Nicotine pouches and other modern, smoke-free nicotine products are rapidly reshaping the landscape of tobacco harm reduction, yet regulatory environments often lag behind scientific evidence. The recent turmoil in Canada illustrates how overly restrictive rules can unintentionally undermine public-health goals. Although nicotine pouches were originally introduced as a smoking-cessation tool and authorised through rigorous review, many jurisdictions have placed disproportionate barriers around them—ironically, barriers never applied to cigarettes, despite their vastly higher health risks. These developments raise broader questions about how governments can better support smokers who are unable or unwilling to quit nicotine entirely but wish to avoid the harms of combustion.
Health Canada’s move to tighten access to nicotine pouches fundamentally altered how smokers can obtain these products. Following the approval of Zonnic—the country’s sole licensed nicotine pouch—adult smokers began reporting substantial success using pouches as a replacement for cigarettes. Imperial Tobacco Canada gathered thousands of testimonials and observed an accelerated decline in cigarette purchases in stores stocking Zonnic, suggesting real-world cessation benefits consistent with international data. Yet within months, public-health organisations raised concerns that making flavoured pouches widely available could mimic what they described as earlier regulatory mistakes with e-cigarettes, particularly around youth access and advertising. In response, Health Canada mandated that all pouches be sold from behind pharmacy counters beginning in August 2024, limiting availability to low-dose mint or menthol variants and requiring pharmacist oversight for each sale.
The result is a paradox: cigarettes remain easier to buy than an approved cessation tool. Consumers, frustrated by new barriers, increasingly access pouches through unofficial channels. British Columbia’s experience echoes these concerns. After the province restricted Zonnic to behind-the-counter pharmacy sales, a legislative finance committee received testimony from healthcare providers who argued that pouches must be at least as accessible as cigarettes if they are to serve as an effective cessation tool. Pharmacists say the current process—finding a pharmacy, waiting in line, speaking with a pharmacist, completing an age check—is enough to derail a quit attempt. Many smokers act on sudden motivation, and delays or discomfort can strip away that opportunity. The rule also imposes additional administrative strain on pharmacists, who already manage vaccinations, prescriptions and clinical consultations. For smokers, this makes a simple, low-risk nicotine product harder to access than the lethal one they are trying to avoid.
Federal rules permit Canadians to import a 90-day personal supply, leading users to turn to online suppliers, vape shops and Indigenous reserves for higher-strength or flavoured products. This has created a growing grey market, precisely the scenario regulators sought to avoid.
Restrictions that fuel illicit markets and hurt smokers
A recent CBC News probe has confirmed that prohibitive rules haven’t eliminated youth-oriented pouches; they’ve simply pushed them underground. Reporters in Vancouver, Toronto, Montreal and Halifax were able to walk into corner stores and buy what appeared to be Zyn—the wildly popular U.S. brand owned by Philip Morris International—in fruity flavours and in strengths up to 15 mg, far exceeding Canada’s legal limit of 4 mg. Online sellers claiming Canadian addresses advertised dozens of unauthorized brands, promising fast, discreet shipping. Imperial Tobacco warns that criminal networks are packaging nicotine pouches alongside illicit drugs and weapons, illustrating how well-intentioned restrictions may unintentionally fuel organised crime rather than protect public health.
Meanwhile, public-health perspectives are shifting globally. In Europe and New Zealand, a growing body of evidence suggests that nicotine pouches have among the lowest risk profiles of all nicotine products. Because they contain no tobacco leaf, require no combustion and generate no harmful particulates, pouches avoid the overwhelming majority of toxicants associated with smoking. Studies conducted in Sweden—where nicotine pouch use is mainstream—show that the country has some of the lowest rates of smoking-related disease in the developed world, a trend partly attributed to the widespread adoption of oral nicotine products.
A setback for harm reduction
This harm-reduction logic mirrors longstanding academic research. Work by Public Health England, the UK Royal College of Physicians and independent tobacco scientists has repeatedly shown that non-combustible nicotine products are dramatically safer than smoking. Nicotine itself, though addictive, is not the primary cause of smoking-related illness; combustion is. Even Canada’s own review process acknowledged that the controlled-dose nicotine in Zonnic poses far less risk than inhaled smoke. The inconsistency lies not in the science but in the regulatory response.
Opponents of wider pouch availability often argue that youth uptake poses too great a risk, yet real-world data from regulated markets suggest that strict age controls, targeted enforcement and responsible retailing are more effective than sweeping bans. In fact, over-regulation tends to drive youth—and adults—toward illicit products, which are entirely outside the reach of safety standards and age restrictions. B.C.’s unregulated market now includes higher-strength pouches sold in youth-oriented flavours, demonstrating that restrictive rules can create exactly the conditions regulators aim to prevent.
In the meantime, health professionals working directly with smokers continue to champion pouches as a valuable tool. For many smokers, especially those who have tried and failed with traditional options like gum or patches, these newer products offer faster relief from cravings and a realistic pathway away from cigarettes. This aligns with international cessation research showing that higher-dose, fast-acting nicotine delivery systems generally produce better quit outcomes than lower-dose pharmaceutical alternatives.
The case for making nicotine pouches (at least) as accessible as cigarettes
Canada’s situation reflects a broader dilemma: how to balance youth protection with the moral and scientific imperative to support adult smokers seeking safer alternatives. Every year of delay keeps combustible cigarettes—responsible for nearly 50,000 Canadian deaths annually—firmly entrenched as the most accessible nicotine option. If the goal is to reduce smoking prevalence to five percent by 2035, restricting one of the most promising harm-reduction tools is counterproductive.
An evidence-based approach would restore over-the-counter access to approved nicotine pouches, encourage improved standards for unregulated products, and align national policy with real-world cessation needs. Ultimately, smokers deserve tools that match their lived experiences, not barriers that push them toward more dangerous behaviour. Modern nicotine pouches, when regulated sensibly, can play a central role in Canada’s public-health strategy—not as a threat, but as one of the most powerful harm-reduction innovations available today.
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