Balancing Harm Reduction and Public Health in the Global Nicotine Dialogue
As policymakers prepare for the WHO’s 11th Conference of the Parties (COP11) to the Framework Convention on Tobacco Control (FCTC), the question of whether to ban flavours in nicotine pouches and other reduced-risk products is front and center. While the WHO frames flavours as a youth-focused marketing tool, harm reduction experts argue that banning them may do more harm than good—especially for adult smokers seeking alternatives to cigarettes.
At the Global Institute for Novel Nicotine (GINN), we believe this debate demands a science-based approach, not one shaped by outdated ideology. The lives of millions of smokers depend on policies that balance prevention with practical, evidence-driven harm reduction.
The Flavour Controversy at COP11
WHO Director-General Dr. Tedros Adhanom Ghebreyesus has called for a global ban on flavours in tobacco and nicotine products, arguing that they mask harsh tastes and attract youth. This narrative, echoed in more than 50 countries with existing flavour bans, ignores a fundamental truth: most adult smokers who switch to safer alternatives do so because those products offer a more appealing experience, often due to flavours.
Clive Bates, former Director of Action on Smoking and Health UK, has labeled the WHO’s anti-flavour stance a “dangerous resistance to innovation,” one that could stall smoking cessation progress.
Dr. Konstantinos Farsalinos, a leading cardiologist and tobacco harm reduction researcher, emphasizes: “It’s not the nicotine that kills—it’s the smoke.” He and others argue that making smoke-free alternatives less attractive, such as by banning flavours, may push users back to combustible cigarettes.
Why Flavours Matter for Adult Smokers
Research consistently shows that adult users of e-cigarettes and nicotine pouches overwhelmingly prefer fruit, mint, and dessert flavours over tobacco. These flavour profiles help:
- Improve smoking cessation success rates
- Increase user satisfaction
- Create a psychological break from the taste of cigarettes
Moreover, most nicotine replacement therapies (NRTs), including gums and lozenges, are available in multiple flavours—a clear double standard if smoke-free pouches or vapes are denied the same.
The Unintended Consequences of Flavour Bans
Real-world evidence demonstrates that flavour bans can lead to:
- Increased cigarette sales, as shown in Yale research following U.S. flavour bans
- Youth switching to more harmful products, like cigarettes
- Illicit market growth, with unregulated products risking public safety
Countries such as Sweden have shown that access to appealing alternatives, including flavoured snus and pouches, correlates with plummeting smoking rates—now under 5%.
Risk-Proportionate Regulation: A Smarter Alternative
Rather than banning flavours outright, GINN supports risk-proportionate regulation, including:
- Strict age verification for purchases
- Packaging and marketing controls to avoid youth appeal
- Clear consumer education on product risks and benefits
As Nancy Loucas of CAPHRA notes, the FCTC must evolve from its “quit or die” legacy. The future lies in pragmatic solutions that prioritize both youth protection and adult harm reduction.
Understanding the Risk Continuum
| Nicotine Product | Approximate Harm (vs. Smoking) |
| Cigarettes (burned tobacco) | ~100% (baseline risk) |
| Smokeless tobacco (snus) | ~5% of the risk |
| E-cigarettes (vapes) | ~4% of the risk |
| Nicotine pouches (tobacco-free) | ~2–3% of the risk |
| Nicotine Replacement Therapies | ~2% of the risk |
Let Science Lead
The WHO’s approach must move beyond fear-based prohibitions and embrace modern harm reduction. The goal should not be to treat all nicotine products equally, but proportionately—based on risk.
GINN urges delegates at COP11 to resist calls for blanket bans and instead adopt a regulatory framework that protects youth and empowers adults to quit smoking. Flavours, when regulated responsibly, can be powerful tools for public health.
Learn more at www.ginn.global and follow expert commentary from Clive Bates, Dr. Konstantinos Farsalinos, and Nancy Loucas.
The world is watching. Millions of lives are at stake. Let’s get this right.
