site ever holds your real card.

• Turn on transaction alerts, so you can see a fraudulent charge in minutes rather than on next months statement.

• And if youre concerned your data may already be circulating from a breach, a credit freeze is the most effective way to stop it being used to open accounts in your name.

Bad actors will almost always create a sense of urgency to get consumers to act without thinking, Bondar-Mucci said. It is never that urgent. Shoppers should take a step back and look for red flags before completing a purchase.

Never give away any personal or financial information to unrecognizable sites. If something feels off, stop the transaction and contact the retailer or financial institution using a phone number or website you locate independently.

Thomas Built Buses is this week's sole auto recall

New research suggests two brain chemicals involved in the stress response can have very different effects on obesity

• Researchers identified two chemical messengers released by the same stress-responsive brain cells that appear to play different roles in weight regulation.

• In animal models, changing the release of either messenger affected the development of obesity when the animals ate a high-fat, high-calorie diet.

• The findings could help researchers better understand how the brain and stress response are connected to obesity, although more research is needed.

Stress can affect how much we eat and how our bodies regulate weight, but scientists are still working to understand exactly how those processes are connected in the brain.

New research from McGovern Medical School at UTHealth Houston offers a closer look at that relationship. The study focused on a group of brain cells called corticotropin-releasing hormone, or CRH, neurons. These neurons are involved in the body's response to stress through a system known as the hypothalamic-pituitary-adrenal axis.

What makes the findings especially interesting is that these neurons release two different chemical messengers: CRH and glutamate. Researchers wanted to find out whether each one might have a different effect on body weight and the development of obesity.

How did the researchers study it?

The researchers used animal models in which they could increase or decrease the release of CRH or glutamate from adult CRH neurons. This approach was different from some earlier research, which altered CRH or its receptors during embryonic development.

According to the researchers, working with adult neurons helped them avoid potential developmental complications and allowed them to focus more directly on the normal functions of these brain cells in regulating body weight and the stress-response system.

The team then observed what happened when the animals ate either a standard diet or a high-fat, high-calorie diet. They specifically looked at how changing the release of the two chemical messengers affected body weight and the development of diet-induced obesity.

What did they find?

The changes made to the brain cells did not affect body weight when the animals ate a standard diet. The results were different when the animals consumed the high-fat diet.

Reducing glutamate release from CRH neurons or increasing CRH release led to severe diet-induced obesity. On the other hand, reducing CRH or increasing glutamate release did not significantly affect the development of obesity.

The findings also challenged an established understanding of the body's stress-response system. Researchers found that removing CRH or glutamate release caused only mild changes in corticosterone levels, even though CRH has traditionally been considered essential to activity in this system.

For consumers, the research doesn't mean that stress directly causes obesity or that changing these brain chemicals is a treatment. Instead, it offers another piece of the puzzle. The researchers' next step is to identify the neurons that receive glutamate signals from CRH neurons and determine how those pathways contribute to diet-induced obesity.