Across Europe and beyond, policymakers continue to debate the future of nicotine regulation as smoking remains one of the leading causes of preventable death. Yet while cigarettes still kill millions annually, the growing body of evidence supporting tobacco harm reduction is being sidelined in favour of bans, restrictions and ideological resistance. Recent events in the UK, Sweden and across the European Union illustrate a widening gap between what the science shows and how governments respond.
In early December, that divide was laid bare inside the UK Parliament. At an event organised by “Quit Like Sweden,” public health advocate Suely Castro challenged lawmakers to confront the ethical consequences of ignoring safer alternatives to smoking. Her organisation was founded to highlight Sweden’s harm-reduction-first approach, which prioritises access to lower-risk nicotine products such as snus, nicotine pouches and vaping. The results are difficult to dismiss. Sweden has reached the lowest smoking prevalence in the world, just above five percent, and records dramatically lower rates of smoking-related cancer, cardiovascular disease and premature death than the European Union average.
From Sweden to Westminster, the numbers are consistent
Rather than presenting a one-sided case, the parliamentary meeting was structured as a formal debate. Tobacco harm reduction expert Clive Bates deliberately took on the role of sceptic, articulating the arguments typically made by prohibition-minded policymakers. This of course was intentional, with Castro explaining that evidence-based policy is strengthened through challenge, not weakened by it. Several speakers contrasted this openness with global tobacco-control forums, where consumer voices and dissenting scientists are frequently excluded altogether.
That imbalance was highlighted by former New Nicotine Alliance chair Martin Cullip, who warned that international tobacco-control processes are increasingly insulated from real-world data. While bans on safer nicotine products are praised at global meetings, Cullip noted that harm reduction is explicitly recognised within the WHO’s own tobacco treaty. Ignoring it, he highlighted, undermines both scientific credibility and democratic accountability.
Beyond philosophy, speakers focused on what actually helps smokers quit. Pharmacologist Bernhard Mayer explained that access to a range of nicotine strengths is essential to prevent relapse, particularly for long-term or heavily dependent smokers. Addiction specialist Dr Garrett McGovern added that enjoyment matters. For many smokers, flavours and product satisfaction are what allow a complete switch away from cigarettes. Regular use alone, he stressed, is not addiction unless it causes meaningful harm—a distinction often lost in public debate.
The importance of placing restrictions where they make sense
Economic policy emerged as another critical factor. David Sweanor, a long-time legal and health policy expert from Canada, argued that taxation should reflect relative risk. Sweden’s success, he explained, was accelerated by making cigarettes far more expensive than snus. Uniform taxes across all nicotine products, by contrast, only make sense if eliminating nicotine use is the goal rather than reducing disease and death. If cigarettes remain the most dangerous product, they should also remain the least affordable.
This harm-reduction-focused perspective is also shaping industry engagement with policymakers in the UK. The UK Vaping Industry Association has submitted detailed evidence to the Department of Health and Social Care as part of consultations on the Tobacco & Vapes Bill. Drawing on data from compliant businesses, the association highlighted that regulation should preserve vaping’s role as a smoking cessation tool, not undermine it through impractical rules or flavour bans that ignore adult behaviour.
Differentiating between lawful and rogue retailers
Market data reinforce these concerns. New analysis from Vape Club, shows how regulatory changes in 2025 reshaped consumer behaviour. Following the ban on disposable vapes, adult users shifted rapidly toward refillable pod systems and reusable devices. From an environmental perspective, this reduced single-use battery waste by an estimated 70 percent. However, data have shown that many consumers are using refillable vapes in the same way as disposables, throwing them away after a single use. Morepover, added Vape Club, inconsistent retail practices, such as selling devices without refill pods, are also undermining the intent of the policy and driving unnecessary waste and costs.
More importantly, the data confirm that flavours remain central to smoking cessation. The vast majority of adults who successfully switch from cigarettes rely on non-tobacco flavours. Dual users, who are particularly vulnerable to relapse, depend heavily on flavoured products to complete their transition away from smoking. Broad flavour restrictions, Vape Club cautions, risk destabilising these gains and pushing smokers back to cigarettes, the most harmful outcome imaginable from a public-health standpoint.
The cost of ignorning harm reduction
Looking ahead to 2026, concerns are mounting over the planned introduction of a new vaping duty. Estimates indicate that higher taxes on e-liquids could significantly narrow the price gap between smoking and vaping, particularly harming lower-income smokers who stand to benefit most from switching. Early enforcement data already show a rise in illegal vape seizures, suggesting that affordability pressures may accelerate illicit trade rather than reduce nicotine use.
Taken together, these developments point to a broader truth that policymakers continue to resist. Novel nicotine products are not risk-free, but their risk profile is dramatically lower than that of combustible tobacco. Multiple independent reviews, by reliable international health and research bodies, consistently conclude that vaping and oral nicotine products expose users to a fraction of the toxicants found in cigarette smoke. Countries that regulate and promote these alternatives see faster declines in smoking and fewer smoking-related deaths. Countries (hello Australia) that ban them, see black markets, slower progress and persistent disease.
The parliamentary forum concluded with an uncomfortable question for governments across Europe: how many lives are being lost by refusing to act on evidence already in hand? Sweden’s experience suggests the answer is not abstract. Harm reduction works when it is allowed to. The real ethical failure, speakers argued, is not the existence of safer nicotine products, but the continued insistence on policies that keep smokers smoking.
As regulation tightens and bans proliferate, the choice facing policymakers is becoming clearer. They can prioritise ideology and prohibition, or they can prioritise outcomes. For those committed to reducing death, disease and inequality caused by smoking, the evidence increasingly points in only one direction.
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