Key Points

  • The FDA has proposed capping nicotine in cigarettes at 0.7 milligrams, down from the 10–14 milligrams a typical cigarette carries; a Rutgers Health simulation projects that, if implemented, the policy could push smoking rates below 1% for all population groups by 2040, prevent 1.6 million premature deaths, and keep 8 million people from developing major depression by 2100. These are modeled projections, not observed results, and the rule is not yet final.
  • People with major depression smoke at significantly higher rates than the general population, and the relationship runs in both directions: depression raises the likelihood of smoking, and smoking raises the likelihood of depression.
  • Nicotine dependence is one of the most common co-occurring conditions in addiction treatment and one of the most routinely overlooked. Dr. Sylvie Stacy notes that clinicians already have effective tools — nicotine replacement therapies, varenicline, bupropion, motivational interviewing, and mobile apps — and do not need to wait for federal policy changes to act.
  • On August 10, 2026, the 9th U.S. Circuit Court of Appeals allowed more than 3,000 lawsuits against Meta, Google, TikTok, and Snap to proceed, finding that Section 230 of the Communications Decency Act provides a defense to liability rather than immunity. The court did not rule on whether the companies harmed anyone.
  • Compulsive platform use is classified clinically as a behavioral addiction in the same broad category as gambling disorder and gaming disorder, and it responds to many of the same therapeutic approaches used for substance use disorders, including cognitive behavioral therapy and family-based work.
  • A SAMHSA report published in August 2026 found that people with serious mental illnesses die 10 to 20 years earlier than the general population, often because physical conditions go unrecognized or undertreated within behavioral health settings; in a 2024 national survey, 66% of community health centers reported offering substance use treatment on-site.

Addiction News Weekly Episode 1.13

In This Episode:

Episode Transcript

Welcome to Addiction News Weekly by Rehab.com, where we break down the biggest stories in addiction, recovery, and public health.

Nicotine Dependence Gets Left Off the Treatment Plan

This week is about the places addiction treatment has not been looking. We start with nicotine. A typical cigarette carries somewhere between 10 and 14 milligrams of nicotine. The Food and Drug Administration has proposed a product standard that would cap that at 0.7 milligrams, a level the agency describes as minimally addictive or non-addictive.

Researchers at Rutgers Health modeled what would happen if that rule were finalized and published the analysis in the journal Tobacco Control.1,2 The distinction at the center of this is worth getting right. Combustion and tar cause most of the physical harm from smoking. Nicotine is the agent that establishes dependence and makes quitting hard. So a cap would not make cigarettes safe. It would aim to make them far less capable of creating an addiction in the first place.

The team at the Rutgers Institute for Nicotine and Tobacco Studies and the Rutgers School of Public Health built a simulation tracking the U.S. population through the year 2100, following people from birth as they moved between states like taking up smoking, starting to vape, doing both, or developing depression. Under the policy, the model projected smoking rates falling below 1% for every population group by 2040. Over a longer period, it projected 1.6 million premature deaths prevented and 8 million people prevented from developing major depression by 2100, along with a $298 billion increase in worker productivity.1

Two things to be clear about. These are modeled projections, not observed results, and they assume the policy is actually implemented and enforced. The rule itself is proposed, not final. Nothing about it changes anything today.

The study focused specifically on adults living with major depression, a group that smokes at considerably higher rates than the general population. Sarah Rivero Skolnick, a postdoctoral associate at the Rutgers Institute, said the policy would directly reduce tobacco-related health disparities and described the relationship as running in both directions, with depression raising the likelihood of smoking and smoking in turn raising the likelihood of depression. That two-way relationship is where this becomes a treatment story.

Here is Rehab.com Chief Medical Officer Dr. Sylvie Stacy. In medicine and in behavioral health, tobacco use is one of the most persistent risk factors we see, and nicotine dependence is one of the most common co-occurring conditions we see. But unfortunately, it is also one that we gloss over or even just ignore.

Someone walks into a clinic or addiction treatment center for, say, alcohol or opioids, and we build this careful treatment plan for their substance use disorder and their co-occurring conditions, such as depression, but we do not necessarily do anything to directly address their nicotine dependence. Somehow that often gets left off the list. Sometimes we do provide brief guidance to quit. I know I try to make the recommendation to quit and offer medication to assist, but I definitely know that I am guilty of not doing this with some of my patients too, especially when their other substance use is their primary concern and if it puts them at more immediate risk, such as an opioid overdose.

In some situations and treatment facilities, I have even seen tobacco use get treated as a kind of acceptable habit or something that is potentially better to deal with down the road. I have had patients that come to my office terrified to change their smoking behavior because they are afraid it will destabilize their recovery from other substance use disorders. But if we are addressing it correctly, the risk of that happening is very low. Treating tobacco use actually improves long-term sobriety from other substances as well as improves psychiatric stability.

And getting back to this study: we definitely should not wait on federal nicotine caps that could take years to finalize and implement. There is no reason to wait for regulatory changes to start adjusting the way that we practice, because we do have effective tools right now. Nicotine replacement therapies, prescription options like Chantix and Wellbutrin — Wellbutrin also being one that works well for coexisting depression — and there is also motivational interviewing and even mobile apps that we can recommend to patients to support their quitting.

Product standards are important and I do think that limitation on the amount of nicotine in available products is something worth considering. Policy change can really impact population-level outcomes and the choices that individuals make. And we need this type of research in addition to a conscious effort to do more in the clinical setting to help people quit.

Social Media Addiction Lawsuits Cleared to Proceed

Our second story moves from a substance to a product. Reuters reported that on August 10, the 9th U.S. Circuit Court of Appeals in San Francisco declined to intervene early in a sprawling set of lawsuits against the largest social media companies.3 Meta, Alphabet’s Google, ByteDance’s TikTok, and Snap had asked the appeals court to reverse a lower court ruling requiring them to face more than 3,000 lawsuits filed in federal court. The appeals court rejected that bid, concluding the challenge had arrived too early because the litigation has not yet reached final judgment.

It is important to be precise about what that does and does not mean. The court did not rule on whether these companies harmed anyone. The companies had argued that Section 230 of the Communications Decency Act, the 1996 law that shields platforms from liability for content their users post, also protects them from claims that they failed to warn the public about how addictive their products are. That argument is not yet resolved. It now waits for a later stage of the case.

Meta and Google have both denied the allegations and said they would appeal. The suits themselves were brought by states, municipalities, school districts, and individuals, and they allege the companies deliberately designed their platforms to hook young users, contributing to rising rates of depression, anxiety, and body image problems among American youth. The federal cases have been centralized before U.S. District Judge Yvonne Gonzalez Rogers in Oakland, and they seek damages, penalties, and restitution.

Here is why we are covering this case. Compulsive platform use is classified clinically as a behavioral addiction in the same broad category as gambling disorder and gaming disorder. These conditions involve repeated engagement with rewarding activity despite mounting harm, and they respond to many of the same approaches used for substance use disorder, including cognitive behavioral therapy and family-based work.

A lot of treatment programs already screen for behavioral problems at intake because they show up alongside substance use and mood disorders often enough to be worth asking about. Litigation on this scale tends to generate discovery documents and public testimony, and over several years that material may genuinely sharpen how clinicians understand compulsive platform use in adolescence. But the near-term effect is narrower than the headlines suggest, and no family should be waiting on a court calendar.

If a teenager’s screen use is displacing sleep, schoolwork, or in-person relationships, that pattern is already reason enough to seek assessment from a licensed clinician. When comparing programs, some useful questions to ask are whether they screen for compulsive technology use, whether they run adolescent-specific tracks with real family participation, and whether they treat co-occurring anxiety or depression in the same setting rather than referring that work out.

Physical Illness Goes Unseen in Behavioral Health Care

Our third story is about the body. SAMHSA published a report this month, part of its Mental Health Innovation series, on addiction treatment for people who also carry a chronic physical illness.4 It is unusually direct about how poorly the current system handles them. The core finding is that people with a substance use disorder or a mental illness have higher rates of co-occurring physical conditions than people without them, including cardiovascular disease, diabetes, respiratory conditions, and communicable diseases.

The report describes mental comorbidities as the leading cause of premature mortality among people with severe mental illness. The number worth sitting with is this one: people with serious mental illnesses such as schizophrenia or bipolar disorder die 10 to 20 years earlier than the general population, often because comorbid physical conditions went unrecognized or undertreated.

SAMHSA’s explanation is structural rather than clinical. U.S. healthcare has historically separated the financing, organization, and delivery of behavioral health services from general medical care. Someone managing both a substance use disorder and a mental illness typically needs coordination across a specialty addiction provider, a primary care physician, and medical specialists, and those providers usually sit in different delivery systems, get paid through different mechanisms, and often cannot see each other’s records.

The report counts 21.2 million U.S. adults living with both mental illness and a substance use disorder.4 The evidence for fixing this is mixed, and the report reflects that. SAMHSA’s demonstration bringing primary care to behavioral health settings was not directly associated with overall physical health improvements, though a smaller study found gains in blood lipids, blood pressure, and diabetes management. An analysis of early grantees found reduced emergency department visits, lower costs, and better follow-up after hospitalization.

The collaborative care model, which pairs a primary care clinician with a behavioral health care manager and a psychiatric consultant, significantly improved depression and anxiety across 79 randomized trials in a Cochrane review, though the evidence for substance use outcomes specifically is thinner. Community health centers have moved the fastest. In a 2024 national survey, 66% reported offering substance use treatment on-site, and 62% reported offering medications for substance use disorder, up from 37% in 2018.

If chronic illness is part of your situation, this changes the questions worth asking. Ask whether a program screens for and monitors physical health conditions. Ask whether it can prescribe and manage medications for both the substance use disorder and the medical condition. Ask who coordinates with your primary care physician while you are in treatment. And ask what happens at discharge, because the report’s evidence on reduced readmissions came from programs that actively managed follow-up, rather than assuming it would happen on its own.

Conclusion

The thread this week is blind spots. A federal rule is being weighed that would target nicotine’s addictiveness at the source, while the treatment system routinely leaves tobacco out of the plan for people it is already treating. A court is letting thousands of lawsuits proceed over whether products were built to be compulsive in a category of addiction that only recently got taken seriously. And a federal report says the physical illnesses most likely to kill people with severe mental illness are going unrecognized inside the care that they are already receiving.

None of those are gaps in what we know how to treat. These are gaps in what gets asked about.

If you or someone you love is looking for treatment, Rehab.com lists thousands of verified centers across the country. And free, confidential support is available anytime through the SAMHSA National Helpline at 1-800-662-4357. And if you are in crisis, you can call or text 988 at any time.

Those are the top stories in the news. For more, visit Rehab.com. We will be back next week. I am Kay, and thank you for listening.

You Might Also Like

  1. Nicotine Addiction and Treatment
  2. How to Quit Smoking Cigarettes
  3. Social Media Addiction
  4. Dual Diagnosis: Addiction and Mental Health

Sources in This Episode

  1. Rivero Skolnick S, Tam J, et al. Impact of reducing nicotine in cigarettes on mortality, economic costs and major depression in the USA. Tobacco Control. Published online July 13, 2026. doi:10.1136/tc-2025-059896. https://tobaccocontrol.bmj.com/content/early/2026/07/13/tc-2025-059896. Accessed August 25, 2026.
  2. Rutgers Health. How a nicotine reduction policy could reduce smoking disparities and boost productivity. Published July 14, 2026. https://research.rutgers.edu/news/how-nicotine-reduction-policy-could-reduce-smoking-disparities-and-boost-productivity. Accessed August 25, 2026.
  3. Reuters. US court rules Meta, other tech companies must face thousands of lawsuits over social media addiction. Published August 10, 2026. https://www.reuters.com. Accessed August 25, 2026.
  4. Substance Abuse and Mental Health Services Administration. Integrating Physical and Behavioral Health: Addressing Co-Occurring Mental Health and Substance Use Disorders with Chronic Physical Illnesses. Published 2026. https://library.samhsa.gov
Dr. Sylvie Stacy Written By: Dr. Sylvie Stacy MD, MPH Chief Medical Officer
Sylvie Stacy, MD, MPH, Medical Officer at Rehab.com, is a board-certified addiction medicine specialist with over a decade of experience treating individuals with addictions in diverse clinical settings including residential treatment programs, detox centers, outpatient clinics, and correctional facilities.