OPINION. Nicotine policy is changing - and the WHO and many EU countries risk being on the wrong side of this trend. Sweden shows that harm reduction works, while many EU countries and the WHO cling to bans that favour cigarettes. Consumers, poorly trained doctors and future generations of nicotine users are in the firing line.
The EU is slowing down - and it's no accident
The EU will not be pushing any bans or aggressive restrictions on smokeless nicotine products in the run-up to the 11th session of the WHO Tobacco Convention. This may not be big news (Vejpkollen has reported on this on a number of occasions) but it is still quite telling. Something is changing in the way smokeless nicotine is viewed - and for both the WHO and parts of the EU health bureaucracy, this is not a pleasant development. They risk losing their monopoly on the interpretation of the “good” in nicotine policy.
Sweden has already moved on from prohibitionist thinking
From a Swedish perspective, the EU's “no line” is actually not that bad. Sweden has already shown that it is possible to get rid of cigarettes without moralising the debate. Snus, nicotine pouches and e-cigarettes have done the job better than any ban ever has.
When the government also changed the tobacco policy objective - from trying to reduce use to reducing harm - everything suddenly made sense. It raised taxes on cigarettes and lowered them on snus. Harm reduction was no longer a suspect concept, but a strategy that both consumers and research could support.
So why, at this stage, should we pretend that all nicotine products are equally dangerous? It would rather be a way to favour cigarettes. And it's hard to see who would think that's a good idea.
WHO and the EU: old stories, new problems
The problem is that several major EU countries still hold to the view that all nicotine use must be equally discouraged. And the WHO is even clearer: it basically doesn't even want the word “harm reduction” to be used.
This leads to a paradoxical situation where smokeless products often face stiffer opposition than cigarettes. None of this is based on science - but it is based on a very convenient political narrative in which industrial ghosts and moralism take centre stage.
The research is there - but it matters less and less
It's almost strange to say it out loud: the research is pretty unanimous. Smoking is dangerous. Smoke-free is significantly less dangerous. It is quite basic.
But in the debate, it is often felt that anyone who suggests this is seen as some kind of lobbyist.
A kind of political bubble has developed where studies are commissioned that avoid the most relevant comparisons, and where anything that does not fit in is dismissed as industrial influence.
It's a strange arrangement - and it's becoming unsustainable.
Other countries are starting to see what Sweden already knows
More and more EU countries are now realising what we in Sweden (and indeed the UK and New Zealand) have been living with for over a decade: it is far easier to reduce harm than to reduce use. And it is far easier and more empathetically acceptable to get people to switch to smokeless nicotine products than to get them to stop using nicotine altogether.
When reality finally breaks through the political filter bubble, it will be difficult to continue pretending that prohibition is the only way forward.
When the bubble controls thinking - it becomes dangerous
In those countries that still hold to the prohibitionist line, policy makers and health professionals find themselves in an almost hermetically sealed world. There, ANYTHING that suggests that smokeless nicotine use can play a positive role is by definition labelled a “myth”.
This is a dangerous development. Those who need to understand the differences best - doctors, health professionals, politicians - only see one side of the story.
The result is confused advice and smokers who don't understand why they should switch from something deadly to something far less harmful. It's hard to call that a successful policy.
Youth drug use: more complex than the slogans allow
There is also a reality here that is often forgotten: young people buy both vapes and cigarettes to a large extent on the black market. That's where the supply is, no matter how many paragraphs you write.
But that's why harm minimisation matters to them too.
It's easy to moralise about fruit flavours, but the fact is that many young people choose products that smell less, are easier to handle - and are significantly less harmful than cigarettes. This does not mean that youth use is unproblematic. But it does mean that the choice between cigarettes and smokeless tobacco is a choice, even on the black market.
It is therefore not surprising that other countries are beginning to cast curious glances at Sweden. It is rather a little too late.
EU starts to back down - but WHO stands by with hands over ears
The EU has started to move away from the hardest line of prohibition. This is a sign that something is loosening. For the WHO, the issue is more acute: if it continues to cover its ears, it risks not only getting it wrong on the nicotine issue - but losing trust on much bigger issues.
In the end, only one question remains:
How long can you hold on to a bubble before it bursts?
