Ever get the sense the U.S. Food and Drug Administration (FDA) is playing the world’s most inconsistent game of Simon Says? First they waved through OxyContin like candy, and now they’re blocking devices that adults could use to ditch cigarettes. Spoiler alert: that’s not great.

Back in the ’90s, the FDA gave the green light to OxyContin without batting an eyelash about long-term safety or addiction risks. Purdue Pharma played hype-man, branding it as a miracle pain reliever—until it turned into a bona fide opioid catastrophe. By the time the company was hauled over the coals in 2007 for misbranding, addiction was already tearing through communities like wildfire.

Fast-forward to today: nicotine pouches, e-cigarettes, heated tobacco—tools that could help adults escape deadly smoking are stuck behind red tape. Seriously, regulation has become Olympic-level rigid. It’s like the FDA saw the opioid tragedy and said, “Y’know what? Let’s not learn anything—let’s just build a wall.”

Meanwhile, they’re laser-focused on youth vaping—even though usage is historically low—and haven’t let crises like the 2019 lung injury outbreak pass without an overreaction. That scare wasn’t caused by nicotine vapes at all, but by illicit THC products. Yet, the FDA still blurted out warnings like confetti.

Here’s the kicker: the very products that could help smokers quit are nearly impossible to bring to market unless you’re a giant tobacco company. Small innovators? Sidelined. Smokers? Blocked from safer options. Public health? Taking a nosedive.

To make matters worse, people dedicated to helping others via harm reduction are being criminalized. Take Tennessee’s Dr. Paige Lemen—arrested for transporting a 0.7-gram sample for scientific testing. Her “crime”? Trying to help. Now outreach centers are shutting down, and trust is evaporating faster than Wednesday’s lunch.

Let’s talk cold, hard facts: Italian studies found that after just 12 weeks, heated tobacco users quit smoking at a nearly 40% rate—and e-cigarette users weren’t far behind. Meta-analyses and broader reviews back it up: nicotine-containing e-cigs, snus, and similar products significantly aid cessation—and with fewer side effects than traditional smoking.

Need more incentive? NIH data shows smokers with other substance use disorders who quit smoking had a 42% higher chance of staying clean from other addictions. That’s not just interesting—that’s life-saving. Smoking isn’t just a separate habit, it’s the stubborn glue that sticks other addictions together.

So what’s the smarter play? Streamline approvals for genuinely safer nicotine alternatives—big companies or indie innovators—it doesn’t matter. Give adults access, protect youth, and also shield the people providing harm reduction from legal landmines. Integrate smoking cessation fully into addiction recovery, and regulators should stop acting like the bouncer at a club nobody’s invited to.