As governments across Europe and beyond move towards tighter restrictions and outright bans on novel nicotine products, with nicotine pouches being at the top of their lists, the scientific evidence continues to point in the opposite direction. From improved designs that eliminate long-standing health concerns to growing real-world data showing their role in smoking cessation, modern nicotine pouches are increasingly demonstrating why harm reduction works, and why prohibition does not.
One of the most persistent criticisms of smokeless nicotine products, has been their association with oral irritation and mucosal lesions. However, a study published in Acta Odontologica Scandinavica challenges the assumption that such effects are inevitable. The study, the first of its kind, shows that relatively minor design improvements to snus pouches can dramatically reduce mouth irritation and tissue damage, effectively eliminating one of the last medical objections to their use.
This finding has important implications for tobacco harm reduction. Snus has long been recognised as a substantially safer alternative to smoking, with decades of epidemiological evidence from Sweden showing no meaningful increase in oral cancer risk and dramatically lower rates of smoking-related disease. Oral irritation was one of the few remaining clinical concerns, and even that was typically mild and reversible. The new evidence suggests that even these effects can now be avoided entirely.
Still favoured by men
Meanwhile, nicotine pouches are seeing rapid uptake across the globe, particularly among young men. A major UK study led by University College London and published in The Lancet Public Health, analysed data from more than 127,000 respondents across England, Scotland and Wales between 2020 and 2025. It found that around 7.5 percent of males aged 16 to 24 now use nicotine pouches, compared to just 1.9 percent of young women and about 1 percent of adults overall.
The researchers estimate that roughly half a million people in Great Britain now use nicotine pouches. Crucially, most are not nicotine-naïve. The majority also smoke or vape, and an increasing share report using pouches as part of attempts to quit smoking or reduce vaping, especially in settings where smoking is prohibited. In fact, by 2025, approximately 6.5 percent of all quit attempts involved nicotine pouches.
Most users are attempting to quit smoking
This pattern mirrors what harm-reduction advocates have long argued: novel nicotine products are most commonly used by existing smokers seeking lower-risk alternatives, not by people who would otherwise avoid nicotine altogether, with use among older adults remaining low and stable. However, uptake among young people has risen sharply since 2022, coinciding with aggressive marketing campaigns rather than changes in product availability. This is where the products’ reputation started taking its main hit, with targeted advertising aimed at young men, including sports sponsorships, music festivals, social media influencers and associations with professional athletes. Then again, this should raise legitimate questions about marketing practices—but not about the fundamental role these products can play in reducing smoking-related harm.
Importantly, nicotine pouches do not involve combustion, smoke or tar, and they avoid the toxicants responsible for the vast majority of smoking-related disease. While the researchers caution that high nicotine exposure may carry cardiovascular risks and note emerging concerns about gum irritation, these risks are orders of magnitude lower than those associated with cigarettes. As with snus, design improvements and product standards can address local oral effects without removing access to safer alternatives.
This is where policy often goes wrong. Instead of regulating nicotine products in proportion to their risk, many governments default to bans. Proposed legislation in the UK, would ban sales to under-18s, restrict advertising and give authorities sweeping powers over flavours, packaging and nicotine strength. While protecting minors is a legitimate goal, the researchers stress that regulation must strike a careful balance. If safer products are made too unattractive or inaccessible, users are likely to revert to smoking.
Why bans are never a good idea
Evidence from other jurisdictions supports this concern. Countries such as Germany and the Netherlands have already banned nicotine pouches outright, with France expected to follow. Yet history shows that bans do not eliminate demand—they simply shift it toward illicit markets or back to combustible tobacco. Similar patterns have been observed with flavour bans on e-cigarettes, which multiple U.S. studies have linked to increases in cigarette smoking among young adults.
The broader harm-reduction literature is clear. Public Health England (now the UK Health Security Agency) has repeatedly concluded that vaping is substantially less harmful than smoking. The Royal College of Physicians has endorsed non-combustible nicotine products as tools for smoking cessation. Large-scale reviews consistently find that switching completely from cigarettes to smoke-free alternatives dramatically reduces exposure to toxins and lowers health risks.
Snus provides perhaps the strongest real-world evidence. Sweden’s exceptionally low smoking rates and correspondingly low rates of smoking-related cancers are widely attributed to the widespread availability of snus. As newer nicotine products build on this model—refined through better engineering, clearer labelling and smarter regulation—the potential public-health gains are substantial.
What is needed for harm reduction to work
Against this backdrop, bans appear increasingly counterproductive. They ignore differences in risk, stifle innovation that could further reduce harm, and undermine smoking cessation efforts by removing viable alternatives. The new research on snus pouch design underscores a broader point: problems associated with nicotine use are best addressed through science, engineering and regulation—not prohibition.
For a harm-reduction strategy to succeed, it must be pragmatic and evidence-based. That means acknowledging that nicotine, while not risk-free, is not the primary cause of smoking-related disease. It means encouraging smokers who cannot or will not quit nicotine to switch to products that dramatically reduce harm. And it means resisting the reflex to ban safer alternatives simply because they resemble cigarettes or challenge ideological positions. The challenge for policymakers is not to eliminate these tools, but to integrate them intelligently into tobacco control strategies that prioritise health outcomes over symbolism.
Snus vs Nicotine Pouches: Comparing the Safety and Science Behind The Products
