(1) Cigarette smoking is the leading cause of preventable disease and death in the world. (2) Nicotine vaccines produce antibodies that bind nicotine, the chief addictive agent in cigarettes, and prevent it from entering the brain. (3) Early trials suggest nicotine vaccines are safe and well tolerated, but the duration of effect is unclear, and immunological response varies across recipients. (4) Nicotine vaccines have not yet been studied in phase 3 trials and the relative performance of different vaccines, alone or in combination with existing therapeutic options, is unknown.