Around the world, governments continue to grapple with how best to reduce smoking-related disease and death. Yet despite decades of evidence showing that people smoke for nicotine but die from smoke, many tobacco control policies still treat all nicotine products as equally dangerous. The result is a growing patchwork of bans, punitive taxes, and regulatory confusion that often undermines public health goals rather than advancing them.
When tobacco control goes wrong
In North America, New York State offers a clear example of how fiscal policy can clash with public health evidence. Under Governor Kathy Hochul’s proposed fiscal year 2027 executive budget, nicotine pouches such as Zyn would be reclassified as tobacco products and subjected to a seventy-five percent wholesale excise tax, the same rate applied to combustible tobacco. State officials argue that addiction alone justifies equal treatment, but this reasoning ignores a substantial body of evidence, including U.S. Food and Drug Administration findings from January 2025, which authorized Zyn after concluding it could benefit adult smokers who switch completely from cigarettes.
Public health researchers have long demonstrated that non-combustible nicotine products dramatically reduce exposure to carcinogens compared with smoking. Studies published in journals such as Tobacco Control and Nicotine & Tobacco Research consistently show that price differentials between cigarettes and safer alternatives are among the strongest drivers of smoking cessation. When those differentials disappear, particularly through heavy taxation, the incentive to switch erodes, especially for lower-income smokers who already face disproportionately high smoking rates.
How misguided tobacco policies are fueling illicit markets
Further South, Mexico illustrates the same dynamic taken to its extreme. In early 2025, the country brought into force a comprehensive prohibition on electronic cigarettes and vaping products under reforms to its General Health Law. Despite this sweeping ban, vaping products remain widely available through informal and illicit markets. Independent analyses and reporting indicate that the ban has not eliminated demand, but has instead removed regulatory oversight while cigarettes remain legally sold nationwide.
Across Europe, tobacco control outcomes vary sharply depending on whether governments embrace or reject harm reduction principles. Sweden stands as the most prominent example of success. Its long-standing acceptance of snus, followed by the regulated availability of nicotine pouches, has coincided with Europe’s lowest smoking rates and the lowest incidence of lung cancer. Large population studies consistently show that replacing smoking with non-combustible oral nicotine products dramatically reduces health risks.
By contrast, countries such as Cyprus illustrate the costs of regulatory paralysis. After classifying nicotine pouches as pharmaceutical products without approving any for sale, Cyprus has effectively created a de facto ban. Demand has not disappeared. Instead, products circulate informally without age verification, safety standards, or taxation, while cigarette smoking remains widespread and lung cancer continues to be a leading cause of death. Public health experts widely describe this as the worst possible outcome: continued smoking combined with unregulated alternative markets.
Over-taxation and bans are sabotaging smoking decline across continents
Georgia’s increasingly restrictive approach also raises concerns among harm reduction experts. While smoking rates have declined over the past decade, policymakers now frame the rise of vaping and heated tobacco as a threat rather than an opportunity. Recent proposals include uniform taxation across all nicotine products, flavour bans, generational sales prohibitions, and tighter advertising restrictions. Evidence from multiple jurisdictions suggests that such measures risk slowing smoking decline by making lower-risk substitutes less attractive or accessible than cigarettes themselves.
In Republika Srpska, authorities have adopted one of Europe’s most far-reaching indoor nicotine bans, prohibiting the use of all tobacco and nicotine products in enclosed public spaces, including e-cigarettes, heated tobacco, and nicotine pouches. Critics argue that failing to distinguish between combustible and non-combustible products undermines harm reduction and discourages smokers from switching, while hospitality groups warn of economic impacts and enforcement challenges.
Across Asia, enforcement-heavy models dominate, and their limitations are increasingly visible. Singapore enforces some of the world’s toughest penalties for vaping, including possible imprisonment and mandatory rehabilitation. Despite this, authorities acknowledge that illicit trade persists and requires constant, resource-intensive enforcement. Research in criminology and public health consistently shows that zero-tolerance regimes displace markets rather than eliminate them, particularly when consumer demand remains strong.
Cambodia provides a similar case. More than a decade after banning e-cigarettes, vaping products remain widely accessible both on the streets and through social media. Even after recently expanding the bans to cover possession, advertising, and storage, enforcement remains inconsistent. Civil society groups point to weak oversight and corruption, while public health researchers warn that illicit markets expose young people to greater risks than regulated alternatives ever would.
Taiwan has taken a more nuanced path by allowing heated tobacco products under a tightly controlled authorization system. While highly restrictive, the framework at least acknowledges differences in risk by permitting specific products under defined conditions. This approach avoids the regulatory vacuum seen in countries that ban alternatives outright while continuing to allow cigarette sales.
Crime, confusion, and continued smoking
Across all these cases, the underlying problem remains the same: policies fail when they ignore how people actually use nicotine. Decades of behavioral and epidemiological research show that most smokers do not quit nicotine abruptly or permanently. Instead, they move along a continuum of risk, often requiring substitutes that address both dependence and habit. Countries that facilitate this transition by making safer products accessible, affordable, and regulated see faster declines in smoking and tobacco-related disease.
Conversely, prohibition and excessive taxation preserve cigarette dominance. Combustible tobacco remains legally available in nearly every jurisdiction discussed, even as far less harmful alternatives are restricted, stigmatized, or banned outright. This contradiction lies at the heart of modern tobacco control failure.
Conversely, evidence from Sweden, New Zealand, the United Kingdom, and Japan, demonstrates that proportional regulation works. Clear product standards, age restrictions, differential taxation based on risk, and honest public communication about relative harms have consistently delivered better outcomes than blanket bans. Reviews by the likes of Cochrane Collaboration, Public Health England, and other independent bodies, reinforce the conclusion that harm reduction is essential to ending smoking.
As governments confront rising illicit trade, stalled declines in smoking, and escalating enforcement costs, the lesson is increasingly difficult to ignore. When tobacco control policies get the risk continuum wrong, people continue to smoke, criminal markets flourish, and public health suffers. The question is no longer whether harm reduction works, but how long policymakers will continue paying the price for ignoring it.
From Vietnam to Mexico, Vape Bans Are Fueling Smoking, Not Stopping It
