Across much of Europe, policymakers are once again approaching tobacco control through the lens of restriction rather than harm reduction. A leaked draft of the European Union’s proposed mandate for the Conference of the Parties of the World Health Organization Framework Convention on Tobacco Control suggests a strategy that promotes an outdated view of nicotine consumption, to the detriment of EU citizens, whom the European Commission’s public health policies are intended to protect.
The European Commission’s current position would effectively limit the potential of far less harmful smoke-free nicotine products to displace far more harmful cigarettes. On one hand, the EU body is working to regulate and tax novel nicotine products, projecting more than 11 billion euros in annual revenue, while at the same time it is considering banning them altogether. The result is a fragmented policy approach that undermines harm reduction and discourages adult smokers from switching to less harmful alternatives.
This reflects the broader challenge of treating tobacco policy as a matter of ideology rather than science.
In the United States, the Food and Drug Administration has begun to demonstrate that a pragmatic, evidence-based approach is both possible and effective. The agency recognizes the “continuum of risk” that exists between combustible cigarettes, the most harmful form of nicotine delivery, and smoke-free alternatives such as nicotine pouches, snus, and heated tobacco. That distinction is critical: While nicotine is addictive and not risk-free, it is the high levels of harmful chemicals in smoke, not the nicotine itself, that principally cause smoking-related diseases.
Recently, the FDA launched a pilot program to streamline the review of nicotine pouch applications — a procedural step that may not make headlines but signals a meaningful shift toward regulatory efficiency and scientific accountability. By linking faster review processes to measurable public health outcomes, the FDA has underscored that positive change can be accelerated by authorizing products that reduce exposure to harmful chemicals compared to smoke, rather than eliminating nicotine altogether.
The results of such an approach are already visible in some countries outside the U.S. For example, in Sweden, where smokeless products such as snus have been widely available for decades, smoking rates are the lowest in Europe — and certain smoking-related disease rates have fallen in tandem. In contrast, the rest of the EU banned snus in the 1990s and still has stubbornly higher smoking incidences compared to Sweden. This misguided decision, combined with illicit trade, could be exacerbated, with some European countries now banning or proposing to ban nicotine pouches.
When policymakers overlook the continuum of risk, it is consumers who bear the consequences. Public health should not be framed as a contest between regulators and industry. It should be a collaborative effort built around a shared goal: helping adults move away from smoking and toward less harmful alternatives if they do not quit tobacco and nicotine altogether. When governments set clear, science-based standards, responsible companies can meet them, and adults can make informed, better choices.
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The EU and the FCTCT at COP11 still have an opportunity to adjust course — to follow the data, recognize the continuum of risk, and establish a regulatory framework that encourages innovation and better choices for the hundreds of millions of adult smokers around the world. The alternative is a path defined by a misguided “quit or die” approach along with bans on less harmful nicotine options, which could inadvertently keep smokers smoking or drive them toward unregulated or illicit markets and delay progress in public health.
Global tobacco control efforts should be guided by science, not slogans. The U.S. has begun to demonstrate what’s possible when regulation is grounded in evidence and pragmatism. Others should take note.
Dr. Tom Price was the 23rd secretary of health and human services, is a former representative from Georgia, and is an adviser to PMI US Corporate Services Inc.