In a recent panel discussion hosted on the 5th of December by MEP Johan Nissinen in the European Parliament, experts and advocates convened to explore the role of harm reduction within tobacco policies. The conversation, under the banner of beating cancer, brought together voices like Clive Bates from ETHRA, Philippe Poirson from French Sovape Association, Tom Gleeson from New Nicotine Alliance, and Julio Ruades Esteban from the Spanish Association of Personal Vaporizer Users (Anesvap). The focus was not only on legislative aspects but also on the lived experiences of ex-smokers who have successfully embraced harm reduction. Below is a summary on the main takeaways from the panel, shedding light on the nuances of harm reduction as a pathway to a smoke-free Europe.

Swedish experience of Harm Reduction
MEP Johan Nissinen, representing the European Conservatives and Reformists (ECR) from Sweden, set the tone by emphasizing Sweden’s integration of harm reduction into national legislation. He described the Swedish model, involving tax adjustments on snus and nicotine pouches. He criticized the European Commission for what he deemed as exaggerated claims about nicotine pouches being “a legal loophole” and member states allegedly desiring more regulation and a ban on nicotine pouches.
MEP Nissinen provided some historical context around the ban of snus. The prohibition on snus within the EU single market, he claims, originates from heavy lobbying on the part of the United Kingdom in the 1980’s. At that time the oral tobacco ‘Skoal Bandit’ gained popularity on the British market and authorities grew worried about youth uptake.

Public health potential of smokeless products
Clive Bates, representing the European Tobacco Harm Reduction Advocates (ETHRA), brought attention to the staggering death toll from cigarette smoking. He emphasized the core health issue as combustion and tar, asserting that regulation should pivot on the difference between combustion and smokeless alternatives.
Bates pointed to Sweden and snus as a “proof of concept of harm reduction,” relying on conditions such as consumer preference, harm displacement, and product safety. He emphasized that Sweden is the only country close to achieving the Smoke-Free Generation objective of the European Union, having only 5,6% smoking prevalence within the Swedish population. The main reason for this success is that the population uses snus instead of smoking combustible cigarettes. The absence of combustion with snus makes it a tool to beat cancer, “all cancers”, as he showed the incidence of various cancers being consistently lower in Sweden than in other EU countries.
Further on he introduced a conceptual framework for harm reduction. Users of novel nicotine products were described as consumers making an informed choice of socially accepted substance consumed for recreational, functional, or self-medication purposes.

Shared experience from consumers
Julio Ruades Esteban from the Spanish Association of Personal Vaporizer Users (ANESVAP) expressed concerns about the revision of the Tobacco Products Directive (TPD2), particularly regarding e-cigarettes and flavors. He argued against flavor bans, asserting that banning flavors could push adults, and even worse, risk groups (such as experimenting youths) towards smoking. Flavors constitute the main pleasure-based incentive for smokers to switch to smokeless products. Philippe Poirson from Sovape emphasized the importance of providing smokers with proper incentives to switch from smoking through satisfactory nicotine delivery, pleasure, physical, economic access, and honest information about novel products.
Representing the New Nicotine Alliance (NNA), Tom Gleeson highlighted the need for balanced regulation and criticizing the undue burden placed on consumers rather than on the industry. He presented snus as a gateway out of smoking. He called for a ‘stick and carrot’ approach, advocating for more availability, affordability, and attractiveness of less harmful products.

Challenges with TPD and Proposed Solutions
The following discussion highlighted specific challenges with the current Tobacco Products Directive (TPD). Clive Bates and Philippe Poirson advocated for risk-proportionate regulations for new nicotine products and pointed to several challenges in the legislation such as advertising restrictions, limits on nicotine strength (see our comment below), health warnings, container size regulations, and cross-border sale restrictions, and ending the ban on snus. In particular, in the countries in which snus was popular, the decrease in smoking prevalence slowed down as an unintended adverse consequence of the ban on snus.
Clive Bates argued that the “same mistake” is being repeated with nicotine pouches. Authorities and the media are creating a moral panic around youth access and uptake (e.g confused articles about “snus in school”) which leads to misinformation.
An exchange with the audience revealed a consensus that a flavour ban should consider safety, sensory experience, and avoid marketing appealing specifically to children. The main challenges with the TPD include considering the harm reduction approach, reversing the snus ban, and adopting risk-proportionate regulations.
The panel discussion highlighted the role of harm reduction within the revision of tobacco policies. From legislative considerations to lived experiences, the discourse emphasized the need for nuanced, evidence-based regulations that prioritize harm reduction over punitive measures. As Europe navigates the road to a smoke-free future, these insights from experts and advocates offer a compass for policymakers to steer towards effective and balanced tobacco regulations.

Comment from the NNPA
The NNPA welcomes this discussion and we are pleased with events that contribute to public dialogue and to spread information about harm reduction through reduced risk alternatives. It should be considered very valuable that MEPs and other legislators are informed about the foundations of harm reduction and the sometimes less intuitive effects of strict regulation on broad product groups with very diverse risk factors. We fully support the focus on evidence-based legislation, the call for equal and fair conditions for nicotine pouches on the single market and the use of tobacco harm reduction as a tool for beating cancer. The NNPA also believes that the experience of using reduced risk product has to achieve a similar satisfaction as the product it is supposed to replace. We are however concerned with the extreme levels of nicotine in some fringe market products, which go far beyond what would be considered normal for the average nicotine products or representable for the market. We would therefore support a cap on the amount of nicotine per pouch that is scientifically founded and balanced. We anticipate that a suitable nicotine level, based on similar criteria, would most likely be around 20mg per pouch.

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