EU report risks derailing smoke-free goals with attack on safer nicotine products

STOCKHOLM – International health experts today accused the European Commission of undermining its own smoke-free ambitions and putting millions of lives at risk by targeting safer nicotine alternatives that are helping smokers to quit.

The Commission’s long-awaited evaluation of EU tobacco laws, published today, could pave the way for sweeping restrictions or bans on vaping, nicotine pouches, heated tobacco and the flavours that make them effective quit-smoking tools.

While the report credits existing rules with reducing smoking rates across the EU from 28% in 2012 to 24% today – a modest 14% decline – it goes on to attack the innovative products that are producing far better results.

Sweden has slashed smoking by 54% over the same period, by ensuring that safer nicotine alternatives – such as snus, nicotine pouches and vapes – are acceptable, accessible and affordable.

As a result, Sweden now has the lowest smoking rates in Europe – 5.3% in 2024 and falling – and a dramatically reduced disease burden, including male lung cancer mortality 61% below the EU average and total cancer deaths 34% lower.

However, the only mention of Sweden in the Commission’s report is as a cautionary tale about the use of nicotine pouches.

Dr Delon Human, leader of Smoke Free Sweden and a former secretary-general of the World Medical Association, said: “This report should have been a turning point for Europe. Instead, it risks becoming a public health catastrophe.

“The Commission openly acknowledges that smoking is falling too slowly, yet it is preparing to clamp down on the very products that are driving real-world success in countries like Sweden.”

The Commission’s report, which is expected to shape the next Tobacco Products Directive (TPD3), highlights the rise of “novel nicotine products” as a growing concern. But this framing ignores overwhelming evidence that these products are displacing cigarettes among adults.

Dr Human said: “Nicotine does not cause cancer – smoke does. By blurring that distinction, policymakers are misleading the public and endangering lives.”

He also criticised recent comments by EU Health Commissioner Olivér Várhelyi, who has repeatedly equated smoke-free products with cigarettes and cited “popcorn lung”, a condition never linked to vaping and associated with a substance already banned in EU e-liquids.

“This is dangerous misinformation at the highest level of policymaking,” Dr Human said.

“The Commission’s position contradicts a mountain of unimpeachable evidence and is a textbook case of science denial. Even if well‑intentioned, this approach may increase smoking‑related disease and mortality in Europe rather than reduce it.

“Dismissing safer nicotine alternatives is as irrational and dangerous as denying that vaccines save lives. It ignores regulators, clinicians, real-world data and lived experience.

“If Brussels restricts access to safer alternatives, it will not stop nicotine use. Instead, it will simply protect the cigarette trade. That would be a historic failure of public health leadership.”