Stories

Sweden’s fight over snus is really a fight over whether Europe will recognise harm reduction. Snus has helped Sweden reach some of the lowest smoking rates in the EU, yet Brussels continues to treat smoke-free nicotine products with deep suspicion. Restricting or taxing lower-risk alternatives like cigarettes risks weakening the very model that has reduced smoking-related harm. Europe should learn from Sweden’s results, not punish them.

Tobacco policy too often speaks about smokers without listening to them. Adults who smoke understand the barriers to quitting, the limits of conventional support and the appeal of lower-risk alternatives better than any committee room. If regulation is meant to reduce harm, consumer experience should be treated as evidence, not an inconvenience. Ask the smoker — not only the room.

Smokers struggling to quit are too often left out of tobacco policy debates. Many have tried conventional methods without success, yet lower-risk alternatives are frequently restricted, stigmatised or treated like cigarettes. Harm reduction starts by recognising smokers as people who need practical options, not moral judgement. Public health should speak for those still facing the greatest risk — and help them move away from combustible tobacco.

Fruit-flavoured vapes are often treated as a youth problem, but for many adult smokers they are part of what makes switching away from cigarettes work. Flavours can help distance people from the taste and ritual of smoking while keeping them within legal, regulated markets. Protecting young people matters, but panic-driven flavour bans risk removing one of the tools adults use to quit combustible tobacco. Regulation should target youth access without undermining harm reduction.

Brussels should be learning from Sweden’s smoke-free progress, not making it harder to sustain. Sweden’s low smoking rates are closely linked to the availability of smoke-free nicotine alternatives, including snus and pouches. EU policy that taxes or restricts these products like cigarettes risks undermining one of Europe’s clearest harm reduction success stories. Regulation should follow real-world outcomes, not sabotage them.

Prohibition raises serious questions for both health and ethics. When safer nicotine products are banned or restricted, people who use nicotine may be pushed towards cigarettes, illicit markets or unsafe supply chains. Harm reduction offers a more ethical approach by recognising real-world behaviour and reducing avoidable risk. Public health policy should protect people from harm, not punish them for failing to meet abstinence-only ideals.

Australia’s tobacco black market shows what happens when policy abandons harm reduction. High cigarette taxes, strict vaping rules and limited legal access to safer nicotine products have helped create space for illicit trade to grow. When smokers are priced out or blocked from lower-risk alternatives, demand does not disappear — it moves into unregulated markets. Better policy should reduce smoking-related harm without handing supply to criminals.

Former WHO directors are warning the UK not to weaken one of its most effective smoking cessation tools. Vaping has played a major role in helping adult smokers move away from combustible tobacco, but new tobacco laws could reduce access, visibility and appeal for those who need it most. Protecting young people is essential, but policy should not make cigarettes the easier option. Evidence-based regulation should preserve vaping’s role in reducing smoking-related harm.

Tobacco harm reduction in the United States is shaped by a complex mix of prohibitionist pressure, strict regulation and uneven enforcement. While adult smokers continue to need realistic alternatives to combustible cigarettes, access to safer nicotine products is often restricted by policies that prioritise fear over relative risk. The result is a market where legal pathways are difficult, illicit supply can grow and consumers receive confusing messages. A better approach would protect young people while keeping harm reduction visible, regulated and accessible.

The European Parliament’s rejection of the EU tobacco tax report deepens the deadlock over how nicotine products should be taxed. While higher cigarette taxes can support public health goals, applying steep or poorly differentiated taxes to smoke-free alternatives risks weakening incentives for smokers to switch. Nicotine taxation should reflect relative risk, not treat all products as if they cause the same harm. Better policy would target combustible tobacco while keeping lower-risk options affordable, legal and regulated.