Cigarette smoking is still the leading preventable cause of death around the globe, claiming more than seven million lives each year. And then there’s the undeniably promising data from countries endorsing the use of safer nicotine alternatives like vaping devices, heated tobacco products, snus, and nicotine pouches, proving that they can really help cut down smoking rates when adults have access to them.
Clickbait vs science
This points to a bigger problem in today’s nicotine policy discussions. Sensationalist headlines often overshadow the public health evidence that should guide decisions. Some researchers have spoken out about the WHO pouch report. Dr Jamie Hartmann-Boyce from the University of Massachusetts Amherst noted that while we still need to learn more about the long-term effects of nicotine pouches, there is already strong evidence that safer alternatives help smokers quit traditional cigarettes. The real issue behind smoking-related cancers is not nicotine itself, but the burning of tobacco. This difference is key to understanding tobacco harm reduction.
Why is tobacco harm reduction not endorsed?
Many policymakers still mix up nicotine use with the diseases caused by smoking, even though decades of research show that smoke, not nicotine, is what leads to tobacco-related deaths.
Even some former WHO officials are now questioning why the organisation resists harm reduction strategies. In a recent article in Nature Health, former directors Robert Beaglehole, Ruth Bonita, and Tikki Pang argued that the world cannot reach the goal of reducing smoking rates below 5 per cent by 2040 without including safer nicotine products in tobacco control plans.
Their criticism was clear and direct. They explained that many policymakers still mix up nicotine use with the diseases caused by smoking, even though decades of research show that smoke, not nicotine, is what leads to tobacco-related deaths. They also warned that the WHO’s Framework Convention on Tobacco Control has focused too much on taxes and advertising restrictions, while ignoring harm-reduction approaches.
Regulation, not prohibition
Professor Caitlin Notley from the University of East Anglia acknowledged that it’s wise to be cautious about claims that nicotine pouches help people quit, since there isn’t much long-term data yet. However, she also noted that new evidence, including her review of over 20,000 online public comments, shows many former smokers found nicotine pouches useful for quitting cigarettes or even vaping.
This idea is becoming more important in global harm reduction policy discussions. Strict measures like flavour bans or high taxes may fit some beliefs about avoiding nicotine, but they could actually make it harder for adults to quit smoking for good. There are plenty of examples; in the Netherlands, a vape flavour ban led to an increase in smoking and black market activity.
The main question isn’t whether smoke-free nicotine products should be regulated—they should. It’s whether regulators will recognise how much safer these options are compared to traditional cigarettes and change their policies to reflect that.
Let’s focus on combustion, not nicotine
For years, public health efforts have rightly focused on lowering smoking rates. But recently, it seems that some parts of the global tobacco control movement want to get rid of all nicotine use, without weighing the different risks involved. This change could have serious costs.

