Across very different nicotine markets, the same question is becoming increasingly important: should non-combustible nicotine products be regulated primarily because they contain nicotine, or according to how their risks compare with smoking?
Developments in Canada, heated tobacco research presented at the Global Forum on Nicotine 2026 (GFN26), and New Zealand’s long-term smoking decline all feed into this debate. Together, they highlight the importance of combustion, relative risk and ensuring smokers have realistic access to alternatives capable of replacing cigarettes.
Canada faces a nicotine pouch access problem
Canada could retain nicotine limits, packaging, and marketing restrictions while permitting authorised pouches through licensed, age-restricted retailers. This could make regulated products more competitive without sacrificing youth protections.
Canada illustrates what can happen when legal access to a non-combustible alternative is tightly constrained. Nicotine pouches are not banned, but the authorised market is highly restricted. Approved products containing no more than 4 mg of nicotine per dose are treated as cessation products, with sales restricted to pharmacies since 2024. Flavours are effectively limited to mint and menthol, while Zonnic remains the only authorised pouch. Ottawa is reportedly open to reconsidering the pharmacy-only model, although no policy change has been confirmed.Meanwhile, unauthorised pouches continue circulating through less regulated channels. One seizure at the Blue Water Bridge reportedly involved 2,796 kilograms of nicotine pouches worth almost CAD 3 million. This creates an awkward imbalance: adults seeking an authorised alternative face limited access and choice, while illicit suppliers can offer stronger products through less controlled channels.
Canada could retain nicotine limits, packaging, and marketing restrictions while permitting authorised pouches through licensed, age-restricted retailers. This could make regulated products more competitive without sacrificing youth protections. The underlying argument is that nicotine products carry different risks—and evidence surrounding heated tobacco provides another illustration.
When combustion is removed
At GFN26, Dr Leonie Price presented research examining heated tobacco products (HTPs) from several angles, including aerosol chemistry, biomarkers of exposure and longer-term consumer behaviour. One laboratory investigation measured 54 harmful and potentially harmful constituents across 12 consumables and several heated tobacco systems. According to Price, substantial emission reductions compared with cigarette smoke appeared consistently across the products examined.
A short randomised trial then compared smokers using blade-heated and newer induction-heated devices with those continuing to smoke. Biomarkers associated with cigarette-smoke toxicants fell substantially among HTP users despite relatively stable nicotine consumption. This distinction is central to tobacco harm reduction: nicotine consumption can be separated to a considerable degree from exposure to many of the toxic substances generated when tobacco burns.
The evidence nevertheless requires caution. Some HTP research has been conducted or supported by manufacturers, while reduced exposure does not automatically translate into an equivalent reduction in long-term disease risk. Independent research, however, also points towards lower toxicant exposure. A 2025 systematic review and meta-analysis of 18 randomised trials found that smokers completely switching to HTPs had significantly lower exposure to 12 measured carcinogenic, harmful and potentially harmful constituents than continued smokers. Longer independent studies remain necessary.
Reduced exposure
Laboratory findings are only part of the picture. Lower-emission products have limited public-health value if smokers do not adopt them or continue smoking indefinitely alongside them. Price therefore also presented a two-year study of IQOS purchasers in Germany and Italy. Around 60% remained users of smoke-free nicotine products, while dual use declined and complete switching and nicotine cessation increased over time.
Participants had already purchased an HTP and were therefore likely more motivated than the average smoker, limiting how widely the results can be applied. Nevertheless, the findings suggest that dual use need not always be permanent. For some smokers, it may represent a transitional stage towards completely replacing cigarettes—important because eliminating smoking generally produces the greatest reductions in combustion-related toxicant exposure.
New Zealand provides the population-level picture
New Zealand takes the same discussion beyond individual smokers. Official figures show daily adult smoking fell from 16.4% in 2011/12 to 6.8% in 2024/25, while the estimated number of daily smokers declined from around 572,000 to 294,000. Over approximately the same period, daily vaping increased from 0.9% when first measured in 2015/16 to 11.7% in 2024/25.
The local Ministry of Health insists that these parallel trends do not prove that vaping caused smoking to fall. Taxation, smoke-free policies, cessation programmes and changing attitudes also contributed. Nevertheless, New Zealand officially recognises vaping as a less harmful alternative for adults who smoke and as a tool that can help people quit.
And while smoking has recently plateaued at around 6.8%, its experience adds a real-world dimension to the laboratory evidence: widespread uptake of a non-combustible nicotine alternative can coexist with historically low smoking prevalence.
Regulation should be risk-relative
Canada, HTP research and New Zealand involve different products and cannot establish that every alternative will produce identical outcomes. But collectively they illustrate why nicotine use and cigarette smoking should not automatically be treated as interchangeable public-health outcomes.
Pouches eliminate combustion and inhalation. HTPs avoid burning tobacco and substantially reduce exposure to many cigarette-smoke toxicants. Vaping similarly eliminates tobacco combustion and has accumulated strong evidence as a smoking-cessation tool.
None are considered risk-free. Youth access, dependence, marketing and product quality require appropriate controls. But regulations that ignore differences in risk may create unintended consequences, particularly when cigarettes remain readily available while lower-risk alternatives become harder to obtain.
For tobacco harm reduction, success should therefore be measured not simply by whether nicotine use declines, but by whether fewer people continue using its most dangerous delivery system: the combustible cigarette.
